Northwest Community Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Northwest Community Hospital, Arlington Heights, IL in 2024, from traditional Medicare claims. Back to the Northwest Community Hospital profile, with quality ratings, finances and negotiated rates.
6,824
Medicare inpatient discharges
In 164 published DRGs
1.74
Case mix index
IPPS FY 2027
20%
Surgical stays
66%
Stays with complications
In DRGs with a CC or MCC
4,868
Medicare outpatient services
In 45 service groups
Inpatient stays by major diagnostic category
Circulatory system1,013 discharges in 27 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 305 | $27,993 | $8,081 | $8,062 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 58 | $92,367 | $22,163 | $26,602 | 3.24 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 50 | $169,212 | $33,681 | $48,733 | 4.88 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 46 | $21,242 | $4,327 | $6,118 | 0.74 |
| Syncope and collapseMS-DRG 312, medical | 46 | $23,943 | $5,190 | $6,896 | 0.86 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 40 | $102,302 | $10,538 | $29,463 | 1.82 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 37 | $154,082 | $19,563 | $44,376 | 2.87 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 33 | $35,472 | $7,669 | $10,216 | 1.20 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 31 | $61,933 | $13,282 | $17,837 | 2.16 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 31 | $47,603 | $6,247 | $13,710 | 1.08 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 30 | $183,413 | $43,733 | $52,823 | 6.25 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 30 | $53,920 | $10,179 | $15,529 | 1.59 |
| Hypertension without MCCMS-DRG 305, medical | 29 | $19,595 | $4,111 | $5,643 | 0.75 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 26 | $31,227 | $6,213 | $8,993 | 1.07 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 25 | $90,461 | $14,498 | $26,053 | 2.28 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 23 | $20,477 | $2,794 | $5,897 | 0.55 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 21 | $52,574 | $13,542 | $15,141 | 2.09 |
| Other vascular procedures with CCMS-DRG 253, surgical | 17 | $100,857 | $17,315 | $29,047 | 2.55 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 17 | $102,092 | $24,718 | $29,403 | 4.16 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 17 | $155,636 | $32,621 | $44,823 | 5.06 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 16 | $158,219 | $29,451 | $45,567 | 3.46 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 15 | $278,709 | $57,011 | $80,268 | 7.80 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 15 | $207,989 | $29,618 | $59,901 | 5.20 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 15 | $39,339 | $5,328 | $11,330 | 0.91 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 14 | $111,740 | $24,999 | $32,181 | 3.35 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 13 | $73,681 | $11,776 | $21,220 | 1.83 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 13 | $30,316 | $6,419 | $8,731 | 0.97 |
Infectious and parasitic diseases977 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical | 632 | $44,755 | $12,491 | $12,889 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 145 | $27,576 | $6,167 | $7,942 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 87 | $102,705 | $31,066 | $29,579 | 5.00 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 32 | $54,437 | $12,563 | $15,678 | 2.04 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 25 | $57,620 | $12,900 | $16,594 | 1.84 |
| Viral illness without MCCMS-DRG 866, medical | 17 | $20,846 | $5,369 | $6,004 | 0.92 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 15 | $180,233 | $41,582 | $51,907 | 6.96 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 13 | $59,197 | $13,388 | $17,049 | 2.14 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 11 | $185,404 | $35,229 | $53,396 | 4.43 |
Respiratory system870 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 167 | $35,679 | $10,651 | $10,276 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 162 | $31,623 | $8,138 | $9,107 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 98 | $34,382 | $8,020 | $9,902 | 1.23 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 64 | $23,095 | $4,773 | $6,651 | 0.82 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 54 | $22,838 | $5,756 | $6,577 | 0.99 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 43 | $43,227 | $8,716 | $12,449 | 1.40 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 37 | $26,209 | $5,832 | $7,548 | 0.96 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 31 | $26,564 | $4,789 | $7,651 | 0.85 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 28 | $46,030 | $11,909 | $13,257 | 1.74 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 27 | $58,266 | $18,387 | $16,781 | 2.70 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 26 | $30,893 | $5,075 | $8,897 | 0.82 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 20 | $36,029 | $11,599 | $10,376 | 1.81 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 18 | $35,704 | $11,857 | $10,283 | 1.90 |
| Major chest trauma with CCMS-DRG 184, medical | 16 | $22,604 | $6,424 | $6,510 | 1.05 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 16 | $30,270 | $6,268 | $8,718 | 1.10 |
| Respiratory infections and inflammations without cc/mccMS-DRG 179, medical | 14 | $18,227 | $4,199 | $5,249 | 0.76 |
| Major chest procedures with CCMS-DRG 164, surgical | 13 | $87,481 | $15,489 | $25,195 | 2.55 |
| Simple pneumonia and pleurisy without cc/mccMS-DRG 195, medical | 13 | $20,740 | $2,536 | $5,973 | 0.63 |
| Major chest procedures with MCCMS-DRG 163, surgical | 12 | $103,253 | $31,070 | $29,737 | 4.71 |
| Respiratory neoplasms with CCMS-DRG 181, medical | 11 | $46,751 | $5,414 | $13,464 | 1.10 |
Musculoskeletal system and connective tissue786 discharges in 21 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 195 | $62,337 | $11,666 | $17,953 | 1.88 |
| Medical back problems without MCCMS-DRG 552, medical | 97 | $23,948 | $5,585 | $6,897 | 0.97 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 71 | $58,021 | $13,249 | $16,710 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 46 | $70,545 | $13,512 | $20,317 | 2.11 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 44 | $26,400 | $6,670 | $7,603 | 1.09 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 40 | $18,281 | $5,048 | $5,265 | 0.82 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 40 | $17,855 | $5,075 | $5,142 | 0.90 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 34 | $83,568 | $19,471 | $24,068 | 2.95 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 33 | $118,613 | $21,955 | $34,161 | 3.66 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 24 | $48,302 | $10,045 | $13,911 | 1.59 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 22 | $18,798 | $4,115 | $5,414 | 0.79 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 17 | $88,111 | $19,587 | $25,376 | 2.96 |
| Medical back problems with MCCMS-DRG 551, medical | 17 | $32,085 | $10,666 | $9,240 | 1.70 |
| Pathological fractures and musculoskeletal and connective tissue malignancy without cc/mMS-DRG 544, medical | 15 | $15,517 | $4,230 | $4,469 | 0.77 |
| Other musculoskeletal system and connective tissue diagnoses with MCCMS-DRG 564, medical | 15 | $34,097 | $9,955 | $9,820 | 1.56 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 15 | $24,868 | $5,932 | $7,162 | 1.00 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 14 | $80,688 | $16,509 | $23,238 | 2.48 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 12 | $74,976 | $14,415 | $21,593 | 2.40 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 12 | $31,834 | $10,675 | $9,168 | 1.82 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 12 | $21,286 | $5,160 | $6,130 | 0.82 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 11 | $86,939 | $19,494 | $25,038 | 2.99 |
Digestive system775 discharges in 18 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 181 | $22,563 | $4,407 | $6,498 | 0.79 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 76 | $24,399 | $5,753 | $7,027 | 0.94 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 74 | $26,985 | $5,812 | $7,772 | 0.98 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 54 | $21,254 | $4,695 | $6,121 | 0.80 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 49 | $38,126 | $10,230 | $10,980 | 1.62 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 47 | $28,693 | $7,968 | $8,264 | 1.28 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 42 | $48,193 | $12,076 | $13,879 | 1.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 41 | $58,550 | $15,050 | $16,862 | 2.37 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 33 | $84,321 | $27,962 | $24,284 | 4.52 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 30 | $18,188 | $2,567 | $5,238 | 0.56 |
| Digestive malignancy with CCMS-DRG 375, medical | 27 | $33,051 | $7,230 | $9,519 | 1.20 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 25 | $36,433 | $9,156 | $10,493 | 1.45 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 23 | $75,348 | $14,926 | $21,700 | 2.50 |
| Digestive malignancy with MCCMS-DRG 374, medical | 22 | $50,745 | $13,644 | $14,615 | 2.10 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 16 | $23,210 | $6,991 | $6,684 | 1.04 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 12 | $134,894 | $28,014 | $38,849 | 4.28 |
| Other digestive system diagnoses without cc/mccMS-DRG 395, medical | 12 | $15,826 | $3,555 | $4,558 | 0.65 |
| Inflammatory bowel disease with CCMS-DRG 386, medical | 11 | $26,570 | $6,202 | $7,652 | 0.97 |
Kidney and urinary tract702 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 144 | $18,608 | $4,655 | $5,359 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 114 | $24,085 | $7,305 | $6,937 | 1.17 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 112 | $37,551 | $10,748 | $10,815 | 1.65 |
| Renal failure with CCMS-DRG 683, medical | 103 | $23,171 | $5,535 | $6,673 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 80 | $33,330 | $9,312 | $9,599 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 72 | $21,693 | $6,416 | $6,248 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 35 | $37,204 | $7,995 | $10,715 | 1.35 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 17 | $27,027 | $6,315 | $7,784 | 1.05 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 13 | $49,675 | $16,471 | $14,307 | 2.59 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 12 | $94,128 | $25,133 | $27,109 | 3.70 |
Nervous system667 discharges in 24 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 104 | $34,464 | $5,972 | $9,926 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 73 | $53,452 | $11,969 | $15,394 | 2.00 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 56 | $22,991 | $7,820 | $6,621 | 1.36 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 32 | $36,565 | $3,882 | $10,531 | 0.69 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 31 | $178,731 | $37,216 | $51,474 | 5.67 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 29 | $41,102 | $6,875 | $11,837 | 1.14 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 29 | $24,781 | $6,287 | $7,137 | 1.03 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 28 | $164,027 | $28,380 | $47,240 | 4.42 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 28 | $27,093 | $4,745 | $7,803 | 0.80 |
| Seizures without MCCMS-DRG 101, medical | 26 | $24,716 | $4,950 | $7,118 | 0.91 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 25 | $34,243 | $13,417 | $9,862 | 2.39 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 23 | $26,984 | $6,258 | $7,771 | 1.06 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 22 | $22,398 | $6,721 | $6,451 | 1.03 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 18 | $42,041 | $15,803 | $12,108 | 2.28 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 18 | $45,055 | $12,004 | $12,976 | 1.79 |
| Seizures with MCCMS-DRG 100, medical | 17 | $45,750 | $12,542 | $13,176 | 1.98 |
| Extracranial procedures with CCMS-DRG 038, surgical | 16 | $62,275 | $10,305 | $17,935 | 1.60 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 15 | $115,590 | $25,822 | $33,290 | 3.79 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 15 | $27,058 | $7,794 | $7,793 | 1.32 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 13 | $31,450 | $7,634 | $9,058 | 1.47 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 13 | $43,117 | $10,400 | $12,418 | 1.79 |
| Hypertensive encephalopathy with CCMS-DRG 078, medical | 12 | $28,107 | $6,134 | $8,095 | 1.02 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 12 | $28,048 | $8,595 | $8,078 | 1.36 |
| Other disorders of nervous system without cc/mccMS-DRG 093, medical | 12 | $20,331 | $4,829 | $5,855 | 0.77 |
Endocrine, nutritional and metabolic368 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 127 | $19,245 | $4,584 | $5,543 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 90 | $27,808 | $8,263 | $8,009 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 59 | $23,062 | $5,423 | $6,642 | 0.90 |
| Endocrine disorders with CCMS-DRG 644, medical | 34 | $26,376 | $6,516 | $7,596 | 1.06 |
| Endocrine disorders with MCCMS-DRG 643, medical | 18 | $32,171 | $9,940 | $9,265 | 1.65 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 15 | $48,449 | $12,515 | $13,953 | 1.98 |
| Endocrine disorders without cc/mccMS-DRG 645, medical | 14 | $17,898 | $4,553 | $5,155 | 0.76 |
| Diabetes with MCCMS-DRG 637, medical | 11 | $32,792 | $9,821 | $9,444 | 1.45 |
Liver, gallbladder and pancreas169 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 40 | $77,751 | $18,244 | $22,392 | 2.89 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 30 | $28,263 | $6,559 | $8,140 | 1.09 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 25 | $47,367 | $11,524 | $13,642 | 1.76 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 17 | $44,561 | $12,120 | $12,834 | 1.92 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 17 | $27,180 | $5,340 | $7,828 | 0.86 |
| Disorders of the biliary tract without cc/mccMS-DRG 446, medical | 15 | $27,358 | $4,488 | $7,879 | 0.80 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 14 | $36,331 | $9,695 | $10,463 | 1.63 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 11 | $163,167 | $35,193 | $46,992 | 5.51 |
Skin, subcutaneous tissue and breast154 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 95 | $18,926 | $4,825 | $5,451 | 0.88 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 25 | $18,475 | $4,897 | $5,321 | 0.91 |
| Cellulitis with MCCMS-DRG 602, medical | 23 | $35,921 | $8,928 | $10,345 | 1.49 |
| Minor skin disorders without MCCMS-DRG 607, medical | 11 | $18,202 | $5,307 | $5,242 | 0.89 |
Blood and immune system114 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 49 | $25,053 | $5,594 | $7,215 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 46 | $31,000 | $8,979 | $8,928 | 1.40 |
| Coagulation disordersMS-DRG 813, medical | 19 | $36,822 | $10,630 | $10,605 | 1.56 |
Injuries, poisonings and toxic effects of drugs70 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 29 | $33,945 | $11,947 | $9,776 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 26 | $28,441 | $6,440 | $8,191 | 1.03 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 15 | $29,380 | $10,371 | $8,462 | 1.60 |
Mental diseases and disorders43 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 30 | $27,860 | $9,596 | $8,024 | 1.76 |
| Acute adjustment reaction and psychosocial dysfunctionMS-DRG 880, medical | 13 | $19,919 | $6,010 | $5,737 | 0.95 |
Ear, nose, mouth and throat30 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 30 | $22,341 | $4,197 | $6,434 | 0.74 |
Other27 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 15 | $74,776 | $14,290 | $21,535 | 2.49 |
| Extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 981, surgical | 12 | $117,959 | $36,787 | $33,972 | 4.74 |
Alcohol and drug use25 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Alcohol, drug abuse or dependence without rehabilitation therapy without MCCMS-DRG 897, medical | 25 | $24,830 | $5,430 | $7,151 | 0.86 |
Blood cancers and poorly differentiated neoplasms23 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 12 | $43,931 | $17,183 | $12,652 | 3.13 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 11 | $43,846 | $10,256 | $12,628 | 1.57 |
Factors influencing health status11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 11 | $24,903 | $4,730 | $7,172 | 0.80 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service (2024 data, released 2026-04-10), traditional Medicare only; CMS omits DRGs with fewer than 11 discharges. Estimated cost is average charges times the hospital's Medicare cost-to-charge ratio from the IPPS Impact File. Weights are the MS-DRG relative weights for the same year.
Outpatient services
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Comprehensive Observation ServicesAPC 8011 | 1,115 | 1,044 | $13,193 | $2,043 | $2,090 |
| Level 2 Upper GI ProceduresAPC 5302 | 359 | 322 | $8,337 | $1,424 | $1,445 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 352 | 318 | $9,876 | $1,215 | $1,220 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 304 | 292 | $52,261 | $10,733 | $10,772 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 164 | 162 | $26,415 | $4,202 | $4,358 |
| Level 3 Vascular ProceduresAPC 5183 | 151 | 145 | $15,407 | $2,359 | $2,405 |
| Level 4 Urology and Related ServicesAPC 5374 | 145 | 125 | $16,743 | $2,615 | $2,629 |
| Level 5 Urology and Related ServicesAPC 5375 | 145 | 143 | $24,924 | $3,874 | $3,918 |
| Level 3 Urology and Related ServicesAPC 5373 | 137 | 108 | $11,744 | $1,531 | $1,516 |
| Level 3 Airway EndoscopyAPC 5153 | 135 | 66 | $4,970 | $1,271 | $1,264 |
| Level 2 Urology and Related ServicesAPC 5372 | 125 | 90 | $3,063 | $503 | $502 |
| Level 2 Endovascular ProceduresAPC 5192 | 119 | 111 | $29,213 | $4,277 | $4,338 |
| Level 3 Lower GI ProceduresAPC 5313 | 117 | 114 | $8,581 | $2,200 | $2,176 |
| Level 3 Endovascular ProceduresAPC 5193 | 116 | 108 | $61,580 | $8,798 | $8,874 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 109 | 108 | $91,822 | $20,840 | $21,117 |
| Level 1 Endovascular ProceduresAPC 5191 | 96 | 96 | $25,785 | $2,213 | $2,208 |
| Level 2 Vascular ProceduresAPC 5182 | 85 | 81 | $5,862 | $1,194 | $1,204 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 79 | 79 | $36,952 | $5,337 | $5,339 |
| Level 4 Airway EndoscopyAPC 5154 | 74 | 73 | $27,362 | $2,833 | $2,833 |
| Complex GI ProceduresAPC 5331 | 72 | 59 | $14,847 | $4,208 | $4,263 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 70 | 62 | $17,595 | $2,569 | $2,636 |
| Level 4 Vascular ProceduresAPC 5184 | 67 | 61 | $32,950 | $4,088 | $3,946 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 65 | 65 | $45,489 | $8,487 | $8,569 |
| Level 3 Upper GI ProceduresAPC 5303 | 58 | 51 | $11,107 | $2,887 | $2,888 |
| Level 5 Airway EndoscopyAPC 5155 | 57 | 56 | $43,914 | $5,177 | $5,183 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 56 | 56 | $14,907 | $2,142 | $2,141 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 51 | 51 | $62,750 | $16,022 | $15,763 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 50 | 50 | $53,109 | $8,127 | $8,164 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 44 | 42 | $16,749 | $2,883 | $2,930 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 44 | 43 | $30,071 | $4,933 | $4,982 |
| Level 4 Endovascular ProceduresAPC 5194 | 44 | 36 | $90,650 | $12,933 | $14,606 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 29 | 29 | $44,950 | $6,407 | $6,514 |
| Level 5 ENT ProceduresAPC 5165 | 28 | 27 | $38,197 | $4,113 | $4,436 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 26 | 26 | $21,110 | $2,443 | $2,373 |
| Level 3 ENT ProceduresAPC 5163 | 26 | 16 | $4,499 | $1,063 | $1,106 |
| Level 1 Nerve ProceduresAPC 5431 | 23 | 21 | $8,039 | $1,450 | $1,407 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 21 | 21 | $127,643 | $28,124 | $29,375 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 19 | 18 | $79,926 | $16,799 | $17,052 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 15 | 15 | $7,619 | $1,216 | $1,196 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 15 | 15 | $39,700 | $5,635 | $5,682 |
| Level 6 Urology and Related ServicesAPC 5376 | 13 | 12 | $26,236 | $7,111 | $7,291 |
| Level 5 Gynecologic ProceduresAPC 5415 | 13 | 13 | $28,874 | $3,762 | $3,792 |
| Level 6 Gynecologic ProceduresAPC 5416 | 12 | 12 | $40,882 | $5,716 | $5,836 |
| Level 7 Radiation TherapyAPC 5627 | 12 | 12 | $54,632 | $5,891 | $6,121 |
| Level 4 Gynecologic ProceduresAPC 5414 | 11 | 11 | $18,609 | $2,365 | $2,389 |
Source: CMS Medicare Outpatient Hospitals by Provider and Service (2024 data, released 2026-06-24), comprehensive APCs for traditional Medicare; CMS omits services with fewer than 11 claims. The US average weights every hospital by its services.