Northwestern Lake Forest Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Northwestern Lake Forest Hospital, Lake Forest, IL in 2024, from traditional Medicare claims. Back to the Northwestern Lake Forest Hospital profile, with quality ratings, finances and negotiated rates.
2,858
Medicare inpatient discharges
In 98 published DRGs
1.66
Case mix index
IPPS FY 2027
13%
Surgical stays
77%
Stays with complications
In DRGs with a CC or MCC
4,785
Medicare outpatient services
In 43 service groups
Inpatient stays by major diagnostic category
Circulatory system596 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 140 | $57,700 | $9,404 | $10,617 | 1.28 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 91 | $123,223 | $16,181 | $22,673 | 2.16 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 56 | $71,080 | $7,873 | $13,079 | 1.08 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 53 | $36,717 | $5,200 | $6,756 | 0.74 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 34 | $53,437 | $8,816 | $9,832 | 1.20 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 28 | $90,960 | $15,409 | $16,737 | 2.09 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 23 | $125,362 | $13,175 | $23,067 | 1.82 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 22 | $33,320 | $3,828 | $6,131 | 0.55 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 20 | $51,605 | $7,893 | $9,495 | 1.07 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 16 | $114,702 | $16,106 | $21,105 | 2.28 |
| Heart failure and shock with CCMS-DRG 292, medical | 15 | $52,198 | $6,412 | $9,604 | 0.86 |
| Syncope and collapseMS-DRG 312, medical | 15 | $48,094 | $6,471 | $8,849 | 0.86 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 14 | $205,282 | $36,299 | $37,772 | 5.06 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 13 | $75,610 | $12,391 | $13,912 | 1.58 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 12 | $164,318 | $23,508 | $30,234 | 2.97 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 11 | $196,383 | $29,612 | $36,135 | 3.35 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 11 | $84,847 | $11,687 | $15,612 | 1.59 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 11 | $75,086 | $6,587 | $13,816 | 0.91 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 11 | $56,361 | $7,153 | $10,370 | 0.97 |
Infectious and parasitic diseases468 discharges in 6 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 | 335 | $96,389 | $14,859 | $17,736 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 59 | $52,081 | $7,213 | $9,583 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 39 | $218,792 | $40,681 | $40,258 | 5.00 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 12 | $114,934 | $16,132 | $21,148 | 2.04 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 12 | $39,187 | $6,633 | $7,210 | 1.01 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 11 | $80,358 | $13,411 | $14,786 | 1.84 |
Respiratory system373 discharges in 14 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 124 | $83,691 | $12,380 | $15,399 | 1.70 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 51 | $48,734 | $6,831 | $8,967 | 0.99 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 24 | $52,703 | $6,966 | $9,697 | 0.96 |
| Major chest procedures with CCMS-DRG 164, surgical | 19 | $187,811 | $18,484 | $34,557 | 2.55 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 19 | $58,471 | $9,516 | $10,759 | 1.33 |
| Respiratory infections and inflammations without cc/mccMS-DRG 179, medical | 18 | $37,478 | $5,315 | $6,896 | 0.76 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 17 | $44,232 | $4,923 | $8,139 | 0.82 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 17 | $56,898 | $7,526 | $10,469 | 1.10 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 16 | $71,161 | $9,967 | $13,094 | 1.40 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 15 | $79,652 | $9,272 | $14,656 | 1.23 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 15 | $41,321 | $5,809 | $7,603 | 0.82 |
| Major chest procedures with MCCMS-DRG 163, surgical | 13 | $233,284 | $31,892 | $42,924 | 4.71 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 13 | $71,828 | $13,572 | $13,216 | 1.74 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 12 | $180,411 | $23,334 | $33,196 | 1.90 |
Digestive system321 discharges in 12 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 | 65 | $33,881 | $5,572 | $6,234 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 40 | $52,208 | $7,379 | $9,606 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 33 | $50,816 | $9,881 | $9,350 | 1.28 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 31 | $77,266 | $11,876 | $14,217 | 1.62 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 27 | $136,573 | $18,435 | $25,129 | 2.37 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 24 | $65,562 | $14,113 | $12,063 | 1.79 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 23 | $45,622 | $7,015 | $8,394 | 0.94 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 20 | $35,756 | $5,368 | $6,579 | 0.80 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 15 | $226,649 | $33,338 | $41,703 | 4.52 |
| Digestive malignancy with MCCMS-DRG 374, medical | 15 | $82,962 | $14,065 | $15,265 | 2.10 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 14 | $38,283 | $11,204 | $7,044 | 1.45 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 14 | $27,192 | $3,317 | $5,003 | 0.56 |
Kidney and urinary tract309 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 58 | $56,279 | $11,575 | $10,355 | 1.65 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 52 | $43,860 | $8,051 | $8,070 | 1.17 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 50 | $35,296 | $5,556 | $6,494 | 0.81 |
| Renal failure with CCMS-DRG 683, medical | 37 | $42,579 | $6,555 | $7,835 | 0.90 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 37 | $42,942 | $7,682 | $7,901 | 1.02 |
| Renal failure with MCCMS-DRG 682, medical | 34 | $55,401 | $11,147 | $10,194 | 1.50 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 15 | $250,352 | $39,306 | $46,065 | 3.70 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 14 | $149,881 | $23,844 | $27,578 | 2.59 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 12 | $78,805 | $10,142 | $14,500 | 1.35 |
Musculoskeletal system and connective tissue209 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 41 | $53,056 | $7,919 | $9,762 | 1.09 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 32 | $136,692 | $13,928 | $25,151 | 1.88 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 20 | $218,248 | $26,432 | $40,158 | 2.95 |
| Medical back problems without MCCMS-DRG 552, medical | 20 | $46,715 | $6,386 | $8,596 | 0.97 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 18 | $55,560 | $12,876 | $10,223 | 1.82 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 15 | $127,688 | $15,324 | $23,495 | 2.07 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 14 | $233,257 | $24,323 | $42,919 | 3.49 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 14 | $42,592 | $5,792 | $7,837 | 0.82 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 12 | $163,819 | $22,192 | $30,143 | 2.99 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 12 | $144,057 | $16,285 | $26,507 | 2.11 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 11 | $44,908 | $6,408 | $8,263 | 0.90 |
Nervous system208 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 44 | $83,428 | $13,967 | $15,351 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 33 | $57,756 | $6,930 | $10,627 | 1.02 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 24 | $54,965 | $9,791 | $10,113 | 1.36 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 22 | $98,383 | $15,572 | $18,102 | 2.39 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 19 | $227,613 | $34,364 | $41,881 | 4.42 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 17 | $58,522 | $13,049 | $10,768 | 1.79 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 15 | $61,838 | $11,089 | $11,378 | 1.47 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 12 | $40,669 | $7,078 | $7,483 | 1.03 |
| Seizures with MCCMS-DRG 100, medical | 11 | $61,518 | $13,765 | $11,319 | 1.98 |
| Seizures without MCCMS-DRG 101, medical | 11 | $65,111 | $6,056 | $11,980 | 0.91 |
Endocrine, nutritional and metabolic172 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 55 | $53,075 | $9,799 | $9,766 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 48 | $39,434 | $5,157 | $7,256 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 25 | $47,476 | $6,654 | $8,736 | 0.90 |
| Endocrine disorders with CCMS-DRG 644, medical | 21 | $37,669 | $6,639 | $6,931 | 1.06 |
| Diabetes with MCCMS-DRG 637, medical | 12 | $55,073 | $10,701 | $10,133 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 11 | $48,154 | $11,896 | $8,860 | 1.65 |
Skin, subcutaneous tissue and breast66 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 51 | $41,396 | $6,263 | $7,617 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 15 | $57,332 | $10,611 | $10,549 | 1.49 |
Liver, gallbladder and pancreas54 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of the biliary tract with CCMS-DRG 445, medical | 16 | $76,717 | $7,539 | $14,116 | 1.09 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 14 | $82,184 | $12,088 | $15,122 | 1.63 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 13 | $98,912 | $12,410 | $18,200 | 1.63 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 11 | $91,509 | $14,456 | $16,838 | 1.76 |
Blood and immune system51 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 | 21 | $41,102 | $7,050 | $7,563 | 0.90 |
| Coagulation disordersMS-DRG 813, medical | 18 | $73,821 | $12,074 | $13,583 | 1.56 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 12 | $52,568 | $10,979 | $9,673 | 1.40 |
Mental diseases and disorders18 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 18 | $40,770 | $11,493 | $7,502 | 1.76 |
Injuries, poisonings and toxic effects of drugs13 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 13 | $86,692 | $13,730 | $15,951 | 1.82 |
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 | 1,126 | 1,040 | $29,323 | $2,038 | $2,090 |
| Level 1 Intraocular ProceduresAPC 5491 | 458 | 290 | $19,899 | $1,752 | $1,752 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 456 | 404 | $14,998 | $1,053 | $1,220 |
| Level 2 Upper GI ProceduresAPC 5302 | 217 | 201 | $22,724 | $1,435 | $1,445 |
| Level 1 Endovascular ProceduresAPC 5191 | 199 | 196 | $33,926 | $2,211 | $2,208 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 176 | 166 | $112,837 | $10,770 | $10,772 |
| Level 4 Urology and Related ServicesAPC 5374 | 167 | 131 | $22,425 | $2,621 | $2,629 |
| Level 3 Urology and Related ServicesAPC 5373 | 165 | 76 | $15,388 | $1,435 | $1,516 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 151 | 133 | $21,862 | $2,549 | $2,636 |
| Level 3 Vascular ProceduresAPC 5183 | 150 | 144 | $26,121 | $2,381 | $2,405 |
| Level 5 Urology and Related ServicesAPC 5375 | 128 | 119 | $34,714 | $3,829 | $3,918 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 105 | 99 | $27,927 | $1,972 | $2,141 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 93 | 91 | $50,374 | $4,292 | $4,358 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 91 | 90 | $67,006 | $5,261 | $5,339 |
| Level 4 Gynecologic ProceduresAPC 5414 | 87 | 85 | $33,430 | $2,297 | $2,389 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 85 | 78 | $31,347 | $2,866 | $2,930 |
| Level 1 Nerve ProceduresAPC 5431 | 79 | 73 | $11,279 | $1,433 | $1,407 |
| Level 3 Endovascular ProceduresAPC 5193 | 68 | 68 | $87,932 | $8,733 | $8,874 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 64 | 56 | $31,321 | $2,320 | $2,373 |
| Level 3 Lower GI ProceduresAPC 5313 | 60 | 55 | $27,063 | $2,177 | $2,176 |
| Level 3 Upper GI ProceduresAPC 5303 | 56 | 56 | $38,930 | $2,892 | $2,888 |
| Level 2 Vascular ProceduresAPC 5182 | 52 | 52 | $7,134 | $1,202 | $1,204 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 47 | 46 | $15,535 | $1,157 | $1,196 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 46 | 45 | $56,709 | $4,903 | $4,982 |
| Level 2 Endovascular ProceduresAPC 5192 | 46 | 43 | $45,148 | $4,109 | $4,338 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 43 | 43 | $18,382 | $1,757 | $1,780 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 38 | 38 | $67,853 | $8,437 | $8,569 |
| Level 4 Airway EndoscopyAPC 5154 | 34 | 31 | $31,980 | $2,816 | $2,833 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 34 | 34 | $55,799 | $6,388 | $6,514 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 34 | 34 | $117,529 | $8,075 | $8,164 |
| Level 4 Vascular ProceduresAPC 5184 | 28 | 26 | $59,970 | $4,132 | $3,946 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 26 | 26 | $167,838 | $20,722 | $21,117 |
| Level 5 Airway EndoscopyAPC 5155 | 24 | 24 | $56,879 | $5,146 | $5,183 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 24 | 17 | $33,306 | $3,857 | $4,524 |
| Level 2 Urology and Related ServicesAPC 5372 | 21 | 12 | $6,477 | $455 | $502 |
| Complex GI ProceduresAPC 5331 | 19 | 15 | $55,531 | $4,285 | $4,263 |
| Level 4 ENT ProceduresAPC 5164 | 14 | 14 | $25,992 | $2,420 | $2,217 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 14 | 14 | $155,511 | $16,714 | $17,052 |
| Level 5 ENT ProceduresAPC 5165 | 13 | 12 | $65,039 | $4,403 | $4,436 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 13 | 13 | $231,562 | $27,065 | $29,375 |
| Level 3 Airway EndoscopyAPC 5153 | 12 | 11 | $20,316 | $1,276 | $1,264 |
| Level 5 Gynecologic ProceduresAPC 5415 | 11 | 11 | $55,575 | $3,740 | $3,792 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 11 | $137,468 | $18,960 | $18,465 |
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.