Northwestern Medicine Central Dupage Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Northwestern Medicine Central Dupage Hospital, Winfield, IL in 2024, from traditional Medicare claims. Back to the Northwestern Medicine Central Dupage Hospital profile, with quality ratings, finances and negotiated rates.
5,590
Medicare inpatient discharges
In 159 published DRGs
1.99
Case mix index
IPPS FY 2027
26%
Surgical stays
73%
Stays with complications
In DRGs with a CC or MCC
5,696
Medicare outpatient services
In 49 service groups
Inpatient stays by major diagnostic category
Circulatory system1,287 discharges in 33 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 303 | $55,103 | $9,100 | $8,817 | 1.28 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 68 | $40,661 | $5,117 | $6,506 | 0.74 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 64 | $73,028 | $10,833 | $11,685 | 1.59 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 58 | $272,771 | $22,441 | $43,643 | 3.24 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 55 | $57,137 | $8,641 | $9,142 | 1.20 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 47 | $475,195 | $45,459 | $76,031 | 6.25 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 47 | $114,785 | $15,144 | $18,366 | 2.16 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 46 | $465,429 | $36,819 | $74,469 | 4.88 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 45 | $92,135 | $14,370 | $14,742 | 2.09 |
| Syncope and collapseMS-DRG 312, medical | 44 | $48,906 | $5,893 | $7,825 | 0.86 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 40 | $443,034 | $56,370 | $70,885 | 7.71 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 36 | $335,806 | $41,998 | $53,729 | 5.88 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 34 | $63,550 | $7,343 | $10,168 | 1.08 |
| Other vascular procedures with CCMS-DRG 253, surgical | 26 | $156,254 | $17,654 | $25,001 | 2.55 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 26 | $332,010 | $31,085 | $53,122 | 4.16 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 26 | $102,759 | $12,415 | $16,441 | 1.82 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 25 | $269,990 | $28,860 | $43,198 | 4.04 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 25 | $131,992 | $15,756 | $21,119 | 2.28 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 25 | $40,749 | $7,397 | $6,520 | 1.07 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 25 | $51,422 | $7,318 | $8,228 | 0.97 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 24 | $35,336 | $3,482 | $5,654 | 0.55 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 24 | $128,670 | $20,429 | $20,587 | 2.87 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 23 | $359,276 | $36,093 | $57,484 | 5.24 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 21 | $54,193 | $6,518 | $8,671 | 0.91 |
| Heart failure and shock with CCMS-DRG 292, medical | 19 | $51,814 | $5,939 | $8,290 | 0.86 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 15 | $446,815 | $52,765 | $71,490 | 7.80 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 15 | $335,783 | $34,654 | $53,725 | 5.20 |
| Hypertension without MCCMS-DRG 305, medical | 15 | $38,632 | $5,339 | $6,181 | 0.75 |
| Chest painMS-DRG 313, medical | 15 | $43,770 | $5,213 | $7,003 | 0.72 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 14 | $169,238 | $22,061 | $27,078 | 3.35 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 14 | $60,940 | $11,996 | $9,750 | 1.58 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 12 | $223,960 | $34,421 | $35,834 | 5.06 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 11 | $166,079 | $24,015 | $26,573 | 3.46 |
Infectious and parasitic diseases766 discharges in 5 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 | 517 | $97,984 | $13,824 | $15,677 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 131 | $49,248 | $7,189 | $7,880 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 73 | $260,045 | $35,961 | $41,607 | 5.00 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 30 | $115,345 | $13,515 | $18,455 | 2.04 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 15 | $85,518 | $13,970 | $13,683 | 1.84 |
Nervous system686 discharges in 26 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 | 96 | $72,014 | $7,420 | $11,522 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 86 | $107,564 | $13,470 | $17,210 | 2.00 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 65 | $45,726 | $9,552 | $7,316 | 1.36 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 56 | $232,176 | $31,207 | $37,148 | 4.42 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 31 | $332,426 | $37,045 | $53,188 | 5.67 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 28 | $78,350 | $11,371 | $12,536 | 1.79 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 26 | $49,682 | $7,140 | $7,949 | 1.03 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 25 | $212,022 | $17,784 | $33,924 | 2.43 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 23 | $65,182 | $15,442 | $10,429 | 2.39 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 19 | $78,017 | $10,028 | $12,483 | 1.36 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 19 | $42,734 | $9,168 | $6,837 | 1.32 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 17 | $247,178 | $27,307 | $39,549 | 3.79 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 17 | $133,299 | $12,104 | $21,328 | 1.81 |
| Seizures without MCCMS-DRG 101, medical | 17 | $56,743 | $6,186 | $9,079 | 0.91 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 16 | $72,884 | $10,451 | $11,661 | 1.47 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 15 | $102,120 | $7,702 | $16,339 | 1.14 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 15 | $142,549 | $16,339 | $22,808 | 2.28 |
| Extracranial procedures with CCMS-DRG 038, surgical | 14 | $124,774 | $11,806 | $19,964 | 1.60 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 14 | $49,231 | $4,327 | $7,877 | 0.69 |
| Seizures with MCCMS-DRG 100, medical | 14 | $111,602 | $13,532 | $17,856 | 1.98 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 13 | $293,636 | $22,001 | $46,982 | 2.95 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 12 | $144,844 | $16,230 | $23,175 | 2.30 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 12 | $50,662 | $6,011 | $8,106 | 0.80 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 12 | $63,504 | $7,808 | $10,161 | 1.06 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 12 | $61,692 | $7,019 | $9,871 | 1.03 |
| Headaches without MCCMS-DRG 103, medical | 12 | $41,233 | $6,050 | $6,597 | 0.84 |
Respiratory system662 discharges in 18 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 142 | $91,031 | $11,609 | $14,565 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 84 | $53,266 | $8,932 | $8,523 | 1.23 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 67 | $63,971 | $6,811 | $10,235 | 0.99 |
| Major chest procedures with CCMS-DRG 164, surgical | 65 | $191,448 | $17,787 | $30,632 | 2.55 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 42 | $64,298 | $9,394 | $10,288 | 1.33 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 30 | $42,366 | $5,457 | $6,778 | 0.82 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 29 | $64,415 | $9,918 | $10,306 | 1.40 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 26 | $39,064 | $6,293 | $6,250 | 0.96 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 25 | $49,804 | $7,907 | $7,969 | 1.10 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 20 | $110,112 | $12,539 | $17,618 | 1.74 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 20 | $120,212 | $18,426 | $19,234 | 2.70 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 19 | $166,648 | $13,349 | $26,664 | 1.88 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 17 | $51,775 | $6,050 | $8,284 | 0.82 |
| Respiratory infections and inflammations without cc/mccMS-DRG 179, medical | 17 | $49,644 | $5,001 | $7,943 | 0.76 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 17 | $44,294 | $5,686 | $7,087 | 0.85 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 16 | $68,100 | $12,248 | $10,896 | 1.81 |
| Major chest procedures with MCCMS-DRG 163, surgical | 15 | $297,557 | $35,028 | $47,609 | 4.71 |
| Pleural effusion with CCMS-DRG 187, medical | 11 | $57,421 | $7,499 | $9,187 | 1.00 |
Digestive system578 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 | 89 | $38,229 | $5,431 | $6,117 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 88 | $50,921 | $6,793 | $8,147 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 53 | $97,224 | $12,806 | $15,556 | 1.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 45 | $139,219 | $15,670 | $22,275 | 2.37 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 42 | $46,369 | $6,590 | $7,419 | 0.94 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 35 | $78,023 | $12,392 | $12,484 | 1.62 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 31 | $203,980 | $29,798 | $32,637 | 4.52 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 30 | $46,168 | $5,064 | $7,387 | 0.80 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 27 | $63,848 | $8,834 | $10,216 | 1.28 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 19 | $99,325 | $11,824 | $15,892 | 1.67 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 19 | $29,193 | $3,613 | $4,671 | 0.56 |
| Digestive malignancy with MCCMS-DRG 374, medical | 17 | $106,038 | $13,577 | $16,966 | 2.10 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 16 | $246,882 | $20,331 | $39,501 | 2.50 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 16 | $76,441 | $7,431 | $12,231 | 1.04 |
| Hernia procedures except inguinal and femoral with CCMS-DRG 354, surgical | 14 | $83,798 | $11,322 | $13,408 | 1.72 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 13 | $121,284 | $11,265 | $19,405 | 1.60 |
| Digestive malignancy with CCMS-DRG 375, medical | 12 | $70,983 | $8,509 | $11,357 | 1.20 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 12 | $66,565 | $9,569 | $10,650 | 1.45 |
Musculoskeletal system and connective tissue464 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 73 | $47,496 | $6,639 | $7,599 | 0.97 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 54 | $132,928 | $14,376 | $21,269 | 2.07 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 51 | $48,258 | $7,562 | $7,721 | 1.09 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 38 | $125,904 | $14,303 | $20,145 | 2.11 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 27 | $156,448 | $16,724 | $25,032 | 2.38 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 23 | $383,571 | $41,794 | $61,371 | 6.12 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 22 | $96,859 | $14,509 | $15,497 | 2.04 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 22 | $70,181 | $12,251 | $11,229 | 1.82 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 21 | $179,029 | $20,667 | $28,645 | 2.95 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 19 | $45,820 | $6,469 | $7,331 | 0.90 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 15 | $131,807 | $14,002 | $21,089 | 1.97 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 14 | $262,225 | $22,024 | $41,956 | 3.49 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 14 | $235,130 | $19,538 | $37,621 | 2.96 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 13 | $34,987 | $6,122 | $5,598 | 0.82 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 13 | $51,582 | $7,359 | $8,253 | 1.00 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 12 | $188,575 | $19,254 | $30,172 | 2.99 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 11 | $350,378 | $25,319 | $56,060 | 3.66 |
| Biopsies of musculoskeletal system and connective tissue with MCCMS-DRG 477, surgical | 11 | $245,172 | $26,924 | $39,227 | 3.37 |
| Medical back problems with MCCMS-DRG 551, medical | 11 | $75,577 | $11,084 | $12,092 | 1.70 |
Kidney and urinary tract438 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 | 89 | $74,885 | $12,270 | $11,982 | 1.65 |
| Renal failure with CCMS-DRG 683, medical | 76 | $43,635 | $6,302 | $6,982 | 0.90 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 66 | $38,393 | $5,718 | $6,143 | 0.81 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 54 | $45,491 | $7,350 | $7,279 | 1.02 |
| Renal failure with MCCMS-DRG 682, medical | 47 | $85,334 | $12,486 | $13,654 | 1.50 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 44 | $42,506 | $8,525 | $6,801 | 1.17 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 40 | $65,806 | $8,938 | $10,529 | 1.35 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 11 | $148,327 | $12,927 | $23,732 | 1.84 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 11 | $137,769 | $18,267 | $22,043 | 2.59 |
Liver, gallbladder and pancreas190 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 30 | $103,451 | $13,535 | $16,552 | 1.76 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 24 | $230,570 | $19,636 | $36,891 | 2.89 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 24 | $87,166 | $11,559 | $13,947 | 1.63 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 20 | $56,891 | $7,389 | $9,103 | 1.09 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 18 | $117,834 | $16,723 | $18,853 | 2.32 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 17 | $136,358 | $11,907 | $21,817 | 1.92 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 15 | $72,042 | $7,361 | $11,527 | 0.95 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 15 | $92,797 | $12,045 | $14,848 | 1.63 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 14 | $105,401 | $13,382 | $16,864 | 1.83 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 13 | $39,882 | $5,320 | $6,381 | 0.86 |
Endocrine, nutritional and metabolic183 discharges in 5 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 | 58 | $35,783 | $5,047 | $5,725 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 48 | $47,998 | $9,009 | $7,680 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 41 | $43,887 | $6,286 | $7,022 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 23 | $61,676 | $9,931 | $9,868 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 13 | $60,818 | $11,782 | $9,731 | 1.65 |
Skin, subcutaneous tissue and breast106 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 60 | $35,334 | $5,695 | $5,653 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 31 | $61,976 | $9,440 | $9,916 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 15 | $46,177 | $6,142 | $7,388 | 0.91 |
Blood and immune system63 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Coagulation disordersMS-DRG 813, medical | 24 | $85,589 | $11,367 | $13,694 | 1.56 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 20 | $44,486 | $6,282 | $7,118 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 19 | $104,903 | $12,741 | $16,784 | 1.40 |
Injuries, poisonings and toxic effects of drugs39 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with CCMS-DRG 920, medical | 17 | $46,727 | $7,816 | $7,476 | 1.03 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 11 | $90,207 | $14,534 | $14,433 | 2.00 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 11 | $60,302 | $11,780 | $9,648 | 1.60 |
Other33 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 MCCMS-DRG 981, surgical | 19 | $215,072 | $33,784 | $34,411 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 14 | $178,006 | $19,100 | $28,481 | 2.49 |
Mental diseases and disorders32 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 | 32 | $51,722 | $10,901 | $8,276 | 1.76 |
Factors influencing health status22 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other factors influencing health statusMS-DRG 951, medical | 22 | $32,413 | $4,179 | $5,186 | 0.59 |
Blood cancers and poorly differentiated neoplasms15 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 15 | $94,750 | $20,830 | $15,160 | 3.13 |
Alcohol and drug use14 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 | 14 | $36,060 | $5,825 | $5,770 | 0.86 |
Ear, nose, mouth and throat12 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 12 | $42,645 | $4,660 | $6,823 | 0.74 |
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 | 936 | 863 | $26,327 | $2,021 | $2,090 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 418 | 379 | $18,617 | $1,204 | $1,220 |
| Level 2 Upper GI ProceduresAPC 5302 | 400 | 360 | $18,932 | $1,438 | $1,445 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 386 | 371 | $109,141 | $10,789 | $10,772 |
| Level 1 Endovascular ProceduresAPC 5191 | 297 | 293 | $28,842 | $2,186 | $2,208 |
| Level 3 Vascular ProceduresAPC 5183 | 229 | 222 | $30,176 | $2,411 | $2,405 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 222 | 219 | $51,233 | $4,247 | $4,358 |
| Level 5 Urology and Related ServicesAPC 5375 | 208 | 201 | $41,455 | $3,894 | $3,918 |
| Level 4 Airway EndoscopyAPC 5154 | 189 | 182 | $41,302 | $2,810 | $2,833 |
| Level 4 Urology and Related ServicesAPC 5374 | 156 | 132 | $30,420 | $2,635 | $2,629 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 153 | 151 | $207,512 | $20,721 | $21,117 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 142 | 137 | $29,499 | $2,119 | $2,141 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 130 | 129 | $99,796 | $8,009 | $8,164 |
| Level 4 Vascular ProceduresAPC 5184 | 103 | 90 | $71,414 | $3,832 | $3,946 |
| Level 3 Urology and Related ServicesAPC 5373 | 100 | 55 | $19,137 | $1,538 | $1,516 |
| Level 1 Intraocular ProceduresAPC 5491 | 100 | 63 | $30,489 | $1,728 | $1,752 |
| Level 1 Nerve ProceduresAPC 5431 | 98 | 73 | $14,739 | $1,443 | $1,407 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 93 | 92 | $71,310 | $5,237 | $5,339 |
| Level 2 Vascular ProceduresAPC 5182 | 86 | 82 | $18,703 | $1,211 | $1,204 |
| Level 3 Endovascular ProceduresAPC 5193 | 84 | 80 | $75,899 | $8,803 | $8,874 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 84 | 72 | $30,363 | $2,585 | $2,636 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 79 | 78 | $144,974 | $16,022 | $15,763 |
| Level 5 Airway EndoscopyAPC 5155 | 79 | 78 | $66,686 | $5,177 | $5,183 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 76 | 74 | $24,236 | $1,720 | $1,780 |
| Level 5 ENT ProceduresAPC 5165 | 64 | 63 | $50,572 | $4,291 | $4,436 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 60 | 60 | $92,765 | $8,356 | $8,569 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 55 | 54 | $61,156 | $4,933 | $4,982 |
| Level 4 Gynecologic ProceduresAPC 5414 | 54 | 54 | $30,465 | $2,321 | $2,389 |
| Level 2 Intraocular ProceduresAPC 5492 | 50 | 49 | $38,647 | $3,014 | $3,116 |
| Level 3 Lower GI ProceduresAPC 5313 | 44 | 41 | $28,358 | $2,115 | $2,176 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 42 | 40 | $36,738 | $2,883 | $2,930 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 42 | 39 | $133,565 | $18,628 | $18,465 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 40 | 40 | $35,515 | $2,444 | $2,373 |
| Level 5 Gynecologic ProceduresAPC 5415 | 40 | 40 | $38,487 | $3,668 | $3,792 |
| Level 7 Radiation TherapyAPC 5627 | 39 | 36 | $55,897 | $5,740 | $6,121 |
| Level 4 Endovascular ProceduresAPC 5194 | 38 | 37 | $144,042 | $14,193 | $14,606 |
| Level 2 Endovascular ProceduresAPC 5192 | 29 | 23 | $39,421 | $4,324 | $4,338 |
| Level 3 Upper GI ProceduresAPC 5303 | 28 | 27 | $28,913 | $2,832 | $2,888 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 28 | 28 | $249,751 | $27,762 | $26,719 |
| Level 3 Airway EndoscopyAPC 5153 | 27 | 27 | $17,088 | $1,236 | $1,264 |
| Complex GI ProceduresAPC 5331 | 24 | 24 | $52,991 | $4,311 | $4,263 |
| Level 4 Extraocular, Repair, and Plastic Eye ProceduresAPC 5504 | 23 | 22 | $25,256 | $2,925 | $2,969 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 22 | 21 | $16,727 | $1,207 | $1,196 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 20 | 20 | $71,434 | $6,434 | $6,514 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 20 | 20 | $338,671 | $29,509 | $29,375 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 20 | 18 | $44,614 | $4,656 | $4,524 |
| Level 4 ENT ProceduresAPC 5164 | 16 | 16 | $30,691 | $2,428 | $2,217 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 12 | 12 | $156,943 | $16,825 | $17,052 |
| Level 6 Urology and Related ServicesAPC 5376 | 11 | 11 | $81,253 | $7,111 | $7,291 |
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.