Novato Community Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Novato Community Hospital, Novato, CA in 2024, from traditional Medicare claims. Back to the Novato Community Hospital profile, with quality ratings, finances and negotiated rates.
446
Medicare inpatient discharges
In 15 published DRGs
1.70
Case mix index
IPPS FY 2027
18%
Surgical stays
64%
Stays with complications
In DRGs with a CC or MCC
701
Medicare outpatient services
In 14 service groups
Inpatient stays by major diagnostic category
Infectious and parasitic diseases213 discharges in 2 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 | 163 | $70,734 | $19,359 | $24,474 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 50 | $42,764 | $10,004 | $14,796 | 1.03 |
Musculoskeletal system and connective tissue82 discharges in 4 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 | 30 | $100,873 | $18,105 | $34,902 | 1.88 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 25 | $244,352 | $49,900 | $84,546 | 4.61 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 15 | $108,727 | $21,848 | $37,620 | 2.11 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 12 | $94,468 | $21,562 | $32,686 | 2.07 |
Circulatory system44 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 44 | $57,182 | $12,831 | $19,785 | 1.28 |
Digestive system38 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 14 | $43,707 | $7,473 | $15,123 | 0.80 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 12 | $57,684 | $9,626 | $19,959 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 12 | $38,587 | $7,433 | $13,351 | 0.79 |
Kidney and urinary tract31 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 19 | $39,220 | $7,698 | $13,570 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 12 | $52,564 | $11,653 | $18,187 | 1.17 |
Respiratory system27 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 16 | $44,780 | $12,993 | $15,494 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 11 | $50,355 | $16,493 | $17,423 | 1.70 |
Skin, subcutaneous tissue and breast11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 11 | $35,807 | $8,188 | $12,389 | 0.88 |
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 |
|---|---|---|---|---|---|
| Level 5 Musculoskeletal ProceduresAPC 5115 | 284 | 277 | $88,984 | $16,588 | $10,772 |
| Comprehensive Observation ServicesAPC 8011 | 106 | 101 | $33,742 | $3,017 | $2,090 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 54 | 52 | $105,822 | $24,321 | $15,763 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 42 | 42 | $48,381 | $8,351 | $5,339 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 39 | 36 | $14,326 | $1,742 | $1,220 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 35 | 35 | $40,670 | $6,426 | $4,358 |
| Level 2 Upper GI ProceduresAPC 5302 | 25 | 24 | $13,676 | $2,133 | $1,445 |
| Level 1 Intraocular ProceduresAPC 5491 | 23 | 17 | $16,684 | $2,593 | $1,752 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 20 | 20 | $29,304 | $3,830 | $2,636 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 18 | 18 | $9,975 | $1,785 | $1,196 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 17 | 17 | $24,550 | $3,162 | $2,141 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 14 | 14 | $33,283 | $3,602 | $2,373 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 13 | 13 | $37,443 | $7,471 | $4,982 |
| Level 5 Gynecologic ProceduresAPC 5415 | 11 | 11 | $42,412 | $5,535 | $3,792 |
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.