Nyu Langone Tisch Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Nyu Langone Tisch, New York, NY in 2024, from traditional Medicare claims. Back to the Nyu Langone Tisch profile, with quality ratings, finances and negotiated rates.
26,286
Medicare inpatient discharges
In 356 published DRGs
2.24
Case mix index
IPPS FY 2027
33%
Surgical stays
70%
Stays with complications
In DRGs with a CC or MCC
26,574
Medicare outpatient services
In 65 service groups
Inpatient stays by major diagnostic category
Circulatory system5,406 discharges in 57 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 785 | $128,516 | $14,673 | $23,390 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 616 | $157,488 | $19,259 | $28,663 | 1.59 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 362 | $425,368 | $42,872 | $77,417 | 3.24 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 289 | $441,341 | $56,481 | $80,324 | 4.88 |
| Syncope and collapseMS-DRG 312, medical | 278 | $91,094 | $9,612 | $16,579 | 0.86 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 274 | $465,907 | $73,041 | $84,795 | 6.25 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 159 | $194,009 | $25,108 | $35,310 | 2.09 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 152 | $518,841 | $89,703 | $94,429 | 7.71 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 149 | $69,166 | $7,916 | $12,588 | 0.74 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 148 | $84,593 | $10,197 | $15,396 | 0.91 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 135 | $264,411 | $29,474 | $48,123 | 2.16 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 113 | $282,456 | $33,684 | $51,407 | 2.87 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 107 | $99,070 | $11,733 | $18,031 | 1.07 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 103 | $156,913 | $18,848 | $28,558 | 1.58 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 97 | $205,459 | $20,124 | $37,393 | 1.82 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 94 | $117,183 | $14,374 | $21,327 | 1.20 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 91 | $88,487 | $10,998 | $16,105 | 0.97 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 78 | $335,981 | $42,342 | $61,149 | 3.35 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 73 | $113,284 | $11,617 | $20,618 | 1.08 |
| Hypertension without MCCMS-DRG 305, medical | 71 | $80,766 | $8,161 | $14,699 | 0.75 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 70 | $345,159 | $58,185 | $62,819 | 5.88 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 70 | $520,632 | $69,849 | $94,755 | 5.06 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 69 | $419,634 | $48,410 | $76,373 | 3.90 |
| Chest painMS-DRG 313, medical | 62 | $71,006 | $7,414 | $12,923 | 0.72 |
| Other vascular procedures with CCMS-DRG 253, surgical | 61 | $270,627 | $31,157 | $49,254 | 2.55 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 56 | $306,098 | $39,019 | $55,710 | 3.46 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 55 | $260,844 | $27,238 | $47,474 | 2.28 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 55 | $347,495 | $40,116 | $63,244 | 3.46 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 50 | $506,141 | $53,483 | $92,118 | 4.16 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 45 | $54,138 | $5,681 | $9,853 | 0.55 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 41 | $501,965 | $66,564 | $91,358 | 5.04 |
| Cardiac pacemaker revision except device replacement with CCMS-DRG 261, surgical | 40 | $203,455 | $20,929 | $37,029 | 1.88 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 39 | $455,441 | $70,598 | $82,890 | 7.80 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 38 | $304,412 | $38,716 | $55,403 | 3.27 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 37 | $406,351 | $62,761 | $73,956 | 5.24 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 35 | $309,168 | $38,441 | $56,269 | 3.18 |
| Cardiac pacemaker revision except device replacement with MCCMS-DRG 260, surgical | 32 | $309,691 | $44,468 | $56,364 | 3.32 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 30 | $409,242 | $55,142 | $74,482 | 4.81 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 28 | $626,353 | $108,693 | $113,996 | 9.71 |
| Other endovascular cardiac valve procedures with MCCMS-DRG 319, surgical | 26 | $378,159 | $54,935 | $68,825 | 4.36 |
| Hypertension with MCCMS-DRG 304, medical | 24 | $87,467 | $13,341 | $15,919 | 1.15 |
| Atherosclerosis without MCCMS-DRG 303, medical | 23 | $73,061 | $7,151 | $13,297 | 0.66 |
| Cardiac defibrillator implant with MCC or carotid sinus neurostimulatorMS-DRG 276, surgical | 22 | $658,465 | $84,157 | $119,841 | 6.21 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 22 | $70,105 | $7,519 | $12,759 | 0.72 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 22 | $267,816 | $30,039 | $48,743 | 1.97 |
| Cardiac defibrillator implant without MCCMS-DRG 277, surgical | 21 | $527,716 | $59,895 | $96,044 | 4.78 |
| Cardiac congenital and valvular disorders with MCCMS-DRG 306, medical | 20 | $127,985 | $19,114 | $23,293 | 1.54 |
| Ultrasound accelerated and other thrombolysis of peripheral vascular structures with MCCMS-DRG 278, surgical | 19 | $445,496 | $59,937 | $81,080 | 4.46 |
| Heart failure and shock with CCMS-DRG 292, medical | 19 | $109,481 | $9,795 | $19,926 | 0.86 |
| Coronary intravascular lithotripsy with intraluminal device with MCCMS-DRG 323, surgical | 17 | $423,915 | $56,716 | $77,153 | 4.14 |
| Aortic and heart assist procedures except pulsation balloon with MCCMS-DRG 268, surgical | 14 | $937,441 | $122,437 | $170,614 | 6.85 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 13 | $284,983 | $41,603 | $51,867 | 4.04 |
| Cardiac congenital and valvular disorders without MCCMS-DRG 307, medical | 13 | $91,062 | $11,646 | $16,573 | 0.94 |
| Cardiac defibrillator implant with cardiac catheterization and MCCMS-DRG 275, surgical | 11 | $801,338 | $95,246 | $145,843 | 7.04 |
| Ultrasound accelerated and other thrombolysis of peripheral vascular structures withoutMS-DRG 279, surgical | 11 | $383,928 | $42,764 | $69,875 | 3.20 |
| Peripheral vascular disorders without cc/mccMS-DRG 301, medical | 11 | $60,799 | $7,729 | $11,065 | 0.71 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 11 | $334,711 | $39,558 | $60,917 | 2.97 |
Musculoskeletal system and connective tissue3,477 discharges in 55 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 | 940 | $224,069 | $21,300 | $40,781 | 1.88 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 216 | $218,662 | $23,163 | $39,797 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 197 | $101,333 | $10,548 | $18,443 | 0.97 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 173 | $280,644 | $34,335 | $51,077 | 2.95 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 101 | $236,070 | $23,281 | $42,965 | 2.11 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 98 | $640,748 | $83,760 | $116,616 | 6.12 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 91 | $270,829 | $29,958 | $49,291 | 2.48 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 91 | $90,412 | $9,555 | $16,455 | 0.90 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 80 | $408,953 | $48,559 | $74,429 | 3.66 |
| Medical back problems with MCCMS-DRG 551, medical | 80 | $151,109 | $19,231 | $27,502 | 1.70 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 78 | $330,842 | $37,639 | $60,213 | 2.99 |
| Major hip and knee joint replacement or reattachment of lower extremity with MCC or totaMS-DRG 469, surgical | 67 | $276,697 | $34,970 | $50,359 | 3.33 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 67 | $316,826 | $34,171 | $57,662 | 2.96 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 63 | $88,961 | $9,480 | $16,191 | 0.79 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 61 | $333,501 | $40,223 | $60,697 | 3.49 |
| Combined anterior and posterior spinal fusion with MCCMS-DRG 453, surgical | 58 | $1,060,385 | $152,787 | $192,990 | 8.86 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 53 | $89,753 | $9,515 | $16,335 | 0.82 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 50 | $184,788 | $19,754 | $33,631 | 1.82 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 50 | $117,431 | $11,775 | $21,372 | 1.09 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 48 | $244,341 | $27,684 | $44,470 | 2.40 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 48 | $75,081 | $9,068 | $13,665 | 0.82 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 40 | $272,944 | $29,640 | $49,676 | 2.67 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 39 | $141,593 | $17,275 | $25,770 | 1.59 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 39 | $194,207 | $23,906 | $35,346 | 2.04 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 33 | $178,998 | $21,068 | $32,578 | 1.97 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCMS-DRG 562, medical | 31 | $119,563 | $16,704 | $21,761 | 1.52 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 30 | $427,608 | $52,743 | $77,825 | 4.61 |
| Tendonitis, myositis and bursitis without MCCMS-DRG 558, medical | 29 | $76,453 | $8,571 | $13,914 | 0.88 |
| Spinal fusion except cervical with MCCMS-DRG 459, surgical | 28 | $537,669 | $68,635 | $97,856 | 6.63 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 28 | $224,293 | $25,980 | $40,821 | 2.38 |
| Revision of hip or knee replacement with MCCMS-DRG 466, surgical | 27 | $538,765 | $63,186 | $98,055 | 5.19 |
| Fractures of hip and pelvis with MCCMS-DRG 535, medical | 27 | $105,807 | $14,308 | $19,257 | 1.30 |
| Other musculoskeletal system and connective tissue diagnoses with MCCMS-DRG 564, medical | 27 | $141,028 | $17,453 | $25,667 | 1.56 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 26 | $339,245 | $32,637 | $61,743 | 3.00 |
| Other musculoskeletal system and connective tissue o.r. procedures with MCCMS-DRG 515, surgical | 24 | $291,898 | $38,885 | $53,125 | 3.16 |
| Connective tissue disorders with MCCMS-DRG 545, medical | 24 | $186,591 | $28,046 | $33,960 | 2.49 |
| Biopsies of musculoskeletal system and connective tissue with MCCMS-DRG 477, surgical | 22 | $330,363 | $39,267 | $60,126 | 3.37 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 22 | $138,100 | $16,302 | $25,134 | 1.49 |
| Tendonitis, myositis and bursitis with MCCMS-DRG 557, medical | 22 | $185,554 | $18,483 | $33,771 | 1.56 |
| Soft tissue procedures with CCMS-DRG 501, surgical | 19 | $177,081 | $18,762 | $32,229 | 1.74 |
| Back and neck procedures except spinal fusion without cc/mccMS-DRG 520, surgical | 18 | $149,046 | $16,266 | $27,126 | 1.43 |
| Bone diseases and arthropathies with MCCMS-DRG 553, medical | 18 | $102,468 | $15,650 | $18,649 | 1.35 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 463, surgical | 17 | $463,547 | $69,404 | $84,366 | 5.66 |
| Cervical spinal fusion with MCCMS-DRG 471, surgical | 17 | $507,222 | $64,848 | $92,314 | 4.92 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 17 | $335,133 | $36,790 | $60,994 | 3.46 |
| Connective tissue disorders with CCMS-DRG 546, medical | 16 | $164,425 | $15,406 | $29,925 | 1.20 |
| Aftercare, musculoskeletal system and connective tissue with MCCMS-DRG 559, medical | 16 | $133,486 | $20,460 | $24,294 | 1.85 |
| Osteomyelitis with CCMS-DRG 540, medical | 15 | $146,538 | $13,261 | $26,670 | 1.30 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 456, surgical | 14 | $979,487 | $131,857 | $178,267 | 8.43 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 457, surgical | 14 | $762,309 | $88,311 | $138,740 | 6.08 |
| Cervical spinal fusion without cc/mccMS-DRG 473, surgical | 14 | $272,028 | $24,841 | $49,509 | 2.46 |
| Osteomyelitis with MCCMS-DRG 539, medical | 14 | $171,113 | $25,347 | $31,143 | 1.98 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 14 | $84,908 | $11,688 | $15,453 | 1.00 |
| Soft tissue procedures with MCCMS-DRG 500, surgical | 13 | $266,647 | $41,543 | $48,530 | 3.24 |
| Aftercare, musculoskeletal system and connective tissue with CCMS-DRG 560, medical | 13 | $101,103 | $10,462 | $18,401 | 1.13 |
Infectious and parasitic diseases3,429 discharges in 13 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 | 2,348 | $184,739 | $23,527 | $33,623 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 358 | $98,829 | $11,168 | $17,987 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 320 | $470,762 | $63,987 | $85,679 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 105 | $575,815 | $88,634 | $104,798 | 6.96 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 58 | $236,673 | $28,567 | $43,075 | 1.84 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 45 | $225,083 | $22,270 | $40,965 | 2.04 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 33 | $170,909 | $11,357 | $31,105 | 1.01 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 32 | $321,847 | $52,573 | $58,576 | 4.43 |
| Viral illness with MCCMS-DRG 865, medical | 31 | $330,441 | $37,926 | $60,140 | 1.64 |
| Viral illness without MCCMS-DRG 866, medical | 30 | $153,577 | $11,448 | $27,951 | 0.92 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 26 | $182,211 | $22,425 | $33,162 | 2.14 |
| Fever and inflammatory conditionsMS-DRG 864, medical | 26 | $135,126 | $12,121 | $24,593 | 0.88 |
| Other infectious and parasitic diseases diagnoses with MCCMS-DRG 867, medical | 17 | $339,475 | $37,396 | $61,784 | 2.09 |
Respiratory system2,858 discharges in 30 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 569 | $167,723 | $19,197 | $30,525 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 465 | $127,394 | $14,784 | $23,186 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 228 | $131,558 | $14,353 | $23,943 | 1.23 |
| Major chest procedures with CCMS-DRG 164, surgical | 169 | $215,377 | $27,986 | $39,199 | 2.55 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 143 | $86,943 | $8,976 | $15,824 | 0.82 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 117 | $97,805 | $10,552 | $17,800 | 0.99 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 109 | $182,146 | $21,353 | $33,151 | 1.88 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 109 | $146,963 | $16,039 | $26,747 | 1.40 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 107 | $102,680 | $12,379 | $18,688 | 1.10 |
| Major chest procedures with MCCMS-DRG 163, surgical | 83 | $301,525 | $50,379 | $54,878 | 4.71 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 83 | $87,476 | $10,273 | $15,921 | 0.96 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 71 | $172,419 | $20,427 | $31,380 | 1.74 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 62 | $78,719 | $9,339 | $14,327 | 0.85 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 56 | $220,165 | $27,334 | $40,070 | 1.81 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 49 | $153,211 | $20,235 | $27,884 | 1.90 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 48 | $80,781 | $9,190 | $14,702 | 0.82 |
| Other respiratory system o.r. procedures with CCMS-DRG 167, surgical | 44 | $194,806 | $19,936 | $35,455 | 1.82 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 40 | $250,883 | $31,415 | $45,661 | 2.70 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 37 | $562,080 | $73,701 | $102,299 | 6.91 |
| Major chest trauma with CCMS-DRG 184, medical | 36 | $106,555 | $12,062 | $19,393 | 1.05 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 36 | $96,912 | $10,257 | $17,638 | 0.91 |
| Major chest trauma with MCCMS-DRG 183, medical | 33 | $130,053 | $18,235 | $23,670 | 1.57 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 28 | $328,288 | $44,426 | $59,748 | 4.06 |
| Pleural effusion with MCCMS-DRG 186, medical | 28 | $178,072 | $19,376 | $32,409 | 1.55 |
| Respiratory signs and symptomsMS-DRG 204, medical | 27 | $80,908 | $9,477 | $14,725 | 0.82 |
| Respiratory neoplasms with CCMS-DRG 181, medical | 20 | $86,732 | $12,829 | $15,785 | 1.10 |
| Pleural effusion with CCMS-DRG 187, medical | 16 | $107,949 | $10,848 | $19,647 | 1.00 |
| Pneumothorax with CCMS-DRG 200, medical | 16 | $85,084 | $11,952 | $15,485 | 1.08 |
| Simple pneumonia and pleurisy without cc/mccMS-DRG 195, medical | 15 | $56,773 | $5,463 | $10,333 | 0.63 |
| Pneumothorax with MCCMS-DRG 199, medical | 14 | $170,253 | $22,259 | $30,986 | 1.77 |
Digestive system2,605 discharges in 36 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 | 320 | $80,495 | $8,632 | $14,650 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 241 | $112,720 | $10,707 | $20,515 | 0.98 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 221 | $235,461 | $26,883 | $42,854 | 2.37 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 205 | $204,192 | $22,486 | $37,163 | 1.79 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 187 | $174,198 | $20,208 | $31,704 | 1.62 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 176 | $446,386 | $57,281 | $81,242 | 4.52 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 164 | $149,926 | $16,374 | $27,286 | 1.28 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 143 | $76,573 | $8,702 | $13,936 | 0.80 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 120 | $100,229 | $10,672 | $18,242 | 0.94 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 89 | $94,084 | $11,482 | $17,123 | 1.04 |
| Digestive malignancy with MCCMS-DRG 374, medical | 84 | $228,942 | $25,614 | $41,667 | 2.10 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 83 | $182,483 | $19,935 | $33,212 | 1.75 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 60 | $164,739 | $18,986 | $29,983 | 1.45 |
| Digestive malignancy with CCMS-DRG 375, medical | 51 | $127,114 | $13,269 | $23,135 | 1.20 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 39 | $415,391 | $64,419 | $75,601 | 5.08 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 39 | $227,435 | $26,692 | $41,393 | 2.50 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 33 | $56,079 | $5,408 | $10,206 | 0.56 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 32 | $355,370 | $49,837 | $64,677 | 4.28 |
| Complicated peptic ulcer with MCCMS-DRG 380, medical | 28 | $246,776 | $24,182 | $44,913 | 1.95 |
| Hernia procedures except inguinal and femoral with CCMS-DRG 354, surgical | 26 | $158,427 | $18,946 | $28,834 | 1.72 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 24 | $223,596 | $23,842 | $40,695 | 2.11 |
| Major esophageal disorders with MCCMS-DRG 368, medical | 23 | $220,553 | $21,068 | $40,141 | 1.65 |
| Peritoneal adhesiolysis with MCCMS-DRG 335, surgical | 21 | $330,719 | $48,116 | $60,191 | 3.58 |
| Inflammatory bowel disease with CCMS-DRG 386, medical | 20 | $110,202 | $11,119 | $20,057 | 0.97 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 19 | $183,309 | $19,254 | $33,362 | 1.67 |
| Complicated peptic ulcer with CCMS-DRG 381, medical | 19 | $142,817 | $11,916 | $25,993 | 1.07 |
| Hernia procedures except inguinal and femoral without cc/mccMS-DRG 355, surgical | 17 | $155,296 | $15,286 | $28,264 | 1.36 |
| Appendix procedures with CCMS-DRG 398, surgical | 17 | $130,727 | $17,405 | $23,792 | 1.51 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 16 | $169,144 | $17,054 | $30,784 | 1.60 |
| Other digestive system o.r. procedures with CCMS-DRG 357, surgical | 15 | $176,296 | $24,141 | $32,086 | 2.20 |
| Inguinal and femoral hernia procedures with CCMS-DRG 351, surgical | 14 | $167,093 | $16,878 | $30,411 | 1.46 |
| Other digestive system diagnoses without cc/mccMS-DRG 395, medical | 13 | $67,820 | $6,595 | $12,343 | 0.65 |
| Major esophageal disorders with CCMS-DRG 369, medical | 12 | $102,499 | $10,425 | $18,655 | 0.99 |
| Inflammatory bowel disease with MCCMS-DRG 385, medical | 12 | $190,153 | $20,008 | $34,608 | 1.57 |
| Inguinal and femoral hernia procedures without cc/mccMS-DRG 352, surgical | 11 | $128,314 | $12,452 | $23,353 | 1.11 |
| Hernia procedures except inguinal and femoral with MCCMS-DRG 353, surgical | 11 | $255,932 | $33,552 | $46,580 | 2.92 |
Nervous system2,202 discharges in 39 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 246 | $192,117 | $22,756 | $34,965 | 2.00 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 172 | $441,619 | $52,947 | $80,375 | 4.42 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 162 | $123,763 | $16,726 | $22,525 | 1.36 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 142 | $103,849 | $10,667 | $18,900 | 1.02 |
| Seizures without MCCMS-DRG 101, medical | 137 | $120,360 | $10,400 | $21,906 | 0.91 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 136 | $110,523 | $11,324 | $20,115 | 1.03 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 130 | $237,760 | $28,133 | $43,272 | 2.39 |
| Seizures with MCCMS-DRG 100, medical | 80 | $177,662 | $22,757 | $32,334 | 1.98 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 79 | $190,784 | $22,417 | $34,723 | 1.79 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 71 | $513,753 | $66,082 | $93,503 | 5.67 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 62 | $264,658 | $30,485 | $48,168 | 2.43 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 50 | $170,282 | $20,312 | $30,991 | 1.79 |
| Extracranial procedures with CCMS-DRG 038, surgical | 48 | $157,938 | $18,280 | $28,745 | 1.60 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 45 | $231,223 | $23,223 | $42,083 | 1.47 |
| Ventricular shunt procedures without cc/mccMS-DRG 033, surgical | 42 | $183,155 | $19,115 | $33,334 | 1.62 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 42 | $131,407 | $12,940 | $23,916 | 1.03 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 41 | $156,271 | $16,795 | $28,441 | 1.14 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 39 | $201,563 | $27,676 | $36,685 | 2.28 |
| Peripheral, cranial nerve and other nervous system procedures with MCCMS-DRG 040, surgical | 37 | $359,222 | $45,263 | $65,378 | 3.85 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 36 | $182,101 | $22,994 | $33,142 | 2.27 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 35 | $126,768 | $13,610 | $23,072 | 1.32 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 32 | $357,170 | $38,901 | $65,005 | 2.95 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 32 | $104,413 | $8,615 | $19,003 | 0.80 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 31 | $125,048 | $11,550 | $22,759 | 1.06 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 27 | $82,462 | $7,446 | $15,008 | 0.69 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 24 | $219,487 | $26,045 | $39,947 | 2.30 |
| Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurMS-DRG 041, surgical | 23 | $236,797 | $25,150 | $43,097 | 2.23 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 23 | $129,348 | $15,740 | $23,541 | 1.36 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 20 | $194,910 | $20,042 | $35,474 | 1.81 |
| Headaches without MCCMS-DRG 103, medical | 20 | $100,670 | $9,044 | $18,322 | 0.84 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 18 | $401,878 | $52,378 | $73,142 | 3.79 |
| Ventricular shunt procedures with CCMS-DRG 032, surgical | 18 | $185,591 | $23,137 | $33,777 | 2.15 |
| Extracranial procedures with MCCMS-DRG 037, surgical | 17 | $314,956 | $49,208 | $57,322 | 3.38 |
| Cranial and peripheral nerve disorders with MCCMS-DRG 073, medical | 17 | $199,124 | $19,411 | $36,240 | 1.51 |
| Intracranial vascular procedures with principal diagnosis hemorrhage with MCCMS-DRG 020, surgical | 16 | $580,001 | $110,433 | $105,560 | 8.45 |
| Nervous system neoplasms without MCCMS-DRG 055, medical | 15 | $127,422 | $12,105 | $23,191 | 1.07 |
| Other disorders of nervous system without cc/mccMS-DRG 093, medical | 15 | $78,570 | $7,720 | $14,300 | 0.77 |
| Ventricular shunt procedures with MCCMS-DRG 031, surgical | 11 | $313,567 | $39,599 | $57,069 | 4.12 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 062, medical | 11 | $245,621 | $21,229 | $44,703 | 1.87 |
Kidney and urinary tract2,085 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 345 | $87,732 | $8,843 | $15,967 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 331 | $123,864 | $13,456 | $22,543 | 1.17 |
| Renal failure with MCCMS-DRG 682, medical | 285 | $159,197 | $18,327 | $28,974 | 1.50 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 272 | $158,510 | $20,182 | $28,849 | 1.65 |
| Renal failure with CCMS-DRG 683, medical | 241 | $90,508 | $9,511 | $16,473 | 0.90 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 195 | $110,193 | $11,247 | $20,055 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 76 | $133,602 | $14,140 | $24,316 | 1.35 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 73 | $436,214 | $56,073 | $79,391 | 3.70 |
| Kidney transplantMS-DRG 652, surgical | 59 | $885,619 | $45,911 | $161,183 | 3.00 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 34 | $316,434 | $40,418 | $57,591 | 2.59 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 30 | $188,272 | $20,789 | $34,266 | 1.84 |
| Kidney transplant with hemodialysis with MCCMS-DRG 650, surgical | 26 | $1,073,445 | $72,622 | $195,367 | 4.50 |
| Urinary stones without MCCMS-DRG 694, medical | 18 | $92,846 | $8,811 | $16,898 | 0.78 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 16 | $132,525 | $12,069 | $24,120 | 1.05 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 16 | $265,194 | $28,500 | $48,265 | 2.38 |
| Kidney and ureter procedures for neoplasm with MCCMS-DRG 656, surgical | 15 | $243,289 | $39,335 | $44,279 | 3.14 |
| Transurethral procedures with CCMS-DRG 669, surgical | 15 | $138,322 | $18,345 | $25,175 | 1.53 |
| Kidney and ureter procedures for neoplasm without cc/mccMS-DRG 658, surgical | 14 | $178,584 | $15,699 | $32,502 | 1.48 |
| Major bladder procedures with CCMS-DRG 654, surgical | 12 | $293,668 | $29,016 | $53,448 | 2.74 |
| Kidney and urinary tract neoplasms with MCCMS-DRG 686, medical | 12 | $142,729 | $22,148 | $25,977 | 1.84 |
Endocrine, nutritional and metabolic845 discharges in 14 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 | 186 | $142,434 | $15,212 | $25,923 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 168 | $81,414 | $8,486 | $14,817 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 96 | $131,252 | $15,482 | $23,888 | 1.45 |
| Diabetes with CCMS-DRG 638, medical | 93 | $89,976 | $10,010 | $16,376 | 0.90 |
| Endocrine disorders with MCCMS-DRG 643, medical | 81 | $139,603 | $17,773 | $25,408 | 1.65 |
| Endocrine disorders with CCMS-DRG 644, medical | 68 | $127,016 | $12,409 | $23,117 | 1.06 |
| Adrenal and pituitary procedures with cc/mccMS-DRG 614, surgical | 35 | $194,229 | $25,635 | $35,350 | 2.25 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 31 | $245,759 | $23,966 | $44,728 | 1.98 |
| Other endocrine, nutritional and metabolic o.r. procedures with CCMS-DRG 629, surgical | 19 | $271,577 | $30,842 | $49,427 | 2.26 |
| Skin grafts and wound debridement for endocrine, nutritional and metabolic disorders witMS-DRG 623, surgical | 17 | $226,127 | $26,737 | $41,155 | 1.86 |
| O.r. procedures for obesity without cc/mccMS-DRG 621, surgical | 16 | $188,423 | $16,091 | $34,293 | 1.52 |
| O.r. procedures for obesity with CCMS-DRG 620, surgical | 12 | $173,459 | $17,055 | $31,570 | 1.62 |
| Other endocrine, nutritional and metabolic o.r. procedures with MCCMS-DRG 628, surgical | 12 | $358,944 | $52,387 | $65,328 | 4.01 |
| Adrenal and pituitary procedures without cc/mccMS-DRG 615, surgical | 11 | $165,888 | $16,759 | $30,192 | 1.47 |
Liver, gallbladder and pancreas687 discharges in 15 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 97 | $174,044 | $17,863 | $31,676 | 1.63 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 88 | $210,319 | $20,508 | $38,278 | 1.76 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 61 | $132,263 | $12,027 | $24,072 | 1.09 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 57 | $572,263 | $79,155 | $104,152 | 5.51 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 49 | $245,459 | $23,990 | $44,673 | 1.83 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 47 | $172,886 | $20,511 | $31,465 | 1.63 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 45 | $345,114 | $38,395 | $62,811 | 2.89 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 44 | $227,110 | $27,031 | $41,334 | 2.32 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 40 | $243,728 | $27,612 | $44,358 | 1.92 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 38 | $81,811 | $9,434 | $14,890 | 0.86 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 35 | $122,059 | $10,594 | $22,215 | 0.95 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 23 | $131,624 | $13,877 | $23,956 | 1.31 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 23 | $174,454 | $21,839 | $31,751 | 1.67 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 20 | $108,412 | $12,310 | $19,731 | 1.03 |
| Malignancy of hepatobiliary system or pancreas with CCMS-DRG 436, medical | 20 | $108,487 | $12,758 | $19,745 | 1.10 |
Skin, subcutaneous tissue and breast598 discharges in 12 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 303 | $90,211 | $9,548 | $16,418 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 98 | $137,441 | $15,372 | $25,014 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 36 | $84,001 | $9,707 | $15,288 | 0.91 |
| Minor skin disorders without MCCMS-DRG 607, medical | 28 | $79,761 | $10,310 | $14,517 | 0.89 |
| Skin ulcers with CCMS-DRG 593, medical | 26 | $99,554 | $13,994 | $18,119 | 1.21 |
| Skin ulcers with MCCMS-DRG 592, medical | 19 | $126,689 | $19,841 | $23,057 | 2.09 |
| Other skin, subcutaneous tissue and breast procedures with CCMS-DRG 580, surgical | 18 | $209,221 | $22,533 | $38,078 | 1.75 |
| Skin debridement with CCMS-DRG 571, surgical | 17 | $189,177 | $19,035 | $34,430 | 1.69 |
| Minor skin disorders with MCCMS-DRG 606, medical | 16 | $138,864 | $17,900 | $25,273 | 1.59 |
| Major skin disorders without MCCMS-DRG 596, medical | 14 | $100,015 | $11,603 | $18,203 | 1.01 |
| Other skin, subcutaneous tissue and breast procedures with MCCMS-DRG 579, surgical | 12 | $216,863 | $33,498 | $39,469 | 3.34 |
| Malignant breast disorders with MCCMS-DRG 597, medical | 11 | $150,854 | $17,460 | $27,455 | 1.60 |
Blood and immune system364 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 128 | $146,489 | $17,466 | $26,661 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 102 | $104,013 | $10,248 | $18,930 | 0.90 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 43 | $257,224 | $31,829 | $46,815 | 2.19 |
| Coagulation disordersMS-DRG 813, medical | 43 | $195,425 | $19,279 | $35,567 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 31 | $125,629 | $14,098 | $22,865 | 1.20 |
| Reticuloendothelial and immunity disorders with CCMS-DRG 815, medical | 17 | $89,898 | $11,092 | $16,362 | 0.99 |
Other337 discharges in 10 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 | 111 | $461,664 | $61,362 | $84,023 | 4.74 |
| Concomitant left atrial appendage closure and cardiac ablationMS-DRG 317 | 59 | $689,469 | $73,450 | $125,483 | |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 51 | $232,649 | $28,112 | $42,342 | 2.49 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 34 | $359,204 | $47,868 | $65,375 | 3.38 |
| Multiple level spinal fusion except cervical without MCCMS-DRG 448 | 17 | $402,751 | $52,879 | $73,301 | |
| Single level combined anterior and posterior spinal fusion except cervicalMS-DRG 402 | 15 | $433,883 | $47,582 | $78,967 | |
| Multiple level combined anterior and posterior spinal fusion except cervical with CCMS-DRG 427 | 15 | $888,952 | $112,634 | $161,789 | |
| Multiple level combined anterior and posterior spinal fusion except cervical with MCC orMS-DRG 426 | 13 | $855,140 | $114,632 | $155,635 | |
| Single level spinal fusion except cervical without MCCMS-DRG 451 | 11 | $375,930 | $41,278 | $68,419 | |
| Non-extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 988, surgical | 11 | $182,510 | $20,441 | $33,217 | 1.70 |
Blood cancers and poorly differentiated neoplasms248 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 63 | $324,893 | $41,942 | $59,130 | 3.13 |
| Chemotherapy without acute leukemia as secondary diagnosis with CCMS-DRG 847, medical | 34 | $92,385 | $15,738 | $16,814 | 1.21 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 31 | $156,014 | $17,741 | $28,394 | 1.57 |
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 21 | $133,902 | $29,043 | $24,370 | 2.44 |
| Acute leukemia with MCCMS-DRG 834, medical | 19 | $641,113 | $102,428 | $116,683 | 5.60 |
| Myeloproliferative disorders or poorly differentiated neoplasms with major o.r. procedurMS-DRG 827, surgical | 18 | $246,872 | $26,823 | $44,931 | 2.32 |
| Myeloproliferative disorders or poorly differentiated neoplasms with other procedures wiMS-DRG 829, surgical | 15 | $252,469 | $40,243 | $45,949 | 3.15 |
| Myeloproliferative disorders or poorly differentiated neoplasms with major o.r. procedurMS-DRG 828, surgical | 13 | $182,285 | $18,652 | $33,176 | 1.64 |
| Lymphoma and leukemia with major o.r. procedures with MCCMS-DRG 820, surgical | 12 | $384,830 | $74,685 | $70,039 | 6.05 |
| Lymphoma and non-acute leukemia with other procedures with MCCMS-DRG 823, surgical | 11 | $646,615 | $79,397 | $117,684 | 4.50 |
| Other myeloproliferative disorders or poorly differentiated neoplastic diagnoses with mcMS-DRG 843, medical | 11 | $152,501 | $20,875 | $27,755 | 1.86 |
Injuries, poisonings and toxic effects of drugs243 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 57 | $185,599 | $23,321 | $33,779 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 56 | $110,642 | $11,217 | $20,137 | 1.03 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 42 | $204,171 | $24,113 | $37,159 | 2.00 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 42 | $147,036 | $17,642 | $26,760 | 1.60 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 35 | $401,456 | $45,921 | $73,065 | 3.72 |
| Poisoning and toxic effects of drugs without MCCMS-DRG 918, medical | 11 | $82,269 | $8,720 | $14,973 | 0.86 |
Mental diseases and disorders172 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 | 146 | $125,452 | $18,130 | $22,832 | 1.76 |
| PsychosesMS-DRG 885, medical | 26 | $154,471 | $16,822 | $28,114 | 1.37 |
Factors influencing health status162 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 84 | $93,027 | $8,804 | $16,931 | 0.80 |
| Signs and symptoms with MCCMS-DRG 947, medical | 46 | $138,730 | $14,189 | $25,249 | 1.25 |
| O.r. procedures with diagnoses of other contact with health services with CCMS-DRG 940, surgical | 21 | $183,100 | $23,217 | $33,324 | 2.17 |
| O.r. procedures with diagnoses of other contact with health services without cc/mccMS-DRG 941, surgical | 11 | $202,206 | $22,213 | $36,801 | 1.86 |
Transplants, ECMO and tracheostomy (pre-MDC)158 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| ECMO or tracheostomy with MV >96 hours or principal diagnosis except face, mouth and necMS-DRG 003, surgical | 60 | $1,917,115 | $284,105 | $348,915 | 21.32 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 35 | $1,156,313 | $188,575 | $210,449 | 14.70 |
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 24 | $3,251,758 | $428,846 | $591,820 | 27.10 |
| Lung transplantMS-DRG 007, surgical | 17 | $1,291,624 | $141,771 | $235,075 | 12.27 |
| Liver transplant with MCC or intestinal transplantMS-DRG 005, surgical | 11 | $1,585,104 | $145,834 | $288,489 | 10.35 |
| Allogeneic bone marrow transplantMS-DRG 014, medical | 11 | $808,424 | $140,611 | $147,133 | 11.46 |
Ear, nose, mouth and throat136 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 67 | $90,757 | $7,481 | $16,518 | 0.74 |
| Otitis media and uri without MCCMS-DRG 153, medical | 17 | $85,260 | $8,354 | $15,517 | 0.73 |
| Other ear, nose, mouth and throat diagnoses with MCCMS-DRG 154, medical | 17 | $148,757 | $17,499 | $27,074 | 1.54 |
| Major head and neck procedures with CCMS-DRG 141, surgical | 13 | $172,756 | $26,499 | $31,442 | 2.07 |
| Dental and oral diseases with MCCMS-DRG 157, medical | 11 | $150,651 | $16,161 | $27,419 | 1.71 |
| Dental and oral diseases with CCMS-DRG 158, medical | 11 | $139,979 | $12,316 | $25,476 | 0.94 |
Male reproductive system82 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Transurethral prostatectomy with cc/mccMS-DRG 713, surgical | 48 | $195,661 | $19,384 | $35,610 | 1.45 |
| Major male pelvic procedures with cc/mccMS-DRG 707, surgical | 19 | $163,108 | $20,492 | $29,686 | 1.96 |
| Inflammation of the male reproductive system without MCCMS-DRG 728, medical | 15 | $85,853 | $8,206 | $15,625 | 0.80 |
Female reproductive system62 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Uterine and adnexa procedures for non-malignancy with cc/mccMS-DRG 742, surgical | 18 | $144,901 | $18,488 | $26,372 | 1.78 |
| Uterine and adnexa procedures for ovarian or adnexal malignancy with CCMS-DRG 737, surgical | 11 | $176,451 | $18,688 | $32,114 | 1.97 |
| Uterine and adnexa procedures for non-malignancy without cc/mccMS-DRG 743, surgical | 11 | $151,292 | $11,981 | $27,535 | 1.16 |
| D&c, conization, laparoscopy and tubal interruption with cc/mccMS-DRG 744, surgical | 11 | $156,529 | $22,371 | $28,488 | 1.88 |
| Malignancy, female reproductive system with MCCMS-DRG 754, medical | 11 | $213,656 | $20,121 | $38,885 | 1.85 |
Alcohol and drug use56 discharges in 2 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 | 37 | $97,638 | $9,997 | $17,770 | 0.86 |
| Alcohol, drug abuse or dependence without rehabilitation therapy with MCCMS-DRG 896, medical | 19 | $143,242 | $20,512 | $26,070 | 1.78 |
Multiple significant trauma47 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Limb reattachment, hip and femur procedures for multiple significant traumaMS-DRG 956, surgical | 30 | $269,543 | $39,812 | $49,057 | 3.88 |
| Other multiple significant trauma with MCCMS-DRG 963, medical | 17 | $299,489 | $39,466 | $54,507 | 2.73 |
HIV infections16 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| HIV with major related condition with MCCMS-DRG 974, medical | 16 | $214,052 | $33,460 | $38,957 | 2.92 |
Eye11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other disorders of the eye without MCCMS-DRG 125, medical | 11 | $59,764 | $8,969 | $10,877 | 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 | 2,823 | 2,659 | $43,280 | $2,434 | $2,090 |
| Level 1 Endovascular ProceduresAPC 5191 | 1,928 | 1,899 | $39,044 | $2,611 | $2,208 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 1,796 | 1,594 | $26,239 | $1,432 | $1,220 |
| Level 1 Intraocular ProceduresAPC 5491 | 1,763 | 1,160 | $37,012 | $2,082 | $1,752 |
| Level 2 Upper GI ProceduresAPC 5302 | 1,238 | 1,146 | $32,122 | $1,708 | $1,445 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 1,083 | 1,054 | $188,372 | $13,048 | $10,772 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 1,080 | 1,057 | $358,685 | $24,954 | $21,117 |
| Level 3 Endovascular ProceduresAPC 5193 | 1,022 | 932 | $133,815 | $10,683 | $8,874 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 860 | 840 | $84,600 | $6,372 | $5,339 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 843 | 839 | $85,567 | $5,150 | $4,358 |
| Level 5 Urology and Related ServicesAPC 5375 | 747 | 701 | $59,145 | $4,601 | $3,918 |
| Level 4 Urology and Related ServicesAPC 5374 | 675 | 608 | $39,906 | $3,121 | $2,629 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 608 | 534 | $38,366 | $2,505 | $2,141 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 596 | 596 | $108,649 | $7,896 | $6,514 |
| Level 1 Nerve ProceduresAPC 5431 | 589 | 504 | $20,278 | $1,705 | $1,407 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 587 | 568 | $37,928 | $2,842 | $2,373 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 526 | 509 | $20,109 | $1,436 | $1,196 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 433 | 401 | $43,928 | $3,392 | $2,930 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 405 | 402 | $147,084 | $10,323 | $8,569 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 401 | 399 | $139,765 | $9,856 | $8,164 |
| Level 4 Airway EndoscopyAPC 5154 | 382 | 343 | $61,956 | $3,351 | $2,833 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 380 | 346 | $55,839 | $3,054 | $2,636 |
| Level 3 Vascular ProceduresAPC 5183 | 368 | 358 | $40,404 | $2,818 | $2,405 |
| Level 4 Gynecologic ProceduresAPC 5414 | 350 | 344 | $37,643 | $2,776 | $2,389 |
| Level 3 Lower GI ProceduresAPC 5313 | 347 | 332 | $39,908 | $2,527 | $2,176 |
| Level 6 Urology and Related ServicesAPC 5376 | 337 | 333 | $133,824 | $8,714 | $7,291 |
| Level 4 Endovascular ProceduresAPC 5194 | 325 | 288 | $210,714 | $17,731 | $14,606 |
| Level 2 Intraocular ProceduresAPC 5492 | 323 | 287 | $79,838 | $3,614 | $3,116 |
| Level 2 Endovascular ProceduresAPC 5192 | 310 | 302 | $72,718 | $5,094 | $4,338 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 293 | 291 | $74,839 | $5,810 | $4,982 |
| Level 3 Urology and Related ServicesAPC 5373 | 289 | 201 | $27,027 | $1,814 | $1,516 |
| Level 5 ENT ProceduresAPC 5165 | 259 | 254 | $65,316 | $5,202 | $4,436 |
| Level 4 Vascular ProceduresAPC 5184 | 217 | 204 | $51,845 | $4,894 | $3,946 |
| Level 5 Airway EndoscopyAPC 5155 | 188 | 187 | $111,761 | $6,107 | $5,183 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 183 | 183 | $378,354 | $34,903 | $29,375 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 162 | 158 | $236,778 | $18,827 | $15,763 |
| Level 7 Radiation TherapyAPC 5627 | 156 | 142 | $151,394 | $7,091 | $6,121 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 149 | 146 | $28,314 | $2,097 | $1,780 |
| Level 3 Upper GI ProceduresAPC 5303 | 139 | 133 | $51,191 | $3,365 | $2,888 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 128 | 127 | $246,816 | $20,247 | $17,052 |
| Level 2 Vascular ProceduresAPC 5182 | 124 | 116 | $29,785 | $1,413 | $1,204 |
| Complex GI ProceduresAPC 5331 | 113 | 100 | $82,963 | $5,026 | $4,263 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 106 | 105 | $420,885 | $32,905 | $26,719 |
| Level 3 Airway EndoscopyAPC 5153 | 103 | 103 | $30,673 | $1,523 | $1,264 |
| Level 3 Intraocular ProceduresAPC 5493 | 98 | 74 | $76,283 | $4,689 | $4,004 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 73 | 71 | $312,747 | $22,933 | $18,465 |
| Level 2 Urology and Related ServicesAPC 5372 | 72 | 52 | $14,584 | $610 | $502 |
| Level 5 Gynecologic ProceduresAPC 5415 | 70 | 68 | $57,018 | $4,398 | $3,792 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 50 | 50 | $259,231 | $24,829 | $21,011 |
| Level 4 ENT ProceduresAPC 5164 | 47 | 45 | $37,841 | $2,889 | $2,217 |
| Level 2 Nerve ProceduresAPC 5432 | 46 | 41 | $64,502 | $5,913 | $4,674 |
| Cochlear Implant ProcedureAPC 5166 | 45 | 44 | $397,717 | $35,293 | $29,489 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 40 | 39 | $94,600 | $5,982 | $4,524 |
| Level 6 Gynecologic ProceduresAPC 5416 | 37 | 37 | $88,389 | $6,876 | $5,836 |
| Level 3 Breast/Lymphatic Surgery and Related ProceduresAPC 5093 | 35 | 35 | $126,483 | $8,972 | $7,546 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 31 | 31 | $140,140 | $6,774 | $5,682 |
| Level 4 Breast/Lymphatic Surgery and Related ProceduresAPC 5094 | 28 | 27 | $169,336 | $18,161 | $15,549 |
| Level 1 Neurostimulator and Related ProceduresAPC 5461 | 28 | 28 | $38,398 | $2,943 | $2,547 |
| Level 4 Extraocular, Repair, and Plastic Eye ProceduresAPC 5504 | 28 | 28 | $31,507 | $3,346 | $2,969 |
| Level 3 Neurostimulator and Related ProceduresAPC 5463 | 27 | 27 | $104,570 | $13,174 | $11,550 |
| Level 8 Urology and Related ServicesAPC 5378 | 25 | 25 | $293,855 | $21,025 | $17,428 |
| Implantation Wireless PA Pressure MonitorAPC 5200 | 18 | 18 | $314,819 | $30,994 | $26,955 |
| Level 3 ENT ProceduresAPC 5163 | 16 | 16 | $18,100 | $1,366 | $1,106 |
| Implantation of Drug Infusion DeviceAPC 5471 | 15 | 15 | $188,810 | $17,175 | $14,829 |
| Level 7 Urology and Related ServicesAPC 5377 | 11 | 11 | $160,629 | $12,788 | $10,388 |
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.