Palos Community Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Palos Community Hospital, Palos Heights, IL in 2024, from traditional Medicare claims. Back to the Palos Community Hospital profile, with quality ratings, finances and negotiated rates.
6,789
Medicare inpatient discharges
In 150 published DRGs
1.81
Case mix index
IPPS FY 2027
16%
Surgical stays
75%
Stays with complications
In DRGs with a CC or MCC
3,956
Medicare outpatient services
In 39 service groups
Inpatient stays by major diagnostic category
Circulatory system1,431 discharges in 29 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 450 | $38,457 | $7,580 | $9,230 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 97 | $52,285 | $9,392 | $12,549 | 1.59 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 81 | $25,952 | $3,713 | $6,228 | 0.74 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 67 | $41,667 | $7,304 | $10,000 | 1.20 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 64 | $82,493 | $19,953 | $19,798 | 3.24 |
| Syncope and collapseMS-DRG 312, medical | 55 | $32,612 | $4,507 | $7,827 | 0.86 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 48 | $24,288 | $2,214 | $5,829 | 0.55 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 43 | $74,170 | $13,811 | $17,801 | 2.16 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 40 | $50,010 | $5,971 | $12,002 | 1.08 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 39 | $29,782 | $5,643 | $7,148 | 1.07 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 37 | $45,175 | $9,604 | $10,842 | 1.58 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 36 | $67,514 | $11,015 | $16,203 | 2.09 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 34 | $75,551 | $10,464 | $18,132 | 1.82 |
| Hypertension without MCCMS-DRG 305, medical | 32 | $31,968 | $3,520 | $7,672 | 0.75 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 31 | $37,585 | $4,524 | $9,020 | 0.91 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 30 | $93,597 | $21,912 | $22,463 | 3.46 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 29 | $93,247 | $17,489 | $22,379 | 2.87 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 26 | $62,093 | $14,346 | $14,902 | 2.28 |
| Chest painMS-DRG 313, medical | 23 | $27,481 | $3,997 | $6,595 | 0.72 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 22 | $189,442 | $34,768 | $45,466 | 5.06 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 22 | $33,825 | $5,350 | $8,118 | 0.97 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 21 | $127,883 | $20,875 | $30,692 | 3.35 |
| Other vascular procedures with CCMS-DRG 253, surgical | 20 | $138,994 | $16,530 | $33,358 | 2.55 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 17 | $393,050 | $59,630 | $94,332 | 7.80 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 16 | $316,450 | $51,278 | $75,948 | 7.71 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 15 | $133,852 | $25,964 | $32,125 | 3.90 |
| Heart failure and shock with CCMS-DRG 292, medical | 13 | $26,384 | $4,742 | $6,332 | 0.86 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 12 | $102,814 | $20,216 | $24,675 | 3.27 |
| Peripheral vascular disorders without cc/mccMS-DRG 301, medical | 11 | $30,210 | $3,187 | $7,250 | 0.71 |
Respiratory system1,070 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 | 304 | $54,895 | $10,162 | $13,175 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 120 | $44,020 | $7,801 | $10,565 | 1.33 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 96 | $40,246 | $6,380 | $9,659 | 1.10 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 82 | $37,712 | $5,058 | $9,051 | 0.99 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 73 | $42,792 | $7,445 | $10,270 | 1.23 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 63 | $28,906 | $4,173 | $6,938 | 0.82 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 50 | $28,467 | $5,084 | $6,832 | 0.96 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 43 | $32,609 | $4,679 | $7,826 | 0.85 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 36 | $58,560 | $8,561 | $14,055 | 1.40 |
| Major chest procedures with CCMS-DRG 164, surgical | 31 | $102,309 | $15,534 | $24,554 | 2.55 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 29 | $35,732 | $4,366 | $8,576 | 0.82 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 28 | $124,431 | $27,130 | $29,864 | 4.06 |
| Major chest procedures with MCCMS-DRG 163, surgical | 26 | $130,317 | $28,663 | $31,276 | 4.71 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 26 | $104,349 | $17,776 | $25,044 | 2.70 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 23 | $56,862 | $11,158 | $13,647 | 1.74 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 16 | $50,457 | $10,528 | $12,110 | 1.90 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 13 | $142,723 | $45,141 | $34,254 | 6.91 |
| Respiratory infections and inflammations without cc/mccMS-DRG 179, medical | 11 | $34,636 | $3,670 | $8,313 | 0.76 |
Infectious and parasitic diseases806 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 | 559 | $63,604 | $11,846 | $15,265 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 102 | $35,357 | $5,509 | $8,486 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 94 | $156,242 | $31,399 | $37,498 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 26 | $143,973 | $39,807 | $34,554 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 25 | $82,993 | $12,449 | $19,918 | 2.04 |
Digestive system760 discharges in 18 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 139 | $37,438 | $5,422 | $8,985 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 129 | $31,712 | $3,978 | $7,611 | 0.79 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 79 | $63,733 | $11,017 | $15,296 | 1.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 53 | $136,135 | $14,837 | $32,672 | 2.37 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 49 | $30,887 | $3,928 | $7,413 | 0.80 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 42 | $183,445 | $26,981 | $44,027 | 4.52 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 42 | $53,375 | $9,704 | $12,810 | 1.62 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 39 | $30,791 | $5,100 | $7,390 | 0.94 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 37 | $37,176 | $6,896 | $8,922 | 1.28 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 23 | $56,268 | $10,550 | $13,504 | 1.75 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 22 | $33,198 | $5,053 | $7,968 | 1.04 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 22 | $48,344 | $8,322 | $11,603 | 1.45 |
| Digestive malignancy with MCCMS-DRG 374, medical | 18 | $57,904 | $10,878 | $13,897 | 2.10 |
| Digestive malignancy with CCMS-DRG 375, medical | 16 | $46,952 | $6,353 | $11,268 | 1.20 |
| Complicated peptic ulcer with CCMS-DRG 381, medical | 15 | $36,496 | $5,976 | $8,759 | 1.07 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 13 | $27,472 | $2,266 | $6,593 | 0.56 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 11 | $88,613 | $8,975 | $21,267 | 1.67 |
| Peritoneal adhesiolysis with MCCMS-DRG 335, surgical | 11 | $140,657 | $21,681 | $33,758 | 3.58 |
Kidney and urinary tract705 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 126 | $28,476 | $4,120 | $6,834 | 0.81 |
| Renal failure with CCMS-DRG 683, medical | 121 | $30,956 | $4,848 | $7,429 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 119 | $47,487 | $8,914 | $11,397 | 1.50 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 114 | $51,854 | $10,027 | $12,445 | 1.65 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 103 | $34,791 | $6,647 | $8,350 | 1.17 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 50 | $28,597 | $5,481 | $6,863 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 31 | $55,231 | $7,627 | $13,256 | 1.35 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 18 | $112,692 | $24,456 | $27,046 | 3.70 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 12 | $52,935 | $5,771 | $12,704 | 1.05 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 11 | $82,782 | $16,554 | $19,868 | 2.59 |
Musculoskeletal system and connective tissue587 discharges in 18 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 104 | $83,869 | $12,647 | $20,129 | 2.07 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 74 | $31,330 | $5,959 | $7,519 | 1.09 |
| Medical back problems without MCCMS-DRG 552, medical | 68 | $32,601 | $5,033 | $7,824 | 0.97 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 44 | $82,831 | $11,053 | $19,879 | 1.88 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 43 | $107,901 | $18,190 | $25,896 | 2.95 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 36 | $91,022 | $12,642 | $21,845 | 2.11 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 32 | $47,784 | $10,450 | $11,468 | 1.82 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 26 | $29,660 | $4,395 | $7,119 | 0.90 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 22 | $72,175 | $12,489 | $17,322 | 2.04 |
| Medical back problems with MCCMS-DRG 551, medical | 19 | $63,352 | $10,406 | $15,205 | 1.70 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 18 | $104,655 | $14,963 | $25,117 | 2.40 |
| Pathological fractures and musculoskeletal and connective tissue malignancy without cc/mMS-DRG 544, medical | 18 | $24,296 | $3,784 | $5,831 | 0.77 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 18 | $22,808 | $4,134 | $5,474 | 0.82 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 16 | $32,629 | $5,533 | $7,831 | 1.00 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 14 | $24,508 | $4,036 | $5,882 | 0.79 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 12 | $134,183 | $18,148 | $32,204 | 3.66 |
| Connective tissue disorders with MCCMS-DRG 545, medical | 12 | $88,487 | $15,540 | $21,237 | 2.49 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 11 | $113,940 | $15,819 | $27,346 | 2.48 |
Nervous system495 discharges in 18 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 85 | $73,150 | $11,937 | $17,556 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 72 | $47,449 | $5,384 | $11,388 | 1.02 |
| Seizures without MCCMS-DRG 101, medical | 39 | $39,475 | $5,069 | $9,474 | 0.91 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 37 | $39,481 | $7,633 | $9,475 | 1.36 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 31 | $45,252 | $4,156 | $10,861 | 0.80 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 25 | $42,231 | $5,332 | $10,136 | 1.03 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 24 | $44,449 | $11,721 | $10,668 | 2.39 |
| Seizures with MCCMS-DRG 100, medical | 23 | $66,483 | $12,023 | $15,956 | 1.98 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 21 | $49,902 | $10,221 | $11,976 | 1.79 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 18 | $40,151 | $3,134 | $9,636 | 0.69 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 18 | $60,226 | $10,695 | $14,454 | 1.79 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 17 | $192,866 | $28,624 | $46,288 | 4.42 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 17 | $43,306 | $6,215 | $10,393 | 1.03 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 16 | $75,108 | $5,406 | $18,026 | 1.14 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 15 | $45,957 | $8,492 | $11,030 | 1.36 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 13 | $77,798 | $14,926 | $18,672 | 2.28 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 13 | $47,304 | $7,486 | $11,353 | 1.32 |
| Extracranial procedures with CCMS-DRG 038, surgical | 11 | $78,053 | $9,316 | $18,733 | 1.60 |
Endocrine, nutritional and metabolic286 discharges in 7 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 | 94 | $41,589 | $7,797 | $9,981 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 60 | $28,218 | $3,907 | $6,772 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 37 | $24,679 | $4,576 | $5,923 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 34 | $37,308 | $8,273 | $8,954 | 1.45 |
| Endocrine disorders with CCMS-DRG 644, medical | 29 | $34,456 | $5,820 | $8,270 | 1.06 |
| Endocrine disorders with MCCMS-DRG 643, medical | 18 | $42,816 | $10,051 | $10,276 | 1.65 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 14 | $51,920 | $11,636 | $12,461 | 1.98 |
Liver, gallbladder and pancreas177 discharges in 8 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 | 34 | $84,463 | $9,609 | $20,271 | 1.63 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 32 | $61,688 | $11,892 | $14,805 | 1.92 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 28 | $48,527 | $5,810 | $11,646 | 1.09 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 25 | $65,217 | $11,206 | $15,652 | 1.76 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 15 | $106,585 | $14,507 | $25,580 | 2.32 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 15 | $33,285 | $4,278 | $7,988 | 0.86 |
| Malignancy of hepatobiliary system or pancreas with CCMS-DRG 436, medical | 14 | $39,085 | $6,180 | $9,380 | 1.10 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 14 | $56,508 | $10,601 | $13,562 | 1.83 |
Skin, subcutaneous tissue and breast146 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 96 | $24,985 | $4,651 | $5,996 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 24 | $40,280 | $8,291 | $9,667 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 14 | $36,234 | $4,588 | $8,696 | 0.91 |
| Skin ulcers with MCCMS-DRG 592, medical | 12 | $39,347 | $12,327 | $9,443 | 2.09 |
Blood and immune system141 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 54 | $35,301 | $5,247 | $8,472 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 29 | $43,286 | $8,560 | $10,389 | 1.40 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 21 | $73,435 | $13,700 | $17,624 | 2.19 |
| Coagulation disordersMS-DRG 813, medical | 21 | $40,052 | $9,846 | $9,613 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 16 | $45,407 | $7,151 | $10,898 | 1.20 |
Injuries, poisonings and toxic effects of drugs50 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 20 | $40,291 | $9,439 | $9,670 | 1.60 |
| Complications of treatment with MCCMS-DRG 919, medical | 15 | $50,451 | $11,243 | $12,108 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 15 | $33,335 | $5,771 | $8,001 | 1.03 |
Factors influencing health status32 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other factors influencing health statusMS-DRG 951, medical | 19 | $18,759 | $3,614 | $4,502 | 0.59 |
| Signs and symptoms without MCCMS-DRG 948, medical | 13 | $26,990 | $4,326 | $6,478 | 0.80 |
Mental diseases and disorders29 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 | 29 | $40,695 | $9,525 | $9,767 | 1.76 |
Blood cancers and poorly differentiated neoplasms29 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Chemotherapy without acute leukemia as secondary diagnosis with CCMS-DRG 847, medical | 15 | $27,295 | $8,026 | $6,551 | 1.21 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 14 | $104,544 | $21,246 | $25,091 | 3.13 |
Ear, nose, mouth and throat28 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 28 | $42,462 | $3,907 | $10,191 | 0.74 |
Other17 discharges in 1 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 | 17 | $142,295 | $28,429 | $34,151 | 4.74 |
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 | 1,257 | 1,160 | $20,928 | $2,036 | $2,090 |
| Level 1 Endovascular ProceduresAPC 5191 | 257 | 257 | $24,940 | $2,189 | $2,208 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 240 | 227 | $13,283 | $1,128 | $1,220 |
| Level 3 Vascular ProceduresAPC 5183 | 196 | 189 | $19,168 | $2,409 | $2,405 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 172 | 172 | $47,201 | $4,289 | $4,358 |
| Level 4 Urology and Related ServicesAPC 5374 | 152 | 126 | $26,650 | $2,636 | $2,629 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 138 | 123 | $28,398 | $2,084 | $2,141 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 127 | 127 | $103,876 | $20,530 | $21,117 |
| Level 5 Urology and Related ServicesAPC 5375 | 104 | 99 | $37,963 | $3,914 | $3,918 |
| Level 2 Upper GI ProceduresAPC 5302 | 103 | 95 | $13,605 | $1,431 | $1,445 |
| Level 5 Airway EndoscopyAPC 5155 | 99 | 92 | $63,215 | $5,177 | $5,183 |
| Level 2 Vascular ProceduresAPC 5182 | 82 | 80 | $8,609 | $1,204 | $1,204 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 79 | 75 | $11,083 | $1,183 | $1,196 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 75 | 74 | $50,701 | $5,410 | $5,339 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 75 | 72 | $87,318 | $10,701 | $10,772 |
| Level 3 Urology and Related ServicesAPC 5373 | 70 | 45 | $13,014 | $1,540 | $1,516 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 69 | 66 | $26,378 | $2,378 | $2,373 |
| Level 3 Endovascular ProceduresAPC 5193 | 66 | 61 | $50,451 | $8,669 | $8,874 |
| Level 3 Airway EndoscopyAPC 5153 | 61 | 56 | $16,157 | $1,284 | $1,264 |
| Level 4 Airway EndoscopyAPC 5154 | 56 | 56 | $28,686 | $2,732 | $2,833 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 48 | 48 | $67,258 | $8,134 | $8,164 |
| Level 4 Gynecologic ProceduresAPC 5414 | 45 | 45 | $25,153 | $2,365 | $2,389 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 43 | 32 | $18,602 | $2,617 | $2,636 |
| Level 4 Vascular ProceduresAPC 5184 | 33 | 29 | $39,975 | $4,157 | $3,946 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 32 | 32 | $61,726 | $16,825 | $17,052 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 30 | 30 | $87,018 | $16,022 | $15,763 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 27 | 27 | $25,963 | $8,493 | $8,569 |
| Level 1 Nerve ProceduresAPC 5431 | 25 | 24 | $22,768 | $1,458 | $1,407 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 23 | 23 | $58,252 | $4,933 | $4,982 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 20 | 20 | $43,225 | $2,883 | $2,930 |
| Level 2 Endovascular ProceduresAPC 5192 | 20 | 18 | $33,214 | $4,324 | $4,338 |
| Level 1 Intraocular ProceduresAPC 5491 | 20 | 15 | $16,037 | $1,763 | $1,752 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 19 | 18 | $37,403 | $5,649 | $5,682 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 19 | 19 | $100,611 | $29,509 | $29,375 |
| Level 3 Lower GI ProceduresAPC 5313 | 18 | 17 | $26,743 | $2,129 | $2,176 |
| Level 4 Endovascular ProceduresAPC 5194 | 15 | 15 | $72,391 | $14,981 | $14,606 |
| Complex GI ProceduresAPC 5331 | 14 | $36,423 | $3,695 | $4,263 | |
| Level 5 Gynecologic ProceduresAPC 5415 | 14 | 14 | $38,113 | $3,762 | $3,792 |
| Level 5 ENT ProceduresAPC 5165 | 13 | 13 | $62,956 | $4,430 | $4,436 |
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.