Parkview Hospital Randallia Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Parkview Hospital Randallia, Fort Wayne, IN in 2024, from traditional Medicare claims. Back to the Parkview Hospital Randallia profile, with quality ratings, finances and negotiated rates.
6,346
Medicare inpatient discharges
In 169 published DRGs
1.90
Case mix index
IPPS FY 2027
23%
Surgical stays
75%
Stays with complications
In DRGs with a CC or MCC
4,301
Medicare outpatient services
In 44 service groups
Inpatient stays by major diagnostic category
Circulatory system1,212 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 | 288 | $43,251 | $8,901 | $9,775 | 1.28 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 81 | $109,317 | $11,376 | $24,706 | 1.82 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 68 | $59,913 | $11,087 | $13,540 | 1.59 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 51 | $237,211 | $34,484 | $53,610 | 4.88 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 50 | $18,545 | $3,242 | $4,191 | 0.55 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 48 | $146,959 | $22,606 | $33,213 | 3.24 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 46 | $29,221 | $5,009 | $6,604 | 0.74 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 46 | $65,414 | $13,630 | $14,784 | 2.09 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 43 | $46,930 | $5,926 | $10,606 | 0.91 |
| Syncope and collapseMS-DRG 312, medical | 42 | $25,445 | $5,883 | $5,750 | 0.86 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 37 | $141,962 | $20,253 | $32,083 | 2.87 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 34 | $84,708 | $12,867 | $19,144 | 2.16 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 34 | $35,525 | $7,168 | $8,029 | 1.07 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 33 | $53,089 | $7,114 | $11,998 | 1.08 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 32 | $52,707 | $11,372 | $11,912 | 1.58 |
| Other vascular procedures with CCMS-DRG 253, surgical | 25 | $127,543 | $17,858 | $28,825 | 2.55 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 25 | $42,802 | $8,171 | $9,673 | 1.20 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 22 | $90,393 | $15,757 | $20,429 | 2.28 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 19 | $44,305 | $4,608 | $10,013 | 0.72 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 18 | $185,975 | $28,204 | $42,030 | 4.04 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 17 | $38,446 | $6,111 | $8,689 | 0.97 |
| Hypertension without MCCMS-DRG 305, medical | 16 | $30,555 | $5,012 | $6,905 | 0.75 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 15 | $142,889 | $24,719 | $32,293 | 3.35 |
| Heart failure and shock with CCMS-DRG 292, medical | 15 | $27,396 | $5,481 | $6,191 | 0.86 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 14 | $294,341 | $36,264 | $66,521 | 4.16 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 13 | $79,909 | $11,867 | $18,059 | 1.83 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 12 | $321,938 | $45,053 | $72,758 | 5.20 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 12 | $119,908 | $24,549 | $27,099 | 3.46 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 12 | $160,758 | $22,600 | $36,331 | 3.46 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 11 | $345,949 | $65,647 | $78,185 | 7.80 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 11 | $141,632 | $30,475 | $32,009 | 4.81 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 11 | $129,497 | $24,518 | $29,266 | 3.27 |
| Hypertension with MCCMS-DRG 304, medical | 11 | $39,753 | $8,025 | $8,984 | 1.15 |
Infectious and parasitic diseases967 discharges in 8 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 | 605 | $62,804 | $13,280 | $14,194 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 139 | $158,029 | $32,178 | $35,715 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 123 | $31,925 | $6,883 | $7,215 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 37 | $57,547 | $12,791 | $13,006 | 2.04 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 24 | $179,499 | $47,535 | $40,567 | 6.96 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 17 | $92,125 | $12,778 | $20,820 | 1.84 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 11 | $173,538 | $31,928 | $39,220 | 4.43 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 11 | $24,182 | $5,919 | $5,465 | 1.01 |
Respiratory system802 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 | 176 | $52,437 | $11,110 | $11,851 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 132 | $41,045 | $8,113 | $9,276 | 1.23 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 113 | $40,580 | $8,898 | $9,171 | 1.33 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 45 | $37,255 | $9,446 | $8,420 | 1.40 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 42 | $23,159 | $5,796 | $5,234 | 0.82 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 41 | $37,260 | $6,644 | $8,421 | 0.99 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 35 | $74,100 | $18,434 | $16,747 | 2.70 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 33 | $58,899 | $12,285 | $13,311 | 1.74 |
| Major chest procedures with MCCMS-DRG 163, surgical | 26 | $176,078 | $31,651 | $39,794 | 4.71 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 26 | $37,382 | $7,048 | $8,448 | 1.10 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 24 | $26,370 | $5,598 | $5,960 | 0.82 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 21 | $28,044 | $5,140 | $6,338 | 0.85 |
| Major chest procedures with CCMS-DRG 164, surgical | 17 | $143,923 | $16,917 | $32,527 | 2.55 |
| Major chest trauma with CCMS-DRG 184, medical | 15 | $28,503 | $7,131 | $6,442 | 1.05 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 15 | $62,971 | $12,946 | $14,231 | 1.81 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 15 | $131,840 | $35,835 | $29,796 | 6.91 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 14 | $135,029 | $29,586 | $30,516 | 4.06 |
| Pneumothorax with CCMS-DRG 200, medical | 12 | $37,620 | $6,892 | $8,502 | 1.08 |
Kidney and urinary tract764 discharges in 15 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with MCCMS-DRG 682, medical | 165 | $38,700 | $9,892 | $8,746 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 153 | $26,709 | $6,034 | $6,036 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 96 | $52,226 | $11,033 | $11,803 | 1.65 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 70 | $25,669 | $5,484 | $5,801 | 0.81 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 51 | $24,923 | $6,996 | $5,633 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 46 | $42,413 | $8,955 | $9,585 | 1.35 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 42 | $29,748 | $8,022 | $6,723 | 1.17 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 26 | $142,213 | $28,079 | $32,140 | 3.70 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 21 | $65,331 | $16,969 | $14,765 | 2.59 |
| Transurethral procedures with CCMS-DRG 669, surgical | 19 | $47,792 | $10,578 | $10,801 | 1.53 |
| Renal failure without cc/mccMS-DRG 684, medical | 19 | $18,074 | $4,065 | $4,085 | 0.61 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 17 | $35,987 | $7,210 | $8,133 | 1.05 |
| Urinary stones without MCCMS-DRG 694, medical | 16 | $32,463 | $5,319 | $7,337 | 0.78 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 12 | $66,271 | $16,520 | $14,977 | 2.38 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 11 | $82,918 | $12,520 | $18,739 | 1.84 |
Digestive system650 discharges in 17 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 123 | $36,974 | $6,765 | $8,356 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 95 | $55,842 | $12,278 | $12,620 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 64 | $26,562 | $5,039 | $6,003 | 0.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 52 | $127,856 | $15,375 | $28,895 | 2.37 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 43 | $42,571 | $6,099 | $9,621 | 0.94 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 33 | $38,815 | $8,595 | $8,772 | 1.28 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 30 | $186,045 | $30,181 | $42,046 | 4.52 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 30 | $29,676 | $5,457 | $6,707 | 0.80 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 27 | $42,860 | $9,736 | $9,686 | 1.45 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 25 | $32,871 | $6,445 | $7,429 | 1.04 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 24 | $109,206 | $10,487 | $24,681 | 1.67 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 24 | $52,130 | $12,363 | $11,781 | 1.75 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 22 | $64,813 | $13,079 | $14,648 | 1.62 |
| Digestive malignancy with MCCMS-DRG 374, medical | 17 | $58,101 | $14,148 | $13,131 | 2.10 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 15 | $17,024 | $3,449 | $3,847 | 0.56 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 14 | $132,978 | $28,142 | $30,053 | 4.28 |
| Digestive malignancy with CCMS-DRG 375, medical | 12 | $40,468 | $8,191 | $9,146 | 1.20 |
Nervous system587 discharges in 22 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 81 | $64,522 | $12,941 | $14,582 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 75 | $41,303 | $6,620 | $9,334 | 1.02 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 49 | $39,133 | $9,234 | $8,844 | 1.36 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 32 | $248,120 | $40,238 | $56,075 | 5.67 |
| Seizures without MCCMS-DRG 101, medical | 32 | $23,065 | $5,946 | $5,213 | 0.91 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 30 | $57,943 | $15,684 | $13,095 | 2.39 |
| Seizures with MCCMS-DRG 100, medical | 29 | $50,372 | $13,377 | $11,384 | 1.98 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 26 | $156,948 | $27,087 | $35,470 | 4.42 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 25 | $90,460 | $7,507 | $20,444 | 1.14 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 24 | $39,283 | $7,118 | $8,878 | 1.03 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 23 | $42,804 | $7,102 | $9,674 | 1.03 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 20 | $44,352 | $9,893 | $10,024 | 1.47 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 20 | $44,895 | $8,758 | $10,146 | 1.36 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 17 | $24,246 | $5,484 | $5,480 | 0.80 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 15 | $36,390 | $8,858 | $8,224 | 1.32 |
| Headaches without MCCMS-DRG 103, medical | 15 | $27,105 | $5,166 | $6,126 | 0.84 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 14 | $29,521 | $4,309 | $6,672 | 0.69 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 14 | $37,496 | $12,408 | $8,474 | 1.79 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 13 | $60,875 | $15,677 | $13,758 | 2.28 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 11 | $123,465 | $17,045 | $27,903 | 2.43 |
| Cranial and peripheral nerve disorders with MCCMS-DRG 073, medical | 11 | $61,137 | $9,710 | $13,817 | 1.51 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 11 | $49,121 | $11,065 | $11,101 | 1.79 |
Musculoskeletal system and connective tissue501 discharges in 16 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 | 97 | $80,605 | $13,582 | $18,217 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 68 | $25,179 | $5,935 | $5,690 | 0.97 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 56 | $79,405 | $14,226 | $17,945 | 2.11 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 45 | $104,718 | $19,685 | $23,666 | 2.95 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 35 | $93,774 | $16,907 | $21,193 | 2.40 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 30 | $34,761 | $6,826 | $7,856 | 1.09 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 25 | $75,653 | $13,862 | $17,097 | 2.04 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 24 | $182,002 | $26,150 | $41,133 | 3.49 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 21 | $89,643 | $18,737 | $20,259 | 2.99 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 21 | $54,000 | $12,501 | $12,204 | 1.82 |
| Other musculoskeletal system and connective tissue o.r. procedures with MCCMS-DRG 515, surgical | 17 | $75,686 | $22,006 | $17,105 | 3.16 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 15 | $27,993 | $5,838 | $6,326 | 0.90 |
| Revision of hip or knee replacement with MCCMS-DRG 466, surgical | 13 | $170,660 | $33,953 | $38,569 | 5.19 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 12 | $67,855 | $10,761 | $15,335 | 1.59 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 11 | $97,869 | $23,207 | $22,118 | 3.46 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 11 | $32,817 | $5,086 | $7,417 | 0.82 |
Endocrine, nutritional and metabolic243 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 | 66 | $34,634 | $8,722 | $7,827 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 49 | $25,073 | $5,100 | $5,666 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 46 | $27,684 | $5,826 | $6,256 | 0.90 |
| Endocrine disorders with CCMS-DRG 644, medical | 28 | $27,496 | $7,314 | $6,214 | 1.06 |
| Diabetes with MCCMS-DRG 637, medical | 22 | $45,623 | $9,494 | $10,311 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 21 | $43,312 | $11,323 | $9,789 | 1.65 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 11 | $81,569 | $11,598 | $18,435 | 1.98 |
Liver, gallbladder and pancreas236 discharges in 12 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 36 | $56,100 | $13,394 | $12,679 | 1.92 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 23 | $99,292 | $10,917 | $22,440 | 1.63 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 21 | $38,303 | $7,691 | $8,656 | 1.09 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 19 | $123,448 | $16,682 | $27,899 | 2.32 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 19 | $26,974 | $7,621 | $6,096 | 1.03 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 19 | $55,393 | $13,139 | $12,519 | 1.83 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 19 | $54,737 | $11,793 | $12,371 | 1.63 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 18 | $76,216 | $12,710 | $17,225 | 1.76 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 18 | $53,817 | $10,141 | $12,163 | 1.67 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 17 | $22,268 | $5,557 | $5,033 | 0.86 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 16 | $89,155 | $9,297 | $20,149 | 1.31 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 11 | $44,199 | $5,851 | $9,989 | 0.95 |
Blood and immune system88 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Coagulation disordersMS-DRG 813, medical | 37 | $31,335 | $10,699 | $7,082 | 1.56 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 23 | $33,535 | $5,711 | $7,579 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 16 | $43,742 | $9,976 | $9,886 | 1.40 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 12 | $41,249 | $8,497 | $9,322 | 1.20 |
Skin, subcutaneous tissue and breast85 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 32 | $26,317 | $5,547 | $5,948 | 0.88 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 15 | $21,671 | $6,330 | $4,898 | 0.91 |
| Cellulitis with MCCMS-DRG 602, medical | 14 | $36,113 | $10,314 | $8,161 | 1.49 |
| Skin debridement with CCMS-DRG 571, surgical | 12 | $87,850 | $13,629 | $19,854 | 1.69 |
| Malignant breast disorders with MCCMS-DRG 597, medical | 12 | $57,042 | $12,074 | $12,891 | 1.60 |
Injuries, poisonings and toxic effects of drugs61 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 21 | $43,644 | $13,391 | $9,864 | 1.82 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 14 | $43,509 | $10,098 | $9,833 | 1.60 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 13 | $80,249 | $13,903 | $18,136 | 2.00 |
| Complications of treatment with CCMS-DRG 920, medical | 13 | $21,116 | $7,118 | $4,772 | 1.03 |
Mental diseases and disorders49 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| PsychosesMS-DRG 885, medical | 34 | $25,877 | $10,102 | $5,848 | 1.37 |
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 15 | $25,790 | $12,032 | $5,829 | 1.76 |
Alcohol and drug use40 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 | 23 | $24,458 | $5,883 | $5,528 | 0.86 |
| Alcohol, drug abuse or dependence without rehabilitation therapy with MCCMS-DRG 896, medical | 17 | $36,708 | $11,271 | $8,296 | 1.78 |
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 | 21 | $137,905 | $32,426 | $31,166 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 12 | $127,225 | $19,931 | $28,753 | 2.49 |
Factors influencing health status15 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 15 | $22,211 | $5,468 | $5,020 | 0.80 |
Blood cancers and poorly differentiated neoplasms13 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 | 13 | $98,156 | $22,866 | $22,183 | 3.13 |
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 | 623 | 573 | $19,117 | $1,998 | $2,090 |
| Level 4 Urology and Related ServicesAPC 5374 | 336 | 293 | $28,038 | $2,564 | $2,629 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 319 | 298 | $15,773 | $1,178 | $1,220 |
| Level 5 Urology and Related ServicesAPC 5375 | 289 | 275 | $35,602 | $3,787 | $3,918 |
| Level 2 Upper GI ProceduresAPC 5302 | 246 | 221 | $15,048 | $1,391 | $1,445 |
| Level 3 Vascular ProceduresAPC 5183 | 238 | 221 | $23,106 | $2,284 | $2,405 |
| Level 1 Endovascular ProceduresAPC 5191 | 205 | 204 | $40,484 | $2,163 | $2,208 |
| Level 3 Urology and Related ServicesAPC 5373 | 177 | 100 | $15,926 | $1,313 | $1,516 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 128 | 124 | $50,749 | $4,195 | $4,358 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 123 | 123 | $81,878 | $7,803 | $8,164 |
| Level 3 Endovascular ProceduresAPC 5193 | 113 | 103 | $81,799 | $8,443 | $8,874 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 111 | 103 | $23,971 | $2,033 | $2,141 |
| Level 6 Urology and Related ServicesAPC 5376 | 95 | 95 | $71,466 | $6,873 | $7,291 |
| Level 2 Urology and Related ServicesAPC 5372 | 92 | 77 | $2,011 | $256 | $502 |
| Level 4 Airway EndoscopyAPC 5154 | 79 | 71 | $38,202 | $2,755 | $2,833 |
| Level 2 Vascular ProceduresAPC 5182 | 77 | 77 | $8,165 | $1,158 | $1,204 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 73 | 68 | $41,864 | $2,803 | $2,930 |
| Level 5 Airway EndoscopyAPC 5155 | 72 | 70 | $49,527 | $5,036 | $5,183 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 71 | 71 | $65,604 | $8,221 | $8,569 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 70 | 70 | $120,698 | $19,954 | $21,117 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 64 | 62 | $76,195 | $4,721 | $4,982 |
| Level 4 Gynecologic ProceduresAPC 5414 | 57 | 56 | $21,643 | $2,299 | $2,389 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 53 | 52 | $33,795 | $2,471 | $2,636 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 46 | 45 | $175,455 | $28,657 | $29,375 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 43 | 42 | $172,844 | $26,332 | $26,719 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 41 | 38 | $61,273 | $5,260 | $5,339 |
| Level 1 Intraocular ProceduresAPC 5491 | 39 | 28 | $12,445 | $1,713 | $1,752 |
| Level 4 Endovascular ProceduresAPC 5194 | 38 | 36 | $112,210 | $14,139 | $14,606 |
| Level 3 Lower GI ProceduresAPC 5313 | 38 | 37 | $27,006 | $2,079 | $2,176 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 36 | 34 | $27,132 | $2,378 | $2,373 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 36 | 36 | $43,339 | $6,251 | $6,514 |
| Level 4 Vascular ProceduresAPC 5184 | 32 | 29 | $67,664 | $4,042 | $3,946 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 28 | 28 | $107,501 | $10,505 | $10,772 |
| Level 2 Endovascular ProceduresAPC 5192 | 28 | 24 | $47,316 | $4,205 | $4,338 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 26 | 26 | $186,575 | $18,519 | $18,465 |
| Level 3 Upper GI ProceduresAPC 5303 | 24 | 24 | $23,409 | $2,818 | $2,888 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 21 | 19 | $9,089 | $1,154 | $1,196 |
| Level 5 ENT ProceduresAPC 5165 | 19 | 19 | $61,175 | $4,309 | $4,436 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 19 | 19 | $118,251 | $16,321 | $17,052 |
| Complex GI ProceduresAPC 5331 | 19 | 15 | $44,069 | $4,193 | $4,263 |
| Level 3 Airway EndoscopyAPC 5153 | 16 | 16 | $21,611 | $1,247 | $1,264 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 16 | 16 | $35,761 | $5,032 | $4,524 |
| Level 5 Gynecologic ProceduresAPC 5415 | 13 | 13 | $60,882 | $3,652 | $3,792 |
| Level 3 Neurostimulator and Related ProceduresAPC 5463 | 12 | 12 | $66,462 | $10,473 | $11,550 |
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.