Promedica Russell J. Ebeid Children S Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Promedica Russell J. Ebeid Children S Hospital, Toledo, OH in 2024, from traditional Medicare claims. Back to the Promedica Russell J. Ebeid Children S Hospital profile, with quality ratings, finances and negotiated rates.
6,007
Medicare inpatient discharges
In 168 published DRGs
2.31
Case mix index
IPPS FY 2027
34%
Surgical stays
72%
Stays with complications
In DRGs with a CC or MCC
9,429
Medicare outpatient services
In 51 service groups
Inpatient stays by major diagnostic category
Circulatory system1,540 discharges in 35 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 279 | $69,364 | $9,014 | $11,168 | 1.28 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 83 | $37,949 | $4,663 | $6,110 | 0.74 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 82 | $131,774 | $22,791 | $21,216 | 3.24 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 79 | $122,171 | $15,008 | $19,669 | 2.16 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 75 | $96,867 | $10,654 | $15,596 | 1.59 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 64 | $148,848 | $13,281 | $23,965 | 1.82 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 58 | $190,129 | $35,960 | $30,611 | 4.88 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 49 | $190,097 | $19,726 | $30,606 | 2.87 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 47 | $211,910 | $46,242 | $34,117 | 6.25 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 45 | $196,222 | $25,937 | $31,592 | 4.04 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 45 | $53,528 | $7,960 | $8,618 | 1.20 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 42 | $278,402 | $35,838 | $44,823 | 5.24 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 39 | $278,957 | $31,672 | $44,912 | 5.20 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 38 | $326,451 | $43,118 | $52,559 | 7.80 |
| Other vascular procedures with CCMS-DRG 253, surgical | 38 | $135,886 | $18,444 | $21,878 | 2.55 |
| Syncope and collapseMS-DRG 312, medical | 38 | $52,472 | $5,620 | $8,448 | 0.86 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 36 | $107,363 | $14,371 | $17,285 | 2.09 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 35 | $313,653 | $47,544 | $50,498 | 7.71 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 34 | $175,390 | $29,200 | $28,238 | 4.16 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 32 | $62,397 | $6,206 | $10,046 | 0.91 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 31 | $265,882 | $37,243 | $42,807 | 5.88 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 31 | $189,975 | $27,546 | $30,586 | 3.35 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 31 | $29,880 | $3,269 | $4,811 | 0.55 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 30 | $80,487 | $16,600 | $12,958 | 2.28 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 24 | $93,046 | $6,286 | $14,980 | 1.08 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 20 | $256,733 | $39,994 | $41,334 | 5.06 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 20 | $166,290 | $24,832 | $26,773 | 3.46 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 17 | $63,455 | $12,889 | $10,216 | 1.83 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 17 | $83,074 | $7,326 | $13,375 | 1.07 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 16 | $66,917 | $10,669 | $10,774 | 1.58 |
| Other vascular procedures without cc/mccMS-DRG 254, surgical | 14 | $129,452 | $11,844 | $20,842 | 1.74 |
| Hypertension without MCCMS-DRG 305, medical | 14 | $53,812 | $4,834 | $8,664 | 0.75 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 13 | $62,623 | $4,592 | $10,082 | 0.72 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 13 | $136,117 | $15,703 | $21,915 | 1.97 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 11 | $114,248 | $21,024 | $18,394 | 3.46 |
Nervous system771 discharges in 27 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 107 | $65,503 | $6,527 | $10,546 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 105 | $99,863 | $13,680 | $16,078 | 2.00 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 68 | $194,432 | $28,317 | $31,304 | 4.42 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 51 | $195,482 | $39,158 | $31,473 | 5.67 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 33 | $82,005 | $7,034 | $13,203 | 1.14 |
| Seizures without MCCMS-DRG 101, medical | 32 | $49,469 | $5,507 | $7,964 | 0.91 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 25 | $63,542 | $4,164 | $10,230 | 0.69 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 24 | $71,496 | $7,531 | $11,511 | 1.36 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 24 | $66,813 | $9,105 | $10,757 | 1.36 |
| Seizures with MCCMS-DRG 100, medical | 22 | $96,533 | $12,797 | $15,542 | 1.98 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 21 | $50,167 | $8,309 | $8,077 | 1.32 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 20 | $108,787 | $25,509 | $17,515 | 3.79 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 20 | $106,118 | $16,335 | $17,085 | 2.39 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 20 | $99,968 | $11,829 | $16,095 | 1.79 |
| Precerebral occlusion without infarction without MCCMS-DRG 068, medical | 19 | $46,999 | $4,873 | $7,567 | 0.87 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 19 | $89,418 | $15,432 | $14,396 | 2.28 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 19 | $61,635 | $6,922 | $9,923 | 1.03 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 18 | $54,059 | $6,565 | $8,703 | 1.06 |
| Extracranial procedures with CCMS-DRG 038, surgical | 17 | $99,479 | $11,533 | $16,016 | 1.60 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 16 | $141,279 | $17,654 | $22,746 | 2.43 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 15 | $108,477 | $14,784 | $17,465 | 2.30 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 15 | $54,817 | $5,277 | $8,826 | 0.80 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 14 | $54,912 | $10,504 | $8,841 | 1.47 |
| Ventricular shunt procedures without cc/mccMS-DRG 033, surgical | 13 | $83,659 | $11,357 | $13,469 | 1.62 |
| Traumatic stupor and coma >1 hour without cc/mccMS-DRG 084, medical | 12 | $34,436 | $5,414 | $5,544 | 0.92 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 11 | $119,321 | $20,290 | $19,211 | 2.95 |
| Nervous system neoplasms without MCCMS-DRG 055, medical | 11 | $40,892 | $6,635 | $6,584 | 1.07 |
Infectious and parasitic diseases748 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 | 445 | $102,776 | $13,981 | $16,547 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 136 | $268,401 | $36,070 | $43,212 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 67 | $52,434 | $6,743 | $8,442 | 1.03 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 41 | $289,892 | $44,096 | $46,673 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 21 | $104,921 | $12,661 | $16,892 | 2.04 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 14 | $175,923 | $29,795 | $28,324 | 4.43 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 13 | $90,836 | $13,106 | $14,625 | 1.84 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 11 | $78,870 | $13,600 | $12,698 | 2.14 |
Respiratory system715 discharges in 14 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 176 | $68,048 | $8,660 | $10,956 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 127 | $78,134 | $11,310 | $12,580 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 111 | $65,275 | $8,157 | $10,509 | 1.23 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 45 | $71,503 | $9,730 | $11,512 | 1.40 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 44 | $143,462 | $18,706 | $23,097 | 2.70 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 43 | $51,533 | $5,301 | $8,297 | 0.82 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 35 | $65,073 | $8,406 | $10,477 | 1.10 |
| Major chest procedures with MCCMS-DRG 163, surgical | 33 | $207,725 | $30,579 | $33,444 | 4.71 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 22 | $49,135 | $5,304 | $7,911 | 0.82 |
| Major chest trauma with CCMS-DRG 184, medical | 20 | $61,707 | $6,459 | $9,935 | 1.05 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 18 | $237,120 | $35,916 | $38,176 | 6.91 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 16 | $84,413 | $11,715 | $13,590 | 1.74 |
| Major chest trauma with MCCMS-DRG 183, medical | 13 | $68,636 | $11,302 | $11,050 | 1.57 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 12 | $44,676 | $5,970 | $7,193 | 0.99 |
Musculoskeletal system and connective tissue598 discharges in 23 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 56 | $53,089 | $5,899 | $8,547 | 0.97 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 55 | $110,636 | $14,110 | $17,812 | 2.07 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 45 | $146,947 | $22,744 | $23,658 | 3.49 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 42 | $103,309 | $14,435 | $16,633 | 2.11 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 38 | $137,211 | $24,635 | $22,091 | 3.66 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 35 | $141,157 | $19,668 | $22,726 | 2.95 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 33 | $104,117 | $13,129 | $16,763 | 1.88 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 27 | $143,988 | $20,117 | $23,182 | 2.96 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 23 | $180,352 | $44,035 | $29,037 | 6.12 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 23 | $53,224 | $5,091 | $8,569 | 0.90 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 21 | $52,740 | $6,980 | $8,491 | 1.09 |
| Medical back problems with MCCMS-DRG 551, medical | 21 | $67,037 | $11,253 | $10,793 | 1.70 |
| Revision of hip or knee replacement with MCCMS-DRG 466, surgical | 20 | $227,061 | $37,654 | $36,557 | 5.19 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 20 | $100,468 | $12,738 | $16,175 | 1.97 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 18 | $97,376 | $12,913 | $15,678 | 2.04 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 17 | $112,596 | $16,890 | $18,128 | 2.40 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 17 | $157,314 | $19,883 | $25,328 | 2.99 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 16 | $104,728 | $16,318 | $16,861 | 2.38 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 16 | $78,559 | $9,773 | $12,648 | 1.49 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 16 | $35,582 | $4,272 | $5,729 | 0.79 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 15 | $112,874 | $16,794 | $18,173 | 2.67 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 463, surgical | 12 | $282,070 | $38,657 | $45,413 | 5.66 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 12 | $55,811 | $6,133 | $8,986 | 1.00 |
Digestive system542 discharges in 15 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 88 | $62,895 | $6,705 | $10,126 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 76 | $102,220 | $12,208 | $16,457 | 1.79 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 60 | $220,416 | $28,810 | $35,487 | 4.52 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 60 | $46,373 | $4,934 | $7,466 | 0.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 42 | $126,044 | $15,996 | $20,293 | 2.37 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 38 | $68,041 | $7,992 | $10,955 | 1.28 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 32 | $42,509 | $5,231 | $6,844 | 0.80 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 30 | $51,684 | $6,063 | $8,321 | 0.94 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 21 | $27,311 | $3,181 | $4,397 | 0.56 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 21 | $65,043 | $11,831 | $10,472 | 1.62 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 19 | $66,737 | $10,666 | $10,745 | 1.45 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 18 | $95,311 | $11,255 | $15,345 | 1.67 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 13 | $261,408 | $37,721 | $42,087 | 5.08 |
| Inflammatory bowel disease with CCMS-DRG 386, medical | 13 | $42,995 | $6,339 | $6,922 | 0.97 |
| Peritoneal adhesiolysis with MCCMS-DRG 335, surgical | 11 | $194,234 | $21,853 | $31,272 | 3.58 |
Kidney and urinary tract366 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with MCCMS-DRG 682, medical | 64 | $69,203 | $10,175 | $11,142 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 63 | $45,310 | $5,905 | $7,295 | 0.90 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 57 | $56,789 | $7,547 | $9,143 | 1.17 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 56 | $49,245 | $4,868 | $7,928 | 0.81 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 48 | $73,583 | $10,684 | $11,847 | 1.65 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 31 | $39,403 | $6,740 | $6,344 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 20 | $65,188 | $7,933 | $10,495 | 1.35 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 14 | $60,569 | $6,328 | $9,752 | 1.05 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 13 | $195,720 | $28,005 | $31,511 | 3.70 |
Liver, gallbladder and pancreas179 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 31 | $117,384 | $16,174 | $18,899 | 2.32 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 26 | $84,448 | $10,976 | $13,596 | 1.76 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 24 | $97,615 | $11,192 | $15,716 | 1.63 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 17 | $43,571 | $7,386 | $7,015 | 1.09 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 15 | $92,770 | $8,047 | $14,936 | 1.31 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 15 | $89,953 | $12,722 | $14,482 | 1.83 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 14 | $263,858 | $38,861 | $42,481 | 5.51 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 14 | $97,599 | $10,938 | $15,713 | 1.63 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 12 | $55,677 | $7,119 | $8,964 | 1.03 |
| Malignancy of hepatobiliary system or pancreas with CCMS-DRG 436, medical | 11 | $51,935 | $7,067 | $8,362 | 1.10 |
Endocrine, nutritional and metabolic168 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 | 40 | $73,273 | $8,740 | $11,797 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 35 | $46,457 | $5,806 | $7,479 | 0.90 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 34 | $44,985 | $4,356 | $7,243 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 17 | $74,682 | $10,605 | $12,024 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 15 | $94,194 | $11,353 | $15,165 | 1.65 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 14 | $107,193 | $13,342 | $17,258 | 1.98 |
| Endocrine disorders with CCMS-DRG 644, medical | 13 | $61,072 | $6,913 | $9,833 | 1.06 |
Skin, subcutaneous tissue and breast83 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 46 | $46,456 | $5,768 | $7,479 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 24 | $66,074 | $8,761 | $10,638 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 13 | $57,364 | $5,502 | $9,236 | 0.91 |
Blood cancers and poorly differentiated neoplasms60 discharges in 4 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 | 22 | $49,154 | $7,810 | $7,914 | 1.21 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 13 | $190,706 | $25,668 | $30,704 | 3.13 |
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 13 | $101,524 | $17,564 | $16,345 | 2.44 |
| Acute leukemia with MCCMS-DRG 834, medical | 12 | $177,692 | $38,896 | $28,608 | 5.60 |
Blood and immune system59 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 25 | $77,108 | $9,699 | $12,414 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 20 | $67,547 | $6,291 | $10,875 | 0.90 |
| Coagulation disordersMS-DRG 813, medical | 14 | $57,826 | $10,808 | $9,310 | 1.56 |
Other54 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 | 36 | $225,296 | $32,350 | $36,273 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 18 | $120,189 | $18,010 | $19,350 | 2.49 |
Injuries, poisonings and toxic effects of drugs50 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 25 | $74,182 | $12,728 | $11,943 | 1.82 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 13 | $181,607 | $27,892 | $29,239 | 3.72 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 12 | $74,147 | $10,002 | $11,938 | 1.60 |
Transplants, ECMO and tracheostomy (pre-MDC)33 discharges in 2 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 | 17 | $583,348 | $115,578 | $93,919 | 21.32 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 16 | $389,921 | $61,296 | $62,777 | 14.70 |
Factors influencing health status18 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 | 18 | $48,408 | $5,471 | $7,794 | 0.80 |
Alcohol and drug use12 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Alcohol, drug abuse or dependence without rehabilitation therapy without MCCMS-DRG 897, medical | 12 | $40,868 | $5,594 | $6,580 | 0.86 |
Multiple significant trauma11 discharges in 1 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 | 11 | $187,083 | $24,040 | $30,120 | 3.88 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service (2024 data, released 2026-04-10), traditional Medicare only; CMS omits DRGs with fewer than 11 discharges. Estimated cost is average charges times the hospital's Medicare cost-to-charge ratio from the IPPS Impact File. Weights are the MS-DRG relative weights for the same year.
Outpatient services
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Level 1 Intraocular ProceduresAPC 5491 | 1,073 | 627 | $12,856 | $807 | $1,752 |
| Comprehensive Observation ServicesAPC 8011 | 1,048 | 996 | $33,515 | $1,882 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 746 | 705 | $60,949 | $9,625 | $10,772 |
| Level 1 Endovascular ProceduresAPC 5191 | 548 | 542 | $43,494 | $1,991 | $2,208 |
| Level 2 Urology and Related ServicesAPC 5372 | 537 | 417 | $5,911 | $466 | $502 |
| Level 3 Urology and Related ServicesAPC 5373 | 494 | 375 | $13,483 | $1,335 | $1,516 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 473 | 422 | $10,955 | $1,129 | $1,220 |
| Level 3 Vascular ProceduresAPC 5183 | 284 | 261 | $27,055 | $2,162 | $2,405 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 272 | 266 | $49,335 | $4,883 | $5,339 |
| Level 2 Intraocular ProceduresAPC 5492 | 266 | 225 | $19,786 | $1,318 | $3,116 |
| Level 2 Upper GI ProceduresAPC 5302 | 259 | 230 | $12,183 | $1,297 | $1,445 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 212 | 208 | $48,190 | $3,988 | $4,358 |
| Level 4 Urology and Related ServicesAPC 5374 | 204 | 176 | $24,750 | $2,400 | $2,629 |
| Level 5 Urology and Related ServicesAPC 5375 | 199 | 187 | $39,003 | $3,606 | $3,918 |
| Level 3 Endovascular ProceduresAPC 5193 | 197 | 180 | $85,546 | $7,894 | $8,874 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 190 | 187 | $20,073 | $1,942 | $2,141 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 167 | 166 | $117,805 | $18,243 | $21,117 |
| Level 2 Endovascular ProceduresAPC 5192 | 153 | 134 | $48,666 | $3,958 | $4,338 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 149 | 148 | $86,753 | $13,565 | $15,763 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 130 | 130 | $73,651 | $7,205 | $8,164 |
| Level 4 Airway EndoscopyAPC 5154 | 120 | 109 | $21,201 | $2,531 | $2,833 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 120 | 120 | $41,252 | $7,436 | $8,569 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 117 | 109 | $19,973 | $672 | $1,780 |
| Level 4 Vascular ProceduresAPC 5184 | 114 | 90 | $46,118 | $3,118 | $3,946 |
| Level 4 Gynecologic ProceduresAPC 5414 | 107 | 105 | $21,566 | $2,137 | $2,389 |
| Level 4 Endovascular ProceduresAPC 5194 | 95 | 88 | $100,470 | $13,253 | $14,606 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 92 | 87 | $27,657 | $2,232 | $2,373 |
| Level 2 Vascular ProceduresAPC 5182 | 88 | 83 | $12,543 | $1,100 | $1,204 |
| Level 5 ENT ProceduresAPC 5165 | 78 | 76 | $48,214 | $3,675 | $4,436 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 77 | 76 | $56,274 | $4,579 | $4,982 |
| Level 3 Airway EndoscopyAPC 5153 | 75 | 71 | $15,218 | $1,200 | $1,264 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 75 | 58 | $28,210 | $2,363 | $2,636 |
| Level 3 Lower GI ProceduresAPC 5313 | 71 | 70 | $16,065 | $2,024 | $2,176 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 69 | 63 | $30,690 | $2,632 | $2,930 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 68 | 68 | $123,628 | $26,435 | $29,375 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 63 | 61 | $22,910 | $5,748 | $6,514 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 49 | 49 | $16,008 | $1,027 | $1,196 |
| Level 3 Intraocular ProceduresAPC 5493 | 45 | 40 | $26,529 | $1,487 | $4,004 |
| Level 5 Airway EndoscopyAPC 5155 | 38 | 38 | $38,844 | $4,613 | $5,183 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 35 | 35 | $74,516 | $14,381 | $17,052 |
| Level 4 ENT ProceduresAPC 5164 | 34 | 31 | $26,006 | $1,923 | $2,217 |
| Level 3 Upper GI ProceduresAPC 5303 | 30 | 30 | $20,771 | $2,634 | $2,888 |
| Level 5 Gynecologic ProceduresAPC 5415 | 29 | 24 | $40,116 | $3,419 | $3,792 |
| Level 6 Urology and Related ServicesAPC 5376 | 25 | 24 | $55,635 | $6,593 | $7,291 |
| Level 1 Nerve ProceduresAPC 5431 | 25 | 23 | $21,205 | $1,319 | $1,407 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 18 | 18 | $160,795 | $26,011 | $26,719 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 17 | 15 | $85,098 | $17,855 | $18,465 |
| Level 7 Radiation TherapyAPC 5627 | 17 | 17 | $34,562 | $5,214 | $6,121 |
| Cochlear Implant ProcedureAPC 5166 | 13 | 13 | $152,991 | $26,052 | $29,489 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 12 | 12 | $85,805 | $18,220 | $21,011 |
| Complex GI ProceduresAPC 5331 | 12 | 11 | $47,640 | $4,042 | $4,263 |
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.