Rio Grande Regional Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Rio Grande Regional Hospital, Mcallen, TX in 2024, from traditional Medicare claims. Back to the Rio Grande Regional Hospital profile, with quality ratings, finances and negotiated rates.
514
Medicare inpatient discharges
In 22 published DRGs
1.92
Case mix index
IPPS FY 2027
15%
Surgical stays
76%
Stays with complications
In DRGs with a CC or MCC
434
Medicare outpatient services
In 17 service groups
Inpatient stays by major diagnostic category
Infectious and parasitic diseases197 discharges in 4 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 | 136 | $152,492 | $15,072 | $9,302 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 28 | $81,665 | $8,850 | $4,982 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 21 | $381,114 | $29,364 | $23,248 | 5.00 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 12 | $279,239 | $14,679 | $17,034 | 2.04 |
Circulatory system101 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 43 | $124,370 | $10,662 | $7,587 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 20 | $319,331 | $24,463 | $19,479 | 3.24 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 14 | $187,524 | $11,434 | $11,439 | 1.59 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 13 | $158,584 | $25,640 | $9,674 | 3.35 |
| Syncope and collapseMS-DRG 312, medical | 11 | $91,877 | $7,875 | $5,604 | 0.86 |
Kidney and urinary tract80 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with MCCMS-DRG 682, medical | 26 | $109,911 | $11,774 | $6,705 | 1.50 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 20 | $136,884 | $11,801 | $8,350 | 1.65 |
| Renal failure with CCMS-DRG 683, medical | 18 | $79,519 | $8,508 | $4,851 | 0.90 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 16 | $77,163 | $7,552 | $4,707 | 0.81 |
Digestive system43 discharges in 3 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 | 20 | $82,292 | $7,467 | $5,020 | 0.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 12 | $254,161 | $18,622 | $15,504 | 2.37 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 11 | $178,920 | $13,221 | $10,914 | 1.79 |
Endocrine, nutritional and metabolic41 discharges in 2 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 | 27 | $69,939 | $10,677 | $4,266 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 14 | $75,124 | $7,320 | $4,583 | 0.78 |
Respiratory system28 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 17 | $163,291 | $11,427 | $9,961 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 11 | $139,569 | $11,870 | $8,514 | 1.70 |
Musculoskeletal system and connective tissue13 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 13 | $105,105 | $8,167 | $6,411 | 0.97 |
Blood and immune system11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 11 | $126,561 | $10,954 | $7,720 | 1.40 |
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 | 85 | 63 | $22,360 | $1,592 | $1,752 |
| Comprehensive Observation ServicesAPC 8011 | 50 | 49 | $41,880 | $1,887 | $2,090 |
| Level 1 Endovascular ProceduresAPC 5191 | 38 | 38 | $100,223 | $2,018 | $2,208 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 30 | 28 | $25,812 | $1,107 | $1,220 |
| Level 3 Vascular ProceduresAPC 5183 | 28 | 28 | $43,780 | $2,204 | $2,405 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 27 | 27 | $19,577 | $1,615 | $1,780 |
| Level 4 Vascular ProceduresAPC 5184 | 25 | 23 | $98,133 | $3,799 | $3,946 |
| Level 2 Upper GI ProceduresAPC 5302 | 23 | 22 | $73,960 | $1,318 | $1,445 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 20 | 20 | $120,936 | $3,989 | $4,358 |
| Level 4 Urology and Related ServicesAPC 5374 | 20 | 16 | $71,696 | $2,410 | $2,629 |
| Level 3 Endovascular ProceduresAPC 5193 | 15 | 13 | $187,130 | $7,907 | $8,874 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 13 | 13 | $149,618 | $4,946 | $5,339 |
| Level 3 Urology and Related ServicesAPC 5373 | 13 | $45,229 | $1,408 | $1,516 | |
| Level 2 Intraocular ProceduresAPC 5492 | 13 | 13 | $37,314 | $2,811 | $3,116 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 12 | 12 | $66,743 | $2,238 | $2,373 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 11 | 11 | $42,635 | $1,964 | $2,141 |
| Level 2 Endovascular ProceduresAPC 5192 | 11 | $92,938 | $3,951 | $4,338 |
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.