Rochester General Hospital Medicare inpatient and outpatient services

Every DRG and outpatient service group CMS publishes for Rochester General Hospital, Rochester, NY in 2024, from traditional Medicare claims. Back to the Rochester General Hospital profile, with quality ratings, finances and negotiated rates.

2,545
Medicare inpatient discharges
In 89 published DRGs
2.11
Case mix index
IPPS FY 2027
23%
Surgical stays
65%
Stays with complications
In DRGs with a CC or MCC
2,125
Medicare outpatient services
In 36 service groups

Inpatient stays by major diagnostic category

Circulatory system719 discharges in 22 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Heart failure and shock with MCCMS-DRG 291, medical	140	$30,391	$11,675	$11,883	1.28
Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical	62	$69,121	$21,968	$27,026	2.16
Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical	59	$150,953	$44,905	$59,023	4.88
Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical	43	$170,092	$56,472	$66,506	6.25
Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical	40	$36,289	$14,053	$14,189	1.59
Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical	37	$100,972	$29,153	$39,480	3.24
Syncope and collapseMS-DRG 312, medical	37	$19,240	$7,745	$7,523	0.86
Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical	33	$30,674	$8,857	$11,994	1.08
Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical	31	$69,473	$14,689	$27,164	1.82
Other circulatory system diagnoses with MCCMS-DRG 314, medical	30	$43,037	$19,106	$16,828	2.09
Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical	27	$16,710	$6,756	$6,533	0.74
Other major cardiovascular procedures with MCCMS-DRG 270, surgical	26	$180,389	$57,208	$70,532	5.06
Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical	19	$119,802	$37,640	$46,842	4.16
Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical	19	$105,156	$26,321	$41,116	2.87
Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical	18	$26,261	$8,200	$10,268	0.91
Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical	18	$27,747	$10,568	$10,849	1.20
Other circulatory system diagnoses with CCMS-DRG 315, medical	16	$21,469	$9,201	$8,394	0.97
Other major cardiovascular procedures without cc/mccMS-DRG 272, surgical	14	$68,237	$15,981	$26,681	2.44
Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical	13	$102,826	$40,525	$40,205	5.20
Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical	13	$54,094	$17,708	$21,151	2.28
Other major cardiovascular procedures with CCMS-DRG 271, surgical	13	$78,448	$30,285	$30,673	3.46
Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical	11	$82,999	$35,114	$32,453	4.04

Infectious and parasitic diseases334 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	205	$56,755	$17,629	$22,191	1.98
Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical	51	$133,524	$45,088	$52,208	5.00
Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical	50	$25,354	$9,192	$9,913	1.03
Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical	17	$222,124	$77,752	$86,851	6.96
Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical	11	$43,024	$17,409	$16,822	2.04

Nervous system304 discharges in 11 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Other cerebrovascular disorders with CCMS-DRG 071, medical	57	$27,459	$8,846	$10,737	1.06
Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical	38	$60,328	$18,702	$23,588	2.00
Seizures without MCCMS-DRG 101, medical	35	$22,834	$8,049	$8,928	0.91
Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical	34	$33,625	$7,826	$13,147	1.02
Extracranial procedures without cc/mccMS-DRG 039, surgical	25	$17,416	$8,643	$6,810	1.14
Degenerative nervous system disorders without MCCMS-DRG 057, medical	23	$35,345	$11,911	$13,820	1.36
Seizures with MCCMS-DRG 100, medical	22	$37,584	$17,873	$14,695	1.98
Other cerebrovascular disorders with MCCMS-DRG 070, medical	21	$36,584	$16,189	$14,304	1.79
Other disorders of nervous system with CCMS-DRG 092, medical	21	$29,729	$9,512	$11,624	1.03
Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical	15	$18,958	$8,115	$7,413	1.03
Transient ischemia without thrombolyticMS-DRG 069, medical	13	$29,897	$6,895	$11,690	0.80

Respiratory system302 discharges in 9 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Respiratory infections and inflammations with MCCMS-DRG 177, medical	77	$48,567	$15,599	$18,990	1.70
Pulmonary edema and respiratory failureMS-DRG 189, medical	51	$45,681	$10,879	$17,861	1.23
Simple pneumonia and pleurisy with MCCMS-DRG 193, medical	45	$29,959	$10,553	$11,714	1.33
Respiratory infections and inflammations with CCMS-DRG 178, medical	31	$27,027	$8,596	$10,568	0.99
Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical	29	$24,667	$9,749	$9,645	1.10
Simple pneumonia and pleurisy with CCMS-DRG 194, medical	21	$19,473	$6,491	$7,614	0.82
Chronic obstructive pulmonary disease with CCMS-DRG 191, medical	20	$17,635	$7,079	$6,895	0.85
Major chest procedures with CCMS-DRG 164, surgical	15	$70,223	$22,492	$27,457	2.55
Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical	13	$60,711	$23,428	$23,738	2.70

Digestive system235 discharges in 9 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	72	$19,468	$6,860	$7,612	0.79
Gastrointestinal hemorrhage with CCMS-DRG 378, medical	41	$28,216	$7,821	$11,033	0.98
Gastrointestinal hemorrhage with MCCMS-DRG 377, medical	32	$47,366	$16,958	$18,520	1.79
Other digestive system diagnoses with CCMS-DRG 394, medical	22	$20,571	$8,059	$8,043	0.94
Gastrointestinal obstruction with CCMS-DRG 389, medical	17	$19,482	$6,732	$7,618	0.80
Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical	16	$47,618	$10,622	$18,619	1.28
Major small and large bowel procedures with MCCMS-DRG 329, surgical	13	$127,849	$34,636	$49,989	4.52
Major small and large bowel procedures without cc/mccMS-DRG 331, surgical	11	$40,903	$12,300	$15,993	1.67
Other digestive system diagnoses with MCCMS-DRG 393, medical	11	$30,736	$15,588	$12,018	1.62

Kidney and urinary tract178 discharges in 7 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical	38	$43,187	$14,668	$16,886	1.65
Renal failure with CCMS-DRG 683, medical	37	$22,400	$7,815	$8,758	0.90
Kidney and urinary tract infections without MCCMS-DRG 690, medical	34	$17,022	$6,641	$6,656	0.81
Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical	19	$91,399	$36,367	$35,737	3.70
Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical	19	$17,448	$8,862	$6,822	1.02
Renal failure with MCCMS-DRG 682, medical	17	$31,685	$13,933	$12,389	1.50
Kidney and urinary tract infections with MCCMS-DRG 689, medical	14	$25,580	$11,064	$10,002	1.17

Musculoskeletal system and connective tissue124 discharges in 7 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Medical back problems without MCCMS-DRG 552, medical	29	$28,036	$8,609	$10,962	0.97
Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical	23	$45,903	$15,268	$17,948	1.88
Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical	20	$22,224	$7,941	$8,690	0.90
Hip and femur procedures except major joint with CCMS-DRG 481, surgical	16	$49,637	$19,246	$19,408	2.07
Spinal fusion except cervical without MCCMS-DRG 460, surgical	13	$53,244	$32,465	$20,818	3.66
Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical	12	$46,049	$19,776	$18,005	2.11
Cervical spinal fusion with CCMS-DRG 472, surgical	11	$54,463	$22,748	$21,295	2.96

Endocrine, nutritional and metabolic118 discharges in 5 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical	39	$22,956	$7,172	$8,976	0.78
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical	31	$21,715	$11,403	$8,491	1.32
Diabetes with MCCMS-DRG 637, medical	26	$41,409	$13,304	$16,191	1.45
Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical	11	$43,224	$16,120	$16,901	1.98
Diabetes with CCMS-DRG 638, medical	11	$18,055	$7,462	$7,059	0.90

Blood and immune system38 discharges in 2 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Red blood cell disorders without MCCMS-DRG 812, medical	22	$32,628	$9,037	$12,757	0.90
Red blood cell disorders with MCCMS-DRG 811, medical	16	$56,696	$10,694	$22,168	1.40

Skin, subcutaneous tissue and breast34 discharges in 1 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Cellulitis without MCCMS-DRG 603, medical	34	$17,693	$7,672	$6,918	0.88

Injuries, poisonings and toxic effects of drugs28 discharges in 2 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	16	$27,617	$14,926	$10,798	1.60
Complications of treatment with MCCMS-DRG 919, medical	12	$52,684	$15,831	$20,599	1.82

Other25 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	25	$150,612	$46,481	$58,889	4.74

Transplants, ECMO and tracheostomy (pre-MDC)24 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	13	$444,346	$152,737	$173,739	21.32
Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical	11	$433,215	$161,391	$169,387	14.70

Liver, gallbladder and pancreas23 discharges in 2 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	12	$37,276	$12,156	$14,575	1.63
Disorders of the biliary tract with CCMS-DRG 445, medical	11	$21,391	$9,278	$8,364	1.09

Alcohol and drug use19 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	19	$27,982	$7,422	$10,941	0.86

Factors influencing health status14 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	14	$20,461	$5,871	$8,000	0.80

Ear, nose, mouth and throat13 discharges in 1 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
DysequilibriumMS-DRG 149, medical	13	$19,490	$6,288	$7,621	0.74

Mental diseases and disorders13 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	13	$25,319	$14,620	$9,900	1.76

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	340	303	$10,420	$2,244	$2,090
Level 1 Endovascular ProceduresAPC 5191	221	217	$13,038	$2,436	$2,208
Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072	127	119	$8,568	$1,266	$1,220
Level 3 Electrophysiologic ProceduresAPC 5213	115	111	$100,001	$23,268	$21,117
Level 3 Vascular ProceduresAPC 5183	107	97	$12,233	$2,667	$2,405
Level 3 Endovascular ProceduresAPC 5193	85	81	$49,397	$9,663	$8,874
Level 4 Urology and Related ServicesAPC 5374	82	76	$11,447	$2,829	$2,629
Level 5 Urology and Related ServicesAPC 5375	82	72	$12,506	$4,262	$3,918
Level 5 Musculoskeletal ProceduresAPC 5115	65	61	$30,970	$11,805	$10,772
Level 2 Endovascular ProceduresAPC 5192	65	57	$23,901	$4,753	$4,338
Level 1 Laparoscopy and Related ServicesAPC 5361	58	58	$16,903	$4,621	$4,358
Level 4 Vascular ProceduresAPC 5184	57	52	$25,518	$4,557	$3,946
Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341	56	52	$11,356	$2,735	$2,636
Level 3 Urology and Related ServicesAPC 5373	56	34	$12,593	$1,689	$1,516
Level 3 Pacemaker and Similar ProceduresAPC 5223	49	49	$33,954	$9,479	$8,569
Level 2 Pacemaker and Similar ProceduresAPC 5222	45	45	$21,357	$7,370	$6,514
Level 2 Upper GI ProceduresAPC 5302	45	39	$6,433	$1,605	$1,445
Level 4 ENT ProceduresAPC 5164	42	23	$5,625	$1,478	$2,217
Level 4 Endovascular ProceduresAPC 5194	42	40	$78,316	$16,514	$14,606
Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092	40	40	$22,741	$5,095	$4,982
Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091	38	35	$13,301	$3,220	$2,930
Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073	31	30	$14,853	$2,245	$2,141
Level 2 Laparoscopy and Related ServicesAPC 5362	31	31	$31,548	$8,971	$8,164
Level 2 Vascular ProceduresAPC 5182	28	25	$3,959	$1,208	$1,204
Level 2 ICD and Similar ProceduresAPC 5232	25	25	$107,945	$31,814	$29,375
Level 5 Airway EndoscopyAPC 5155	24	24	$54,212	$5,782	$5,183
Level 4 Gynecologic ProceduresAPC 5414	23	22	$10,372	$2,641	$2,389
Level 4 Musculoskeletal ProceduresAPC 5114	21	20	$21,767	$5,756	$5,339
Level 6 Urology and Related ServicesAPC 5376	21	20	$24,121	$7,741	$7,291
Level 6 Musculoskeletal ProceduresAPC 5116	19	19	$30,729	$16,176	$15,763
Level 3 Musculoskeletal ProceduresAPC 5113	18	17	$11,048	$2,430	$2,373
Level 4 Airway EndoscopyAPC 5154	17	17	$26,031	$3,163	$2,833
Level 5 Gynecologic ProceduresAPC 5415	14		$16,317	$4,202	$3,792
Level 5 ENT ProceduresAPC 5165	13	13	$17,363	$4,566	$4,436
Level 3 Lower GI ProceduresAPC 5313	12	12	$8,849	$2,421	$2,176
Level 3 ENT ProceduresAPC 5163	11		$7,205	$1,054	$1,106

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.