Rush University Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Rush University Medical Center, Chicago, IL in 2024, from traditional Medicare claims. Back to the Rush University Medical Center profile, with quality ratings, finances and negotiated rates.
5,255
Medicare inpatient discharges
In 178 published DRGs
2.45
Case mix index
IPPS FY 2027
37%
Surgical stays
73%
Stays with complications
In DRGs with a CC or MCC
7,117
Medicare outpatient services
In 52 service groups
Inpatient stays by major diagnostic category
Circulatory system957 discharges in 28 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 189 | $38,009 | $13,870 | $11,213 | 1.28 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 71 | $175,904 | $53,484 | $51,892 | 4.88 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 58 | $132,242 | $33,978 | $39,011 | 3.24 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 55 | $73,654 | $22,221 | $21,728 | 2.09 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 53 | $129,299 | $38,806 | $38,143 | 3.35 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 40 | $31,185 | $11,060 | $9,200 | 1.07 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 38 | $73,764 | $23,741 | $21,760 | 2.16 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 36 | $22,020 | $7,194 | $6,496 | 0.74 |
| Syncope and collapseMS-DRG 312, medical | 36 | $32,502 | $9,530 | $9,588 | 0.86 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 32 | $50,547 | $11,137 | $14,911 | 1.08 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 30 | $231,947 | $66,656 | $68,424 | 6.25 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 29 | $74,712 | $16,927 | $22,040 | 1.59 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 27 | $187,233 | $58,776 | $55,234 | 5.88 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 25 | $196,983 | $57,494 | $58,110 | 5.06 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 24 | $86,878 | $18,534 | $25,629 | 1.82 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 23 | $264,972 | $81,340 | $78,167 | 7.71 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 23 | $165,512 | $44,216 | $48,826 | 3.90 |
| Other vascular procedures with CCMS-DRG 253, surgical | 22 | $129,768 | $28,447 | $38,282 | 2.55 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 18 | $48,872 | $16,005 | $14,417 | 1.58 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 18 | $50,296 | $12,870 | $14,837 | 1.20 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 18 | $36,457 | $10,056 | $10,755 | 0.97 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 14 | $268,304 | $86,092 | $79,150 | 7.80 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 14 | $78,966 | $24,613 | $23,295 | 2.28 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 14 | $202,437 | $49,108 | $59,719 | 3.46 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 14 | $34,641 | $9,577 | $10,219 | 0.91 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 13 | $159,235 | $43,405 | $46,974 | 4.81 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 12 | $134,139 | $32,763 | $39,571 | 2.87 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 11 | $113,526 | $34,697 | $33,490 | 3.27 |
Musculoskeletal system and connective tissue743 discharges in 27 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 100 | $73,066 | $20,067 | $21,554 | 1.88 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 74 | $111,268 | $37,889 | $32,824 | 3.66 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 57 | $163,432 | $60,335 | $48,212 | 6.12 |
| Medical back problems without MCCMS-DRG 552, medical | 45 | $28,096 | $9,815 | $8,288 | 0.97 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 41 | $89,374 | $28,691 | $26,365 | 2.96 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 38 | $137,549 | $37,277 | $40,577 | 3.49 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 457, surgical | 37 | $211,363 | $64,644 | $62,352 | 6.08 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 31 | $75,398 | $20,438 | $22,242 | 2.04 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 27 | $118,350 | $48,827 | $34,913 | 4.61 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 24 | $122,348 | $30,711 | $36,093 | 3.00 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 23 | $67,457 | $20,332 | $19,900 | 1.97 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 22 | $84,778 | $28,597 | $25,009 | 2.67 |
| Knee procedures without principal diagnosis of infection without cc/mccMS-DRG 489, surgical | 21 | $36,463 | $12,930 | $10,757 | 1.24 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 20 | $32,247 | $10,707 | $9,513 | 1.09 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 18 | $93,794 | $25,860 | $27,669 | 2.40 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 17 | $86,902 | $25,548 | $25,636 | 2.48 |
| Cervical spinal fusion with MCCMS-DRG 471, surgical | 15 | $129,826 | $53,752 | $38,299 | 4.92 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 15 | $90,177 | $22,469 | $26,602 | 2.07 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 15 | $47,947 | $18,778 | $14,144 | 1.82 |
| Combined anterior and posterior spinal fusion with MCCMS-DRG 453, surgical | 14 | $315,023 | $95,002 | $92,932 | 8.86 |
| Knee procedures without principal diagnosis of infection with cc/mccMS-DRG 488, surgical | 14 | $62,628 | $21,989 | $18,475 | 2.11 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 463, surgical | 13 | $337,554 | $70,201 | $99,578 | 5.66 |
| Major hip and knee joint replacement or reattachment of lower extremity with MCC or totaMS-DRG 469, surgical | 13 | $111,224 | $31,864 | $32,811 | 3.33 |
| Connective tissue disorders with MCCMS-DRG 545, medical | 13 | $73,063 | $27,451 | $21,553 | 2.49 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 12 | $79,320 | $22,439 | $23,399 | 2.38 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 12 | $47,241 | $15,753 | $13,936 | 1.49 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 12 | $90,176 | $20,379 | $26,602 | 2.11 |
Nervous system667 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 121 | $75,251 | $19,757 | $22,199 | 2.00 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 66 | $121,816 | $46,945 | $35,936 | 4.42 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 57 | $48,442 | $10,654 | $14,290 | 1.02 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 48 | $39,842 | $14,135 | $11,754 | 1.36 |
| Seizures without MCCMS-DRG 101, medical | 48 | $27,632 | $8,340 | $8,151 | 0.91 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 43 | $66,438 | $24,784 | $19,599 | 2.39 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 42 | $162,584 | $61,761 | $47,962 | 5.67 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 31 | $52,962 | $15,101 | $15,624 | 1.47 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 31 | $39,046 | $10,167 | $11,519 | 1.03 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 21 | $49,744 | $19,858 | $14,675 | 1.79 |
| Seizures with MCCMS-DRG 100, medical | 21 | $81,617 | $22,830 | $24,077 | 1.98 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 19 | $29,541 | $13,115 | $8,715 | 1.32 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 18 | $142,426 | $41,347 | $42,016 | 3.79 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 17 | $32,485 | $9,846 | $9,583 | 1.03 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 16 | $96,237 | $26,311 | $28,390 | 2.43 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 16 | $94,502 | $25,284 | $27,878 | 2.30 |
| Headaches without MCCMS-DRG 103, medical | 16 | $33,103 | $8,941 | $9,765 | 0.84 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 13 | $42,420 | $25,294 | $12,514 | 2.28 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 12 | $44,876 | $22,714 | $13,238 | 2.27 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 11 | $96,969 | $29,375 | $28,606 | 2.95 |
Respiratory system550 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 77 | $44,210 | $16,184 | $13,042 | 1.70 |
| Major chest procedures with CCMS-DRG 164, surgical | 55 | $56,977 | $25,061 | $16,808 | 2.55 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 55 | $33,587 | $13,618 | $9,908 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 52 | $41,125 | $12,974 | $12,132 | 1.23 |
| Major chest procedures with MCCMS-DRG 163, surgical | 41 | $106,894 | $49,306 | $31,534 | 4.71 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 28 | $51,460 | $18,512 | $15,181 | 1.88 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 28 | $70,920 | $19,185 | $20,921 | 1.74 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 24 | $22,665 | $8,225 | $6,686 | 0.82 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 23 | $27,384 | $10,262 | $8,078 | 0.99 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 23 | $88,258 | $30,028 | $26,036 | 2.70 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 20 | $52,955 | $15,578 | $15,622 | 1.40 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 19 | $59,256 | $20,782 | $17,481 | 1.90 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 17 | $58,488 | $19,351 | $17,254 | 1.81 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 16 | $25,020 | $11,646 | $7,381 | 1.10 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 16 | $154,472 | $53,367 | $45,569 | 6.91 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 15 | $30,720 | $7,932 | $9,062 | 0.82 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 14 | $125,148 | $43,197 | $36,919 | 4.06 |
| Other respiratory system o.r. procedures with CCMS-DRG 167, surgical | 14 | $50,738 | $17,051 | $14,968 | 1.82 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 13 | $29,441 | $10,010 | $8,685 | 0.96 |
Digestive system457 discharges in 16 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 47 | $37,617 | $10,009 | $11,097 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 47 | $33,551 | $8,376 | $9,898 | 0.79 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 38 | $47,690 | $17,798 | $14,069 | 1.62 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 37 | $45,669 | $13,099 | $13,472 | 1.28 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 35 | $88,843 | $22,555 | $26,209 | 2.37 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 33 | $33,615 | $9,666 | $9,916 | 0.94 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 32 | $90,395 | $19,745 | $26,667 | 1.79 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 32 | $31,515 | $8,173 | $9,297 | 0.80 |
| Digestive malignancy with MCCMS-DRG 374, medical | 27 | $75,909 | $22,938 | $22,393 | 2.10 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 24 | $29,362 | $9,881 | $8,662 | 1.04 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 22 | $170,555 | $52,258 | $50,314 | 4.52 |
| Digestive malignancy with CCMS-DRG 375, medical | 21 | $49,617 | $12,364 | $14,637 | 1.20 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 20 | $180,420 | $52,113 | $53,224 | 5.08 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 17 | $41,045 | $18,340 | $12,108 | 1.75 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 14 | $106,472 | $27,052 | $31,409 | 2.50 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 11 | $72,487 | $15,363 | $21,384 | 1.45 |
Kidney and urinary tract421 discharges in 12 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 | 69 | $41,989 | $16,864 | $12,387 | 1.65 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 64 | $31,279 | $10,451 | $9,227 | 1.02 |
| Renal failure with CCMS-DRG 683, medical | 59 | $30,697 | $9,020 | $9,056 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 51 | $39,848 | $14,528 | $11,755 | 1.50 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 33 | $26,193 | $8,246 | $7,727 | 0.81 |
| Kidney transplantMS-DRG 652, surgical | 30 | $250,371 | $31,611 | $73,859 | 3.00 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 27 | $32,221 | $12,055 | $9,505 | 1.17 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 22 | $86,346 | $39,200 | $25,472 | 3.70 |
| Major bladder procedures with CCMS-DRG 654, surgical | 20 | $101,154 | $28,680 | $29,840 | 2.74 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 19 | $70,613 | $19,683 | $20,831 | 1.84 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 14 | $76,056 | $23,737 | $22,437 | 2.38 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 13 | $64,671 | $14,672 | $19,078 | 1.35 |
Infectious and parasitic diseases406 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 | 221 | $73,075 | $21,551 | $21,557 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 61 | $175,208 | $50,273 | $51,686 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 44 | $35,523 | $10,518 | $10,479 | 1.03 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 22 | $57,305 | $18,774 | $16,905 | 1.84 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 20 | $83,595 | $22,251 | $24,661 | 2.14 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 15 | $136,696 | $60,982 | $40,325 | 6.96 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 12 | $230,096 | $56,954 | $67,878 | 4.43 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 11 | $23,246 | $10,054 | $6,857 | 1.01 |
Endocrine, nutritional and metabolic251 discharges in 8 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 | 120 | $43,692 | $13,704 | $12,889 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 37 | $22,201 | $7,999 | $6,549 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 25 | $28,296 | $9,181 | $8,347 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 18 | $42,361 | $14,746 | $12,497 | 1.45 |
| O.r. procedures for obesity without cc/mccMS-DRG 621, surgical | 14 | $52,592 | $13,474 | $15,515 | 1.52 |
| Endocrine disorders with MCCMS-DRG 643, medical | 13 | $69,824 | $19,596 | $20,598 | 1.65 |
| Endocrine disorders with CCMS-DRG 644, medical | 13 | $25,775 | $10,324 | $7,604 | 1.06 |
| Adrenal and pituitary procedures with cc/mccMS-DRG 614, surgical | 11 | $113,601 | $21,247 | $33,512 | 2.25 |
Liver, gallbladder and pancreas198 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 39 | $67,067 | $20,361 | $19,785 | 1.92 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 27 | $79,884 | $18,612 | $23,566 | 1.76 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 22 | $94,097 | $28,639 | $27,759 | 2.89 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 22 | $55,807 | $11,082 | $16,463 | 1.09 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 17 | $42,613 | $9,712 | $12,571 | 0.95 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 16 | $24,834 | $9,711 | $7,326 | 1.03 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 15 | $78,394 | $18,252 | $23,126 | 1.63 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 14 | $41,205 | $18,403 | $12,155 | 1.67 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 13 | $168,921 | $60,345 | $49,832 | 5.51 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 13 | $112,987 | $21,435 | $33,331 | 1.83 |
Blood cancers and poorly differentiated neoplasms138 discharges in 7 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 | 37 | $33,432 | $14,176 | $9,863 | 1.21 |
| Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy aMS-DRG 837, medical | 22 | $146,609 | $56,455 | $43,250 | 4.84 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 19 | $128,774 | $34,277 | $37,988 | 3.13 |
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 18 | $51,992 | $28,342 | $15,338 | 2.44 |
| Acute leukemia with MCCMS-DRG 834, medical | 15 | $283,275 | $70,412 | $83,566 | 5.60 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 15 | $59,042 | $14,582 | $17,418 | 1.57 |
| Lymphoma and non-acute leukemia with other procedures with MCCMS-DRG 823, surgical | 12 | $235,789 | $53,217 | $69,558 | 4.50 |
Blood and immune system115 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 | 39 | $33,850 | $9,649 | $9,986 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 31 | $54,830 | $14,600 | $16,175 | 1.40 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 16 | $140,771 | $33,637 | $41,528 | 2.19 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 16 | $48,711 | $13,404 | $14,370 | 1.20 |
| Coagulation disordersMS-DRG 813, medical | 13 | $68,621 | $29,875 | $20,243 | 1.56 |
Other104 discharges in 5 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 | 39 | $169,592 | $52,399 | $50,029 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 22 | $76,267 | $25,491 | $22,499 | 2.49 |
| Single level spinal fusion except cervical without MCCMS-DRG 451 | 19 | $109,892 | $32,199 | $32,418 | |
| Multiple level combined anterior and posterior spinal fusion except cervical with CCMS-DRG 427 | 12 | $232,144 | $79,848 | $68,483 | |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 12 | $137,966 | $33,610 | $40,700 | 3.38 |
Injuries, poisonings and toxic effects of drugs100 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 27 | $75,111 | $20,658 | $22,158 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 25 | $40,583 | $11,372 | $11,972 | 1.03 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 20 | $75,287 | $19,248 | $22,210 | 2.00 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 15 | $128,820 | $38,230 | $38,002 | 3.72 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 13 | $48,633 | $14,091 | $14,347 | 1.60 |
Skin, subcutaneous tissue and breast39 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 39 | $27,040 | $9,039 | $7,977 | 0.88 |
Transplants, ECMO and tracheostomy (pre-MDC)35 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 | 20 | $510,629 | $184,009 | $150,636 | 21.32 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 15 | $279,609 | $116,182 | $82,485 | 14.70 |
Mental diseases and disorders33 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 20 | $55,951 | $17,834 | $16,506 | 1.76 |
| Acute adjustment reaction and psychosocial dysfunctionMS-DRG 880, medical | 13 | $39,630 | $10,319 | $11,691 | 0.95 |
Ear, nose, mouth and throat29 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major head and neck procedures with CCMS-DRG 141, surgical | 18 | $95,751 | $22,418 | $28,247 | 2.07 |
| Other ear, nose, mouth and throat o.r. procedures with CCMS-DRG 144, surgical | 11 | $78,125 | $18,549 | $23,047 | 1.73 |
Factors influencing health status12 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 | 12 | $23,710 | $7,739 | $6,995 | 0.80 |
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 | 834 | 734 | $15,207 | $2,088 | $2,090 |
| Level 2 Urology and Related ServicesAPC 5372 | 772 | 502 | $3,358 | $514 | $502 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 558 | 504 | $8,574 | $1,194 | $1,220 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 538 | 505 | $54,013 | $11,045 | $10,772 |
| Level 3 Urology and Related ServicesAPC 5373 | 399 | 300 | $11,609 | $1,550 | $1,516 |
| Level 2 Upper GI ProceduresAPC 5302 | 357 | 278 | $15,755 | $1,466 | $1,445 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 288 | 255 | $14,649 | $2,194 | $2,141 |
| Level 3 Vascular ProceduresAPC 5183 | 268 | 241 | $20,243 | $2,451 | $2,405 |
| Level 1 Intraocular ProceduresAPC 5491 | 225 | 163 | $18,989 | $1,790 | $1,752 |
| Level 3 Airway EndoscopyAPC 5153 | 179 | 114 | $6,295 | $1,198 | $1,264 |
| Level 1 Endovascular ProceduresAPC 5191 | 167 | 167 | $21,426 | $2,278 | $2,208 |
| Level 4 Urology and Related ServicesAPC 5374 | 153 | 109 | $19,694 | $2,683 | $2,629 |
| Level 4 Vascular ProceduresAPC 5184 | 132 | 104 | $31,077 | $3,452 | $3,946 |
| Level 5 Airway EndoscopyAPC 5155 | 131 | 130 | $38,987 | $5,263 | $5,183 |
| Level 3 Endovascular ProceduresAPC 5193 | 130 | 111 | $54,014 | $9,054 | $8,874 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 118 | 113 | $37,542 | $5,496 | $5,339 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 118 | 116 | $118,645 | $21,043 | $21,117 |
| Level 2 Intraocular ProceduresAPC 5492 | 118 | 101 | $30,332 | $3,151 | $3,116 |
| Level 2 Vascular ProceduresAPC 5182 | 113 | 99 | $8,827 | $1,200 | $1,204 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 101 | 74 | $14,318 | $2,628 | $2,636 |
| Level 2 Endovascular ProceduresAPC 5192 | 94 | 78 | $34,806 | $4,427 | $4,338 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 91 | 91 | $68,653 | $15,910 | $15,763 |
| Level 3 Lower GI ProceduresAPC 5313 | 87 | 85 | $21,400 | $2,152 | $2,176 |
| Level 5 Urology and Related ServicesAPC 5375 | 87 | 84 | $30,741 | $4,010 | $3,918 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 84 | 83 | $22,863 | $2,919 | $2,930 |
| Level 4 Airway EndoscopyAPC 5154 | 76 | 72 | $24,608 | $2,902 | $2,833 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 66 | 66 | $30,576 | $5,050 | $4,982 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 64 | 64 | $34,742 | $4,470 | $4,358 |
| Complex GI ProceduresAPC 5331 | 61 | 47 | $37,747 | $4,343 | $4,263 |
| Level 5 ENT ProceduresAPC 5165 | 57 | 55 | $32,363 | $4,220 | $4,436 |
| Level 4 Endovascular ProceduresAPC 5194 | 54 | 47 | $78,066 | $15,386 | $14,606 |
| Level 7 Radiation TherapyAPC 5627 | 53 | 34 | $25,520 | $5,966 | $6,121 |
| Level 3 Upper GI ProceduresAPC 5303 | 50 | 49 | $28,795 | $2,969 | $2,888 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 49 | 49 | $60,940 | $8,372 | $8,164 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 45 | 45 | $50,686 | $8,735 | $8,569 |
| Level 3 Neurostimulator and Related ProceduresAPC 5463 | 43 | 40 | $49,300 | $5,251 | $11,550 |
| Level 3 ENT ProceduresAPC 5163 | 40 | 27 | $5,551 | $1,020 | $1,106 |
| Level 4 Gynecologic ProceduresAPC 5414 | 37 | 37 | $20,741 | $2,422 | $2,389 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 36 | 32 | $18,458 | $1,811 | $1,780 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 33 | 33 | $110,135 | $19,590 | $18,465 |
| Level 4 ENT ProceduresAPC 5164 | 31 | 31 | $23,767 | $2,447 | $2,217 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 28 | 28 | $104,927 | $27,462 | $26,719 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 24 | 24 | $37,140 | $6,630 | $6,514 |
| Level 6 Urology and Related ServicesAPC 5376 | 19 | 19 | $45,035 | $6,939 | $7,291 |
| Level 1 Nerve ProceduresAPC 5431 | 18 | 18 | $16,725 | $1,413 | $1,407 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 17 | 17 | $137,115 | $30,268 | $29,375 |
| Level 8 Urology and Related ServicesAPC 5378 | 15 | 15 | $90,123 | $16,744 | $17,428 |
| Level 3 Intraocular ProceduresAPC 5493 | 15 | 13 | $42,138 | $4,050 | $4,004 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 11 | 11 | $11,383 | $1,245 | $1,196 |
| Cochlear Implant ProcedureAPC 5166 | 11 | 11 | $95,431 | $30,883 | $29,489 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 11 | 11 | $102,945 | $17,275 | $17,052 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 11 | 11 | $88,516 | $21,233 | $21,011 |
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.