Saint Francis Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Saint Francis Hospital, Tulsa, OK in 2024, from traditional Medicare claims. Back to the Saint Francis Hospital profile, with quality ratings, finances and negotiated rates.
9,148
Medicare inpatient discharges
In 201 published DRGs
2.26
Case mix index
IPPS FY 2027
28%
Surgical stays
79%
Stays with complications
In DRGs with a CC or MCC
6,321
Medicare outpatient services
In 47 service groups
Inpatient stays by major diagnostic category
Circulatory system1,801 discharges in 37 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 324 | $36,700 | $8,232 | $8,845 | 1.28 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 128 | $21,233 | $4,378 | $5,117 | 0.74 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 120 | $37,019 | $7,852 | $8,922 | 1.20 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 108 | $74,601 | $13,490 | $17,979 | 2.16 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 84 | $172,972 | $30,850 | $41,686 | 4.88 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 69 | $87,425 | $20,094 | $21,069 | 3.24 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 63 | $53,884 | $10,044 | $12,986 | 1.59 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 62 | $43,016 | $6,616 | $10,367 | 1.08 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 57 | $69,786 | $14,080 | $16,818 | 2.09 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 56 | $105,464 | $17,822 | $25,417 | 2.87 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 53 | $159,556 | $34,465 | $38,453 | 5.88 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 47 | $24,471 | $6,828 | $5,897 | 1.07 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 42 | $86,930 | $11,042 | $20,950 | 1.82 |
| Syncope and collapseMS-DRG 312, medical | 40 | $24,950 | $5,769 | $6,013 | 0.86 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 37 | $63,740 | $13,332 | $15,361 | 2.28 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 36 | $97,095 | $21,097 | $23,400 | 3.46 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 35 | $220,166 | $41,310 | $53,060 | 7.80 |
| Other vascular procedures with CCMS-DRG 253, surgical | 35 | $110,086 | $16,418 | $26,531 | 2.55 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 34 | $35,674 | $5,577 | $8,597 | 0.91 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 33 | $221,553 | $42,944 | $53,394 | 7.71 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 33 | $125,381 | $19,603 | $30,217 | 3.35 |
| Hypertension without MCCMS-DRG 305, medical | 31 | $22,633 | $4,257 | $5,454 | 0.75 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 28 | $39,023 | $9,682 | $9,404 | 1.58 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 25 | $142,128 | $23,021 | $34,253 | 4.04 |
| Hypertension with MCCMS-DRG 304, medical | 25 | $52,292 | $6,599 | $12,602 | 1.15 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 24 | $30,538 | $5,903 | $7,360 | 0.97 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 22 | $182,619 | $36,167 | $44,011 | 5.06 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 21 | $132,788 | $28,257 | $32,002 | 3.90 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 20 | $165,753 | $32,016 | $39,946 | 4.81 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 19 | $211,272 | $41,872 | $50,917 | 6.25 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 19 | $160,764 | $23,664 | $38,744 | 3.46 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 14 | $56,680 | $11,377 | $13,660 | 1.97 |
| Aortic and heart assist procedures except pulsation balloon with MCCMS-DRG 268, surgical | 12 | $183,422 | $34,710 | $44,205 | 6.85 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 12 | $131,026 | $27,718 | $31,577 | 4.16 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 11 | $132,927 | $21,640 | $32,035 | 3.27 |
| Chest painMS-DRG 313, medical | 11 | $26,185 | $4,988 | $6,310 | 0.72 |
| Coronary intravascular lithotripsy with intraluminal device with MCCMS-DRG 323, surgical | 11 | $152,472 | $28,406 | $36,746 | 4.14 |
Infectious and parasitic diseases1,472 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 | 1,007 | $59,081 | $12,620 | $14,239 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 195 | $143,448 | $32,416 | $34,571 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 123 | $32,909 | $6,073 | $7,931 | 1.03 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 65 | $228,110 | $44,483 | $54,974 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 30 | $64,495 | $11,875 | $15,543 | 2.04 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 23 | $98,996 | $12,729 | $23,858 | 1.84 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 16 | $113,789 | $24,477 | $27,423 | 4.43 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 13 | $33,072 | $7,492 | $7,970 | 1.01 |
Musculoskeletal system and connective tissue1,056 discharges in 31 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 | 142 | $77,520 | $12,961 | $18,682 | 2.07 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 80 | $96,050 | $18,634 | $23,148 | 2.95 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 72 | $109,713 | $19,994 | $26,441 | 3.49 |
| Medical back problems without MCCMS-DRG 552, medical | 69 | $26,352 | $5,724 | $6,351 | 0.97 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 68 | $69,812 | $13,151 | $16,825 | 2.11 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 57 | $66,842 | $11,491 | $16,109 | 1.88 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 53 | $29,698 | $6,831 | $7,157 | 1.09 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 45 | $96,614 | $15,153 | $23,284 | 2.40 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 42 | $54,544 | $12,153 | $13,145 | 2.04 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 41 | $83,270 | $18,130 | $20,068 | 2.99 |
| Medical back problems with MCCMS-DRG 551, medical | 39 | $42,221 | $10,229 | $10,175 | 1.70 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 34 | $122,945 | $21,872 | $29,630 | 3.66 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 34 | $54,816 | $11,805 | $13,211 | 1.82 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 29 | $93,817 | $18,136 | $22,610 | 2.96 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 25 | $98,701 | $17,432 | $23,787 | 3.00 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 25 | $32,567 | $5,623 | $7,849 | 0.90 |
| Other musculoskeletal system and connective tissue o.r. procedures with MCCMS-DRG 515, surgical | 20 | $73,806 | $18,411 | $17,787 | 3.16 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 20 | $63,043 | $12,532 | $15,193 | 1.97 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 19 | $76,123 | $15,615 | $18,346 | 2.48 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 16 | $109,451 | $21,474 | $26,378 | 3.46 |
| Revision of hip or knee replacement with MCCMS-DRG 466, surgical | 12 | $145,199 | $27,385 | $34,993 | 5.19 |
| Soft tissue procedures with CCMS-DRG 501, surgical | 12 | $75,168 | $10,919 | $18,116 | 1.74 |
| Aftercare, musculoskeletal system and connective tissue with MCCMS-DRG 559, medical | 12 | $52,072 | $9,852 | $12,549 | 1.85 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCMS-DRG 562, medical | 12 | $29,164 | $9,370 | $7,028 | 1.52 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 12 | $39,741 | $6,772 | $9,578 | 1.00 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 11 | $98,328 | $15,781 | $23,697 | 2.67 |
| Major hip and knee joint replacement or reattachment of lower extremity with MCC or totaMS-DRG 469, surgical | 11 | $82,136 | $17,944 | $19,795 | 3.33 |
| Cervical spinal fusion with MCCMS-DRG 471, surgical | 11 | $123,726 | $32,612 | $29,818 | 4.92 |
| Biopsies of musculoskeletal system and connective tissue with MCCMS-DRG 477, surgical | 11 | $98,460 | $16,655 | $23,729 | 3.37 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 11 | $21,027 | $4,463 | $5,068 | 0.79 |
| Other musculoskeletal system and connective tissue diagnoses with MCCMS-DRG 564, medical | 11 | $64,405 | $10,312 | $15,522 | 1.56 |
Nervous system1,004 discharges in 27 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 168 | $58,431 | $12,311 | $14,082 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 83 | $31,765 | $6,094 | $7,655 | 1.02 |
| Seizures with MCCMS-DRG 100, medical | 68 | $60,514 | $12,445 | $14,584 | 1.98 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 58 | $167,086 | $29,095 | $40,268 | 4.42 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 53 | $51,303 | $15,348 | $12,364 | 2.39 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 45 | $25,995 | $5,282 | $6,265 | 0.80 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 43 | $51,927 | $14,055 | $12,514 | 2.27 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 40 | $25,012 | $8,752 | $6,028 | 1.36 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 40 | $41,694 | $12,111 | $10,048 | 1.79 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 38 | $30,594 | $8,228 | $7,373 | 1.32 |
| Seizures without MCCMS-DRG 101, medical | 38 | $26,980 | $5,814 | $6,502 | 0.91 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 36 | $56,182 | $14,951 | $13,540 | 2.28 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 33 | $148,250 | $32,571 | $35,728 | 5.67 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 31 | $43,355 | $10,882 | $10,448 | 1.79 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 24 | $29,364 | $6,784 | $7,077 | 1.06 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 24 | $35,256 | $8,006 | $8,497 | 1.36 |
| Extracranial procedures with CCMS-DRG 038, surgical | 22 | $55,779 | $10,698 | $13,443 | 1.60 |
| Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurMS-DRG 041, surgical | 22 | $56,132 | $13,861 | $13,528 | 2.23 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 20 | $24,445 | $6,594 | $5,891 | 1.03 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 20 | $33,139 | $6,395 | $7,986 | 1.03 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 18 | $52,365 | $11,467 | $12,620 | 1.81 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 15 | $30,125 | $9,906 | $7,260 | 1.47 |
| Nontraumatic stupor and coma with MCCMS-DRG 080, medical | 15 | $60,059 | $12,372 | $14,474 | 2.21 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 14 | $51,380 | $6,826 | $12,383 | 1.14 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 12 | $125,586 | $16,920 | $30,266 | 2.95 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 12 | $61,279 | $15,333 | $14,768 | 2.30 |
| Peripheral, cranial nerve and other nervous system procedures with MCCMS-DRG 040, surgical | 12 | $101,825 | $24,576 | $24,540 | 3.85 |
Respiratory system845 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 | 234 | $44,904 | $10,070 | $10,822 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 159 | $38,455 | $7,962 | $9,268 | 1.23 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 98 | $88,179 | $17,641 | $21,251 | 2.70 |
| Major chest procedures with MCCMS-DRG 163, surgical | 42 | $149,712 | $28,665 | $36,081 | 4.71 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 37 | $24,789 | $6,122 | $5,974 | 0.99 |
| Major chest procedures with CCMS-DRG 164, surgical | 31 | $73,066 | $14,690 | $17,609 | 2.55 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 29 | $40,262 | $8,939 | $9,703 | 1.40 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 28 | $56,978 | $11,760 | $13,732 | 1.74 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 27 | $40,532 | $7,619 | $9,768 | 1.33 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 19 | $92,731 | $23,043 | $22,348 | 4.06 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 19 | $181,375 | $39,905 | $43,711 | 6.91 |
| Pleural effusion with MCCMS-DRG 186, medical | 17 | $56,239 | $10,816 | $13,553 | 1.55 |
| Pneumothorax with MCCMS-DRG 199, medical | 17 | $59,901 | $11,236 | $14,436 | 1.77 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 16 | $41,560 | $7,063 | $10,016 | 1.10 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 15 | $24,563 | $5,202 | $5,920 | 0.82 |
| Major chest trauma with CCMS-DRG 184, medical | 15 | $24,521 | $6,200 | $5,910 | 1.05 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 15 | $52,460 | $11,817 | $12,643 | 1.90 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 15 | $61,403 | $11,725 | $14,798 | 1.81 |
| Pneumothorax with CCMS-DRG 200, medical | 12 | $40,313 | $6,190 | $9,715 | 1.08 |
Kidney and urinary tract775 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with MCCMS-DRG 682, medical | 190 | $35,812 | $9,437 | $8,631 | 1.50 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 154 | $46,065 | $10,901 | $11,102 | 1.65 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 113 | $30,816 | $7,353 | $7,427 | 1.17 |
| Renal failure with CCMS-DRG 683, medical | 106 | $23,901 | $5,573 | $5,760 | 0.90 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 52 | $44,682 | $8,599 | $10,768 | 1.35 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 43 | $23,910 | $4,711 | $5,762 | 0.81 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 39 | $110,682 | $25,273 | $26,674 | 3.70 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 35 | $25,676 | $6,805 | $6,188 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 27 | $77,950 | $15,761 | $18,786 | 2.59 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 16 | $62,954 | $11,345 | $15,172 | 1.84 |
Digestive system752 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 107 | $49,889 | $11,679 | $12,023 | 1.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 93 | $26,055 | $6,266 | $6,279 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 72 | $23,150 | $5,023 | $5,579 | 0.79 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 63 | $21,300 | $4,653 | $5,133 | 0.80 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 53 | $122,827 | $27,752 | $29,601 | 4.52 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 44 | $29,497 | $6,740 | $7,109 | 1.04 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 43 | $47,910 | $10,889 | $11,546 | 1.62 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 38 | $74,484 | $14,053 | $17,951 | 2.37 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 38 | $35,133 | $8,470 | $8,467 | 1.28 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 38 | $24,025 | $5,375 | $5,790 | 0.94 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 36 | $46,605 | $10,219 | $11,232 | 1.75 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 22 | $33,837 | $8,737 | $8,155 | 1.45 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 20 | $107,437 | $26,655 | $25,892 | 5.08 |
| Digestive malignancy with MCCMS-DRG 374, medical | 18 | $51,379 | $12,539 | $12,382 | 2.10 |
| Major esophageal disorders with MCCMS-DRG 368, medical | 17 | $68,750 | $12,437 | $16,569 | 1.65 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 15 | $129,324 | $29,091 | $31,167 | 4.28 |
| Digestive malignancy with CCMS-DRG 375, medical | 12 | $30,965 | $7,778 | $7,463 | 1.20 |
| Complicated peptic ulcer with MCCMS-DRG 380, medical | 12 | $62,931 | $11,962 | $15,166 | 1.95 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 11 | $59,399 | $12,676 | $14,315 | 2.11 |
Endocrine, nutritional and metabolic299 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 | 99 | $38,254 | $8,337 | $9,219 | 1.32 |
| Diabetes with MCCMS-DRG 637, medical | 47 | $50,542 | $9,746 | $12,181 | 1.45 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 46 | $24,863 | $4,848 | $5,992 | 0.78 |
| Endocrine disorders with MCCMS-DRG 643, medical | 35 | $54,387 | $10,536 | $13,107 | 1.65 |
| Diabetes with CCMS-DRG 638, medical | 30 | $25,754 | $5,434 | $6,207 | 0.90 |
| Endocrine disorders with CCMS-DRG 644, medical | 17 | $32,103 | $6,579 | $7,737 | 1.06 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 13 | $79,907 | $11,213 | $19,258 | 1.98 |
| Other endocrine, nutritional and metabolic o.r. procedures with MCCMS-DRG 628, surgical | 12 | $117,233 | $24,933 | $28,253 | 4.01 |
Liver, gallbladder and pancreas240 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 | 43 | $59,968 | $12,804 | $14,452 | 1.92 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 32 | $32,814 | $6,686 | $7,908 | 1.09 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 31 | $57,878 | $10,462 | $13,949 | 1.63 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 29 | $42,965 | $11,665 | $10,355 | 1.83 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 22 | $65,599 | $9,348 | $15,809 | 1.76 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 19 | $69,885 | $13,620 | $16,842 | 2.32 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 18 | $52,715 | $10,763 | $12,704 | 1.67 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 17 | $27,117 | $5,770 | $6,535 | 0.86 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 16 | $67,868 | $11,183 | $16,356 | 1.63 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 13 | $25,738 | $6,155 | $6,203 | 0.95 |
Blood and immune system203 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 98 | $37,235 | $9,436 | $8,974 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 47 | $30,109 | $5,887 | $7,256 | 0.90 |
| Coagulation disordersMS-DRG 813, medical | 32 | $37,938 | $9,939 | $9,143 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 14 | $39,850 | $6,963 | $9,604 | 1.20 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 12 | $52,241 | $15,203 | $12,590 | 2.19 |
Mental diseases and disorders175 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 79 | $25,842 | $10,097 | $6,228 | 1.76 |
| PsychosesMS-DRG 885, medical | 73 | $29,312 | $8,655 | $7,064 | 1.37 |
| Acute adjustment reaction and psychosocial dysfunctionMS-DRG 880, medical | 23 | $34,249 | $5,985 | $8,254 | 0.95 |
Injuries, poisonings and toxic effects of drugs154 discharges in 6 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 | 58 | $40,180 | $10,638 | $9,683 | 1.60 |
| Complications of treatment with MCCMS-DRG 919, medical | 37 | $55,386 | $11,371 | $13,348 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 22 | $23,235 | $6,629 | $5,600 | 1.03 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 13 | $122,826 | $20,815 | $29,601 | 3.72 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 12 | $68,550 | $11,809 | $16,521 | 2.00 |
| Poisoning and toxic effects of drugs without MCCMS-DRG 918, medical | 12 | $44,275 | $4,720 | $10,670 | 0.86 |
Other113 discharges in 4 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 | 54 | $129,677 | $28,687 | $31,252 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 26 | $64,580 | $14,695 | $15,564 | 2.49 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 19 | $109,042 | $21,177 | $26,279 | 3.38 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 988, surgical | 14 | $55,551 | $10,810 | $13,388 | 1.70 |
Skin, subcutaneous tissue and breast68 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis with MCCMS-DRG 602, medical | 34 | $44,554 | $9,363 | $10,738 | 1.49 |
| Cellulitis without MCCMS-DRG 603, medical | 23 | $26,324 | $5,810 | $6,344 | 0.88 |
| Other skin, subcutaneous tissue and breast procedures with CCMS-DRG 580, surgical | 11 | $42,452 | $11,305 | $10,231 | 1.75 |
Blood cancers and poorly differentiated neoplasms52 discharges in 3 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 | 25 | $50,431 | $6,576 | $12,154 | 1.21 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 16 | $75,426 | $18,201 | $18,178 | 3.13 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 11 | $47,298 | $9,409 | $11,399 | 1.57 |
Multiple significant trauma49 discharges in 3 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 | 23 | $117,417 | $21,851 | $28,298 | 3.88 |
| Other multiple significant trauma with MCCMS-DRG 963, medical | 15 | $64,939 | $18,042 | $15,650 | 2.73 |
| Other o.r. procedures for multiple significant trauma with MCCMS-DRG 957, surgical | 11 | $264,496 | $47,975 | $63,744 | 7.23 |
Transplants, ECMO and tracheostomy (pre-MDC)41 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 | 24 | $581,223 | $127,087 | $140,075 | 21.32 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 17 | $284,903 | $56,120 | $68,662 | 14.70 |
Alcohol and drug use22 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 with MCCMS-DRG 896, medical | 22 | $38,571 | $11,545 | $9,296 | 1.78 |
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 | $18,669 | $4,054 | $4,499 | 0.80 |
Male reproductive system12 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major male pelvic procedures with cc/mccMS-DRG 707, surgical | 12 | $75,529 | $10,698 | $18,202 | 1.96 |
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 | 935 | 859 | $17,581 | $1,831 | $2,090 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 455 | 435 | $9,802 | $1,072 | $1,220 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 442 | 418 | $54,351 | $9,400 | $10,772 |
| Level 1 Endovascular ProceduresAPC 5191 | 317 | 317 | $23,036 | $1,933 | $2,208 |
| Level 3 Vascular ProceduresAPC 5183 | 316 | 292 | $18,840 | $2,149 | $2,405 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 230 | 224 | $88,961 | $17,944 | $21,117 |
| Level 1 Intraocular ProceduresAPC 5491 | 225 | 129 | $11,263 | $1,521 | $1,752 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 209 | 204 | $38,678 | $4,665 | $5,339 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 194 | 185 | $21,708 | $1,892 | $2,141 |
| Level 1 Nerve ProceduresAPC 5431 | 184 | 157 | $9,119 | $1,273 | $1,407 |
| Level 5 Urology and Related ServicesAPC 5375 | 176 | 171 | $29,125 | $3,419 | $3,918 |
| Level 4 Urology and Related ServicesAPC 5374 | 174 | 148 | $18,959 | $2,304 | $2,629 |
| Level 2 Upper GI ProceduresAPC 5302 | 171 | 153 | $8,362 | $1,270 | $1,445 |
| Level 3 Urology and Related ServicesAPC 5373 | 162 | 109 | $11,077 | $1,359 | $1,516 |
| Level 2 Vascular ProceduresAPC 5182 | 151 | 140 | $8,205 | $1,066 | $1,204 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 147 | 140 | $12,416 | $1,070 | $1,196 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 141 | 138 | $62,691 | $13,960 | $15,763 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 133 | 131 | $31,974 | $3,841 | $4,358 |
| Level 3 Endovascular ProceduresAPC 5193 | 125 | 112 | $59,931 | $7,457 | $8,874 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 117 | 116 | $36,115 | $4,374 | $4,982 |
| Level 2 Endovascular ProceduresAPC 5192 | 109 | 102 | $29,389 | $3,796 | $4,338 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 106 | 104 | $22,745 | $2,149 | $2,373 |
| Level 5 Airway EndoscopyAPC 5155 | 92 | 89 | $29,563 | $4,529 | $5,183 |
| Level 4 Airway EndoscopyAPC 5154 | 90 | 86 | $16,535 | $2,506 | $2,833 |
| Level 5 ENT ProceduresAPC 5165 | 87 | 82 | $27,628 | $3,895 | $4,436 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 87 | 87 | $56,316 | $7,101 | $8,164 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 80 | 80 | $45,792 | $7,332 | $8,569 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 63 | 60 | $113,832 | $24,766 | $29,375 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 60 | 57 | $24,450 | $2,536 | $2,930 |
| Level 3 Airway EndoscopyAPC 5153 | 55 | 53 | $6,851 | $1,126 | $1,264 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 52 | 52 | $27,110 | $5,745 | $6,514 |
| Level 4 Vascular ProceduresAPC 5184 | 47 | 43 | $38,625 | $3,560 | $3,946 |
| Level 4 Endovascular ProceduresAPC 5194 | 45 | 45 | $89,651 | $13,230 | $14,606 |
| Implantation Wireless PA Pressure MonitorAPC 5200 | 43 | 43 | $108,863 | $22,981 | $26,955 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 38 | 34 | $19,971 | $2,336 | $2,636 |
| Level 4 ENT ProceduresAPC 5164 | 31 | 30 | $14,246 | $2,108 | $2,217 |
| Level 3 Lower GI ProceduresAPC 5313 | 31 | 30 | $15,049 | $1,869 | $2,176 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 30 | 30 | $75,981 | $14,468 | $17,052 |
| Level 4 Gynecologic ProceduresAPC 5414 | 26 | 26 | $13,722 | $2,073 | $2,389 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 26 | 26 | $68,245 | $16,247 | $18,465 |
| Cochlear Implant ProcedureAPC 5166 | 25 | 25 | $95,870 | $25,691 | $29,489 |
| Level 6 Gynecologic ProceduresAPC 5416 | 22 | 21 | $32,967 | $5,113 | $5,836 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 19 | 19 | $82,661 | $23,364 | $26,719 |
| Level 5 Gynecologic ProceduresAPC 5415 | 17 | 17 | $24,049 | $3,355 | $3,792 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 14 | 14 | $86,856 | $18,336 | $21,011 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 11 | 11 | $14,585 | $4,207 | $4,524 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 11 | 11 | $16,910 | $1,581 | $1,780 |
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.