Silver Cross Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Silver Cross Hospital, New Lenox, IL in 2024, from traditional Medicare claims. Back to the Silver Cross Hospital profile, with quality ratings, finances and negotiated rates.
5,659
Medicare inpatient discharges
In 156 published DRGs
1.79
Case mix index
IPPS FY 2027
19%
Surgical stays
75%
Stays with complications
In DRGs with a CC or MCC
5,044
Medicare outpatient services
In 38 service groups
Inpatient stays by major diagnostic category
Circulatory system1,262 discharges in 31 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 381 | $22,848 | $8,065 | $8,134 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 106 | $27,919 | $9,930 | $9,939 | 1.59 |
| Syncope and collapseMS-DRG 312, medical | 70 | $22,631 | $5,384 | $8,057 | 0.86 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 52 | $73,711 | $10,802 | $26,241 | 1.82 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 44 | $45,093 | $13,769 | $16,053 | 2.16 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 44 | $17,151 | $4,315 | $6,106 | 0.74 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 41 | $21,694 | $7,397 | $7,723 | 1.20 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 38 | $115,646 | $39,242 | $41,170 | 5.88 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 32 | $79,786 | $25,617 | $28,404 | 4.04 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 32 | $33,846 | $13,661 | $12,049 | 2.09 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 29 | $22,132 | $5,237 | $7,879 | 0.91 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 27 | $71,106 | $21,727 | $25,314 | 3.35 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 27 | $91,114 | $19,642 | $32,437 | 2.87 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 26 | $56,968 | $23,273 | $20,281 | 3.46 |
| Hypertension without MCCMS-DRG 305, medical | 26 | $24,769 | $4,377 | $8,818 | 0.75 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 25 | $25,360 | $10,040 | $9,028 | 1.58 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 24 | $137,758 | $31,801 | $49,042 | 4.88 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 24 | $28,142 | $6,656 | $10,019 | 1.08 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 22 | $14,359 | $2,413 | $5,112 | 0.55 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 20 | $111,253 | $31,536 | $39,606 | 5.20 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 20 | $118,832 | $34,599 | $42,304 | 5.06 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 18 | $186,869 | $55,531 | $66,525 | 7.80 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 18 | $40,259 | $20,218 | $14,332 | 3.27 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 18 | $149,427 | $43,109 | $53,196 | 6.25 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 18 | $21,041 | $6,363 | $7,491 | 1.07 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 16 | $50,642 | $14,803 | $18,029 | 2.28 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 15 | $179,752 | $49,178 | $63,992 | 7.71 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 14 | $50,096 | $21,742 | $17,834 | 3.46 |
| Heart failure and shock with CCMS-DRG 292, medical | 12 | $16,612 | $4,508 | $5,914 | 0.86 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 12 | $19,333 | $5,980 | $6,882 | 0.97 |
| Other vascular procedures with CCMS-DRG 253, surgical | 11 | $67,898 | $15,889 | $24,172 | 2.55 |
Respiratory system805 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 246 | $30,382 | $10,649 | $10,816 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 133 | $23,293 | $7,846 | $8,292 | 1.33 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 80 | $24,170 | $6,472 | $8,604 | 1.10 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 43 | $18,244 | $5,306 | $6,495 | 0.99 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 42 | $22,077 | $7,561 | $7,859 | 1.23 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 39 | $16,063 | $4,230 | $5,718 | 0.82 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 27 | $28,609 | $9,080 | $10,185 | 1.40 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 24 | $46,322 | $11,975 | $16,490 | 1.74 |
| Major chest procedures with MCCMS-DRG 163, surgical | 20 | $77,802 | $28,712 | $27,697 | 4.71 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 20 | $18,366 | $4,621 | $6,538 | 0.85 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 17 | $31,341 | $11,835 | $11,157 | 1.90 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 16 | $22,705 | $5,398 | $8,083 | 0.96 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 15 | $18,659 | $5,241 | $6,643 | 0.82 |
| Major chest procedures with CCMS-DRG 164, surgical | 14 | $54,777 | $16,785 | $19,501 | 2.55 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 12 | $28,399 | $11,297 | $10,110 | 1.88 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 12 | $116,227 | $41,108 | $41,377 | 6.91 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 12 | $39,769 | $14,497 | $14,158 | 2.70 |
| Respiratory infections and inflammations without cc/mccMS-DRG 179, medical | 11 | $15,497 | $4,383 | $5,517 | 0.76 |
| Major chest trauma with CCMS-DRG 184, medical | 11 | $24,481 | $5,384 | $8,715 | 1.05 |
| Pneumothorax with CCMS-DRG 200, medical | 11 | $19,197 | $6,429 | $6,834 | 1.08 |
Digestive system667 discharges in 20 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 | 98 | $16,708 | $4,510 | $5,948 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 83 | $23,659 | $5,938 | $8,423 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 61 | $35,779 | $11,327 | $12,737 | 1.79 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 48 | $19,361 | $4,455 | $6,893 | 0.80 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 43 | $39,333 | $13,577 | $14,003 | 2.37 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 40 | $26,402 | $8,156 | $9,399 | 1.28 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 39 | $20,097 | $5,671 | $7,155 | 0.94 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 35 | $33,140 | $10,683 | $11,798 | 1.62 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 33 | $74,424 | $28,939 | $26,495 | 4.52 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 26 | $21,166 | $6,271 | $7,535 | 1.04 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 24 | $33,094 | $11,532 | $11,782 | 1.75 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 23 | $14,034 | $2,753 | $4,996 | 0.56 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 19 | $35,340 | $10,299 | $12,581 | 1.67 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 19 | $25,308 | $9,239 | $9,010 | 1.45 |
| Digestive malignancy with MCCMS-DRG 374, medical | 16 | $33,152 | $13,275 | $11,802 | 2.10 |
| Major esophageal disorders with MCCMS-DRG 368, medical | 13 | $23,098 | $10,983 | $8,223 | 1.65 |
| Complicated peptic ulcer with CCMS-DRG 381, medical | 13 | $28,328 | $6,067 | $10,085 | 1.07 |
| Digestive malignancy with CCMS-DRG 375, medical | 12 | $33,116 | $7,439 | $11,789 | 1.20 |
| Inflammatory bowel disease with CCMS-DRG 386, medical | 11 | $20,597 | $4,814 | $7,333 | 0.97 |
| Appendix procedures with CCMS-DRG 398, surgical | 11 | $43,851 | $7,838 | $15,611 | 1.51 |
Kidney and urinary tract627 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 134 | $16,159 | $4,745 | $5,753 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 132 | $20,044 | $7,202 | $7,136 | 1.17 |
| Renal failure with CCMS-DRG 683, medical | 100 | $16,483 | $5,171 | $5,868 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 94 | $24,379 | $10,338 | $8,679 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 90 | $26,366 | $9,227 | $9,386 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 44 | $14,612 | $6,323 | $5,202 | 1.02 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 21 | $47,297 | $24,370 | $16,838 | 3.70 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 12 | $49,235 | $17,261 | $17,528 | 2.59 |
Infectious and parasitic diseases595 discharges in 6 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 | 388 | $35,072 | $12,441 | $12,486 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 84 | $21,582 | $5,791 | $7,683 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 81 | $85,307 | $31,559 | $30,369 | 5.00 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 16 | $40,666 | $12,421 | $14,477 | 2.04 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 15 | $23,282 | $4,698 | $8,288 | 1.01 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 11 | $34,180 | $10,900 | $12,168 | 1.84 |
Musculoskeletal system and connective tissue431 discharges in 17 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 | 57 | $43,342 | $12,510 | $15,430 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 57 | $21,532 | $5,449 | $7,665 | 0.97 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 49 | $42,336 | $13,171 | $15,072 | 2.11 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 37 | $15,998 | $5,273 | $5,695 | 0.90 |
| Medical back problems with MCCMS-DRG 551, medical | 33 | $31,170 | $10,331 | $11,097 | 1.70 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 26 | $55,994 | $19,033 | $19,934 | 2.95 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 25 | $56,069 | $12,480 | $19,961 | 2.04 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 23 | $13,689 | $4,387 | $4,873 | 0.79 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 17 | $25,379 | $6,634 | $9,035 | 1.09 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 16 | $69,807 | $21,062 | $24,851 | 3.49 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 14 | $52,082 | $12,078 | $18,541 | 1.88 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 14 | $37,135 | $10,199 | $13,220 | 1.59 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 14 | $56,620 | $15,502 | $20,157 | 2.40 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 14 | $20,238 | $5,983 | $7,205 | 1.00 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 13 | $57,357 | $18,850 | $20,419 | 2.99 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 11 | $60,313 | $15,148 | $21,471 | 2.48 |
| Other musculoskeletal system and connective tissue diagnoses with MCCMS-DRG 564, medical | 11 | $25,948 | $9,907 | $9,237 | 1.56 |
Nervous system419 discharges in 18 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 | 76 | $27,833 | $5,792 | $9,909 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 61 | $39,140 | $12,686 | $13,934 | 2.00 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 32 | $18,876 | $7,769 | $6,720 | 1.36 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 30 | $25,257 | $4,601 | $8,992 | 0.80 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 24 | $22,128 | $3,721 | $7,878 | 0.69 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 23 | $25,094 | $6,881 | $8,933 | 1.14 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 19 | $100,821 | $28,379 | $35,892 | 4.42 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 19 | $29,098 | $13,993 | $10,359 | 2.39 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 17 | $102,333 | $38,221 | $36,430 | 5.67 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 16 | $19,501 | $5,633 | $6,942 | 1.03 |
| Seizures with MCCMS-DRG 100, medical | 16 | $31,620 | $12,414 | $11,257 | 1.98 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 14 | $24,084 | $11,360 | $8,574 | 1.79 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 13 | $44,426 | $8,910 | $15,816 | 1.47 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 13 | $25,092 | $8,990 | $8,933 | 1.36 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 062, medical | 12 | $47,108 | $10,122 | $16,771 | 1.87 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 12 | $30,859 | $14,699 | $10,986 | 2.27 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 11 | $21,692 | $5,817 | $7,722 | 1.03 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 11 | $47,418 | $14,998 | $16,881 | 2.28 |
Endocrine, nutritional and metabolic255 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 | 61 | $24,337 | $8,532 | $8,664 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 56 | $16,873 | $4,456 | $6,007 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 55 | $17,491 | $5,232 | $6,227 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 33 | $30,312 | $7,848 | $10,791 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 21 | $22,966 | $10,376 | $8,176 | 1.65 |
| Endocrine disorders with CCMS-DRG 644, medical | 16 | $18,015 | $5,015 | $6,413 | 1.06 |
| O.r. procedures for obesity without cc/mccMS-DRG 621, surgical | 13 | $32,026 | $7,920 | $11,401 | 1.52 |
Liver, gallbladder and pancreas154 discharges in 10 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 | 24 | $40,496 | $10,448 | $14,417 | 1.63 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 23 | $28,757 | $6,342 | $10,238 | 1.09 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 17 | $48,933 | $15,369 | $17,420 | 2.32 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 14 | $39,087 | $10,963 | $13,915 | 1.92 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 14 | $32,340 | $8,516 | $11,513 | 1.63 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 13 | $49,121 | $11,118 | $17,487 | 1.76 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 13 | $20,469 | $5,291 | $7,287 | 0.86 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 13 | $32,252 | $12,586 | $11,482 | 1.83 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 12 | $27,668 | $10,458 | $9,850 | 1.67 |
| Malignancy of hepatobiliary system or pancreas with CCMS-DRG 436, medical | 11 | $32,048 | $6,622 | $11,409 | 1.10 |
Skin, subcutaneous tissue and breast132 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 82 | $14,121 | $4,838 | $5,027 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 37 | $26,176 | $8,967 | $9,319 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 13 | $19,560 | $5,638 | $6,963 | 0.91 |
Blood and immune system105 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 38 | $29,762 | $8,824 | $10,595 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 31 | $20,173 | $5,545 | $7,182 | 0.90 |
| Coagulation disordersMS-DRG 813, medical | 23 | $32,279 | $9,612 | $11,491 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 13 | $47,628 | $13,189 | $16,955 | 2.19 |
Injuries, poisonings and toxic effects of drugs53 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 15 | $34,372 | $11,862 | $12,236 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 15 | $19,005 | $6,206 | $6,766 | 1.03 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 12 | $62,496 | $24,350 | $22,249 | 3.72 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 11 | $30,567 | $10,123 | $10,882 | 1.60 |
Other43 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 | 27 | $81,938 | $27,432 | $29,170 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 16 | $40,612 | $13,798 | $14,458 | 2.49 |
Factors influencing health status37 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 24 | $16,571 | $4,865 | $5,899 | 0.80 |
| Signs and symptoms with MCCMS-DRG 947, medical | 13 | $17,247 | $8,331 | $6,140 | 1.25 |
Mental diseases and disorders26 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 | 26 | $20,317 | $10,253 | $7,233 | 1.76 |
Ear, nose, mouth and throat22 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 22 | $19,138 | $4,114 | $6,813 | 0.74 |
Alcohol and drug use15 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 | 15 | $43,893 | $11,420 | $15,626 | 1.78 |
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 | $62,108 | $23,529 | $22,110 | 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 |
|---|---|---|---|---|---|
| Comprehensive Observation ServicesAPC 8011 | 1,336 | 1,218 | $14,023 | $2,067 | $2,090 |
| Level 2 Upper GI ProceduresAPC 5302 | 508 | 444 | $5,605 | $1,420 | $1,445 |
| Level 1 Endovascular ProceduresAPC 5191 | 476 | 473 | $17,493 | $2,200 | $2,208 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 299 | 288 | $33,006 | $10,707 | $10,772 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 282 | 256 | $7,247 | $1,199 | $1,220 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 217 | 214 | $15,875 | $4,284 | $4,358 |
| Level 3 Endovascular ProceduresAPC 5193 | 190 | 173 | $52,037 | $8,755 | $8,874 |
| Level 3 Vascular ProceduresAPC 5183 | 186 | 180 | $12,415 | $2,423 | $2,405 |
| Level 5 Urology and Related ServicesAPC 5375 | 106 | 104 | $17,773 | $3,914 | $3,918 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 97 | 96 | $26,228 | $8,049 | $8,164 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 93 | 93 | $63,170 | $20,409 | $21,117 |
| Level 3 Upper GI ProceduresAPC 5303 | 92 | 88 | $7,710 | $2,801 | $2,888 |
| Level 4 Urology and Related ServicesAPC 5374 | 92 | 87 | $12,208 | $2,551 | $2,629 |
| Level 2 Vascular ProceduresAPC 5182 | 84 | 80 | $5,964 | $1,204 | $1,204 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 80 | 75 | $12,019 | $2,148 | $2,141 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 79 | 73 | $14,164 | $2,846 | $2,930 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 78 | 73 | $25,416 | $5,342 | $5,339 |
| Complex GI ProceduresAPC 5331 | 68 | 56 | $11,060 | $4,121 | $4,263 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 58 | 58 | $47,579 | $15,746 | $15,763 |
| Level 4 Airway EndoscopyAPC 5154 | 55 | 51 | $11,201 | $2,833 | $2,833 |
| Level 1 Intraocular ProceduresAPC 5491 | 47 | 31 | $8,552 | $1,760 | $1,752 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 46 | 41 | $12,520 | $2,442 | $2,636 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 44 | 43 | $29,030 | $4,821 | $4,982 |
| Level 5 Airway EndoscopyAPC 5155 | 44 | 43 | $17,007 | $5,177 | $5,183 |
| Level 3 Airway EndoscopyAPC 5153 | 42 | 41 | $6,345 | $1,284 | $1,264 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 40 | 40 | $26,163 | $8,285 | $8,569 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 37 | 35 | $11,618 | $2,443 | $2,373 |
| Level 2 Endovascular ProceduresAPC 5192 | 36 | 35 | $25,739 | $4,318 | $4,338 |
| Level 4 Endovascular ProceduresAPC 5194 | 35 | 34 | $75,819 | $14,981 | $14,606 |
| Level 3 Urology and Related ServicesAPC 5373 | 34 | 32 | $9,738 | $1,541 | $1,516 |
| Level 3 Lower GI ProceduresAPC 5313 | 30 | 28 | $10,513 | $2,142 | $2,176 |
| Level 4 Gynecologic ProceduresAPC 5414 | 30 | 30 | $12,018 | $2,286 | $2,389 |
| Level 4 Vascular ProceduresAPC 5184 | 25 | 24 | $22,889 | $3,989 | $3,946 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 22 | 21 | $6,853 | $1,161 | $1,196 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 17 | 17 | $64,168 | $29,509 | $29,375 |
| Level 5 ENT ProceduresAPC 5165 | 15 | 15 | $16,115 | $4,430 | $4,436 |
| Level 2 Intraocular ProceduresAPC 5492 | 13 | 13 | $12,193 | $3,076 | $3,116 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 11 | 11 | $37,926 | $16,825 | $17,052 |
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.