Spartanburg Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Spartanburg Medical Center, Spartanburg, SC in 2024, from traditional Medicare claims. Back to the Spartanburg Medical Center profile, with quality ratings, finances and negotiated rates.
6,005
Medicare inpatient discharges
In 166 published DRGs
2.00
Case mix index
IPPS FY 2027
27%
Surgical stays
66%
Stays with complications
In DRGs with a CC or MCC
7,845
Medicare outpatient services
In 47 service groups
Inpatient stays by major diagnostic category
Circulatory system1,435 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 | 315 | $41,978 | $9,877 | $10,075 | 1.28 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 95 | $119,476 | $12,485 | $28,674 | 1.82 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 83 | $31,814 | $5,228 | $7,635 | 0.74 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 73 | $255,092 | $39,768 | $61,222 | 4.88 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 72 | $131,053 | $24,805 | $31,453 | 3.24 |
| Syncope and collapseMS-DRG 312, medical | 67 | $31,640 | $6,303 | $7,594 | 0.86 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 53 | $61,013 | $9,511 | $14,643 | 1.20 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 50 | $62,428 | $11,899 | $14,983 | 1.59 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 50 | $158,940 | $22,088 | $38,146 | 2.87 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 43 | $21,512 | $4,113 | $5,163 | 0.55 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 38 | $46,818 | $6,573 | $11,236 | 0.91 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 35 | $103,933 | $18,424 | $24,944 | 2.28 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 32 | $281,706 | $52,833 | $67,609 | 6.25 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 29 | $57,862 | $6,795 | $13,887 | 1.08 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 28 | $250,998 | $37,260 | $60,239 | 5.20 |
| Hypertension without MCCMS-DRG 305, medical | 27 | $28,004 | $5,551 | $6,721 | 0.75 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 26 | $64,555 | $16,472 | $15,493 | 2.09 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 24 | $185,063 | $33,571 | $44,415 | 4.04 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 23 | $161,193 | $28,061 | $38,686 | 3.35 |
| Other vascular procedures with CCMS-DRG 253, surgical | 20 | $118,536 | $18,580 | $28,449 | 2.55 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 20 | $42,267 | $12,294 | $10,144 | 1.58 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 19 | $179,133 | $42,097 | $42,992 | 5.06 |
| Hypertension with MCCMS-DRG 304, medical | 19 | $35,138 | $9,321 | $8,433 | 1.15 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 18 | $38,707 | $7,831 | $9,290 | 1.07 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 16 | $77,534 | $14,356 | $18,608 | 1.83 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 16 | $74,795 | $17,495 | $17,951 | 2.16 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 16 | $40,082 | $6,819 | $9,620 | 0.97 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 15 | $140,584 | $26,189 | $33,740 | 3.46 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 15 | $41,810 | $5,059 | $10,034 | 0.72 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 14 | $222,883 | $38,632 | $53,492 | 5.24 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 14 | $148,592 | $22,284 | $35,662 | 2.97 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 13 | $150,600 | $34,521 | $36,144 | 4.16 |
| Chest painMS-DRG 313, medical | 13 | $28,168 | $5,253 | $6,760 | 0.72 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 11 | $292,678 | $64,358 | $70,243 | 7.80 |
| Cardiac defibrillator implant without MCCMS-DRG 277, surgical | 11 | $200,739 | $39,307 | $48,177 | 4.78 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 11 | $82,773 | $17,686 | $19,866 | 1.97 |
| Heart failure and shock with CCMS-DRG 292, medical | 11 | $29,924 | $6,433 | $7,182 | 0.86 |
Respiratory system952 discharges in 22 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 158 | $48,215 | $10,104 | $11,572 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 146 | $47,681 | $12,694 | $11,443 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 108 | $43,365 | $9,024 | $10,408 | 1.23 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 96 | $31,334 | $5,834 | $7,520 | 0.82 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 46 | $79,266 | $21,372 | $19,024 | 2.70 |
| Major chest procedures with CCMS-DRG 164, surgical | 43 | $153,678 | $18,552 | $36,883 | 2.55 |
| Major chest procedures with MCCMS-DRG 163, surgical | 41 | $229,408 | $34,923 | $55,058 | 4.71 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 40 | $30,696 | $6,902 | $7,367 | 0.99 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 37 | $47,331 | $7,958 | $11,359 | 1.10 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 36 | $52,507 | $10,607 | $12,602 | 1.40 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 23 | $28,967 | $6,030 | $6,952 | 0.85 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 21 | $32,534 | $5,959 | $7,808 | 0.82 |
| Major chest trauma with CCMS-DRG 184, medical | 21 | $40,136 | $7,785 | $9,633 | 1.05 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 19 | $88,427 | $13,959 | $21,222 | 1.88 |
| Simple pneumonia and pleurisy without cc/mccMS-DRG 195, medical | 19 | $31,564 | $4,664 | $7,575 | 0.63 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 18 | $111,932 | $33,308 | $26,864 | 4.06 |
| Pneumothorax with CCMS-DRG 200, medical | 17 | $47,452 | $7,986 | $11,389 | 1.08 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 15 | $29,767 | $6,916 | $7,144 | 0.96 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 13 | $54,109 | $13,186 | $12,986 | 1.74 |
| Other respiratory system o.r. procedures with CCMS-DRG 167, surgical | 12 | $76,800 | $14,331 | $18,432 | 1.82 |
| Respiratory neoplasms with CCMS-DRG 181, medical | 12 | $38,333 | $7,920 | $9,200 | 1.10 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 11 | $135,021 | $52,404 | $32,405 | 6.91 |
Kidney and urinary tract648 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 145 | $28,648 | $5,858 | $6,876 | 0.81 |
| Renal failure with CCMS-DRG 683, medical | 113 | $32,467 | $6,545 | $7,792 | 0.90 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 98 | $35,162 | $8,630 | $8,439 | 1.17 |
| Renal failure with MCCMS-DRG 682, medical | 81 | $54,804 | $11,620 | $13,153 | 1.50 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 68 | $55,144 | $13,129 | $13,235 | 1.65 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 49 | $47,586 | $9,373 | $11,421 | 1.35 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 39 | $32,611 | $7,664 | $7,827 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 15 | $86,214 | $19,935 | $20,691 | 2.59 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 15 | $143,066 | $31,589 | $34,336 | 3.70 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 13 | $90,311 | $19,190 | $21,675 | 2.38 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 12 | $37,904 | $7,414 | $9,097 | 1.05 |
Musculoskeletal system and connective tissue563 discharges in 16 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 | 110 | $75,769 | $16,118 | $18,185 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 76 | $75,469 | $16,475 | $18,113 | 2.11 |
| Medical back problems without MCCMS-DRG 552, medical | 62 | $39,427 | $6,936 | $9,462 | 0.97 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 42 | $37,260 | $6,378 | $8,942 | 0.90 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 38 | $89,606 | $19,015 | $21,505 | 2.40 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 36 | $75,792 | $14,533 | $18,190 | 1.88 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 32 | $109,616 | $24,759 | $26,308 | 2.95 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 31 | $28,281 | $5,606 | $6,787 | 0.79 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 27 | $60,681 | $10,474 | $14,564 | 1.59 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 22 | $104,214 | $27,617 | $25,011 | 3.49 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 17 | $139,636 | $26,474 | $33,513 | 3.66 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 16 | $79,970 | $20,657 | $19,193 | 2.67 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 15 | $28,543 | $8,243 | $6,850 | 1.09 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 14 | $91,211 | $13,731 | $21,891 | 1.87 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 13 | $148,538 | $32,157 | $35,649 | 4.61 |
| Fractures of hip and pelvis with MCCMS-DRG 535, medical | 12 | $60,161 | $10,393 | $14,439 | 1.30 |
Nervous system558 discharges in 22 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 85 | $61,352 | $15,252 | $14,724 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 85 | $40,672 | $7,166 | $9,761 | 1.02 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 42 | $46,936 | $10,019 | $11,265 | 1.36 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 27 | $79,116 | $13,862 | $18,988 | 1.79 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 26 | $39,708 | $7,952 | $9,530 | 1.06 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 23 | $30,899 | $4,952 | $7,416 | 0.69 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 23 | $49,641 | $10,027 | $11,914 | 1.36 |
| Seizures with MCCMS-DRG 100, medical | 23 | $81,365 | $15,283 | $19,528 | 1.98 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 22 | $38,990 | $7,698 | $9,358 | 1.03 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 20 | $139,444 | $37,167 | $33,467 | 4.42 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 20 | $68,016 | $13,770 | $16,324 | 1.79 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 19 | $39,431 | $10,262 | $9,463 | 1.32 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 18 | $57,280 | $8,449 | $13,747 | 1.14 |
| Seizures without MCCMS-DRG 101, medical | 18 | $38,119 | $6,271 | $9,148 | 0.91 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 17 | $64,633 | $13,433 | $15,512 | 1.81 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 17 | $36,651 | $5,791 | $8,796 | 0.80 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 14 | $48,869 | $10,440 | $11,729 | 1.47 |
| Traumatic stupor and coma >1 hour without cc/mccMS-DRG 084, medical | 14 | $28,235 | $6,678 | $6,776 | 0.92 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 062, medical | 12 | $68,721 | $14,480 | $16,493 | 1.87 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 11 | $80,891 | $18,380 | $19,414 | 2.30 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 11 | $44,738 | $7,783 | $10,737 | 1.03 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 11 | $74,921 | $18,650 | $17,981 | 2.27 |
Digestive system517 discharges in 16 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 102 | $37,286 | $7,269 | $8,949 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 89 | $31,472 | $5,379 | $7,553 | 0.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 42 | $97,235 | $18,092 | $23,336 | 2.37 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 41 | $61,777 | $14,992 | $14,826 | 1.79 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 35 | $174,268 | $33,681 | $41,824 | 4.52 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 29 | $68,402 | $11,575 | $16,417 | 1.67 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 29 | $26,522 | $5,579 | $6,365 | 0.80 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 28 | $20,342 | $4,041 | $4,882 | 0.56 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 24 | $33,172 | $7,306 | $7,961 | 0.94 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 17 | $30,376 | $7,734 | $7,290 | 1.04 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 16 | $51,954 | $13,359 | $12,469 | 1.62 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 15 | $64,232 | $10,627 | $15,416 | 1.28 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 14 | $74,172 | $13,093 | $17,801 | 1.75 |
| Digestive malignancy with CCMS-DRG 375, medical | 13 | $31,176 | $8,645 | $7,482 | 1.20 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 12 | $175,547 | $42,554 | $42,131 | 5.08 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 11 | $58,443 | $11,506 | $14,026 | 1.45 |
Infectious and parasitic diseases442 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 | 301 | $59,472 | $15,706 | $14,273 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 61 | $166,054 | $41,640 | $39,853 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 40 | $42,273 | $7,604 | $10,146 | 1.03 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 14 | $52,252 | $6,662 | $12,540 | 1.01 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 13 | $91,850 | $14,835 | $22,044 | 2.04 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 13 | $73,180 | $10,539 | $17,563 | 1.84 |
Endocrine, nutritional and metabolic260 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 with MCCMS-DRG 640, medical | 93 | $36,735 | $9,866 | $8,817 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 90 | $29,641 | $5,842 | $7,114 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 37 | $27,217 | $5,508 | $6,532 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 23 | $49,925 | $11,519 | $11,982 | 1.45 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 17 | $72,258 | $13,926 | $17,342 | 1.98 |
Liver, gallbladder and pancreas159 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 | 21 | $65,808 | $12,061 | $15,794 | 1.63 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 21 | $46,387 | $14,797 | $11,133 | 1.92 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 20 | $34,331 | $6,956 | $8,239 | 0.95 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 18 | $30,415 | $5,500 | $7,300 | 0.86 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 15 | $89,957 | $15,228 | $21,590 | 2.32 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 14 | $61,397 | $8,327 | $14,735 | 1.31 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 14 | $30,080 | $8,254 | $7,219 | 1.03 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 14 | $43,132 | $7,819 | $10,352 | 1.09 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 11 | $48,317 | $14,004 | $11,596 | 1.76 |
| Disorders of the biliary tract without cc/mccMS-DRG 446, medical | 11 | $35,598 | $5,882 | $8,543 | 0.80 |
Skin, subcutaneous tissue and breast134 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 83 | $35,031 | $6,303 | $8,408 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 20 | $54,729 | $12,382 | $13,135 | 1.49 |
| Other skin, subcutaneous tissue and breast procedures with CCMS-DRG 580, surgical | 17 | $70,265 | $13,722 | $16,864 | 1.75 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 14 | $36,402 | $6,509 | $8,737 | 0.91 |
Blood and immune system96 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 49 | $36,483 | $6,802 | $8,756 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 36 | $47,703 | $10,830 | $11,449 | 1.40 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 11 | $55,890 | $10,010 | $13,414 | 1.20 |
Injuries, poisonings and toxic effects of drugs67 discharges in 5 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 | 18 | $45,268 | $12,549 | $10,864 | 1.60 |
| Complications of treatment with MCCMS-DRG 919, medical | 13 | $64,715 | $13,013 | $15,532 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 13 | $44,158 | $7,910 | $10,598 | 1.03 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 12 | $139,271 | $29,201 | $33,425 | 3.72 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 11 | $63,879 | $14,954 | $15,331 | 2.00 |
Mental diseases and disorders64 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| PsychosesMS-DRG 885, medical | 33 | $28,009 | $9,627 | $6,722 | 1.37 |
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 31 | $37,090 | $13,204 | $8,902 | 1.76 |
Other26 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 | 26 | $148,991 | $40,020 | $35,758 | 4.74 |
Transplants, ECMO and tracheostomy (pre-MDC)23 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 | 12 | $516,307 | $145,532 | $123,914 | 21.32 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 11 | $341,046 | $118,437 | $81,851 | 14.70 |
Factors influencing health status21 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 | 21 | $28,104 | $6,145 | $6,745 | 0.80 |
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 without MCCMS-DRG 897, medical | 15 | $39,994 | $6,447 | $9,599 | 0.86 |
Multiple significant trauma13 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 | 13 | $172,554 | $38,842 | $41,413 | 3.88 |
Ear, nose, mouth and throat12 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 12 | $31,483 | $5,740 | $7,556 | 0.74 |
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 | 1,596 | 1,415 | $19,277 | $2,032 | $2,090 |
| Level 2 Urology and Related ServicesAPC 5372 | 1,095 | 655 | $798 | $506 | $502 |
| Level 3 Urology and Related ServicesAPC 5373 | 438 | 366 | $12,171 | $1,529 | $1,516 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 399 | 368 | $9,777 | $1,193 | $1,220 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 397 | 381 | $56,173 | $10,801 | $10,772 |
| Level 2 Upper GI ProceduresAPC 5302 | 338 | 260 | $12,203 | $1,413 | $1,445 |
| Level 1 Endovascular ProceduresAPC 5191 | 251 | 250 | $28,940 | $2,138 | $2,208 |
| Level 3 Vascular ProceduresAPC 5183 | 244 | 224 | $22,435 | $2,341 | $2,405 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 230 | 224 | $35,733 | $4,249 | $4,358 |
| Level 5 Urology and Related ServicesAPC 5375 | 230 | 217 | $29,524 | $3,823 | $3,918 |
| Level 2 Endovascular ProceduresAPC 5192 | 206 | 173 | $29,415 | $4,251 | $4,338 |
| Level 3 Endovascular ProceduresAPC 5193 | 202 | 178 | $67,101 | $8,659 | $8,874 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 198 | 195 | $41,779 | $5,291 | $5,339 |
| Level 3 Airway EndoscopyAPC 5153 | 183 | 159 | $6,389 | $1,239 | $1,264 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 143 | 139 | $95,164 | $20,227 | $21,117 |
| Level 4 Urology and Related ServicesAPC 5374 | 139 | 117 | $23,931 | $2,625 | $2,629 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 137 | 137 | $51,823 | $7,984 | $8,164 |
| Level 4 Endovascular ProceduresAPC 5194 | 127 | 120 | $97,668 | $13,602 | $14,606 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 123 | 122 | $20,855 | $2,127 | $2,141 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 101 | 96 | $30,903 | $2,863 | $2,930 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 91 | 75 | $22,913 | $2,592 | $2,636 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 84 | 84 | $48,866 | $8,523 | $8,569 |
| Level 2 Intraocular ProceduresAPC 5492 | 79 | 70 | $23,744 | $3,042 | $3,116 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 75 | 74 | $44,490 | $4,813 | $4,982 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 75 | 75 | $92,990 | $15,861 | $15,763 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 72 | 67 | $26,515 | $2,330 | $2,373 |
| Level 2 Vascular ProceduresAPC 5182 | 69 | 66 | $14,867 | $1,147 | $1,204 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 57 | 55 | $16,533 | $1,155 | $1,196 |
| Level 4 Gynecologic ProceduresAPC 5414 | 53 | 52 | $20,568 | $2,327 | $2,389 |
| Level 4 Vascular ProceduresAPC 5184 | 51 | 49 | $31,726 | $4,118 | $3,946 |
| Level 3 Lower GI ProceduresAPC 5313 | 38 | 36 | $22,611 | $2,096 | $2,176 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 32 | 31 | $37,715 | $6,326 | $6,514 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 32 | 32 | $99,168 | $26,981 | $26,719 |
| Level 4 Airway EndoscopyAPC 5154 | 30 | 28 | $17,249 | $2,747 | $2,833 |
| Level 5 Gynecologic ProceduresAPC 5415 | 29 | 29 | $27,933 | $3,774 | $3,792 |
| Level 5 ENT ProceduresAPC 5165 | 28 | 28 | $40,376 | $4,285 | $4,436 |
| Level 7 Radiation TherapyAPC 5627 | 26 | 23 | $51,229 | $5,909 | $6,121 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 23 | 23 | $172,673 | $28,307 | $29,375 |
| Level 1 Nerve ProceduresAPC 5431 | 22 | 21 | $22,264 | $1,396 | $1,407 |
| Level 6 Urology and Related ServicesAPC 5376 | 18 | 17 | $40,620 | $6,741 | $7,291 |
| Complex GI ProceduresAPC 5331 | 14 | 13 | $22,856 | $4,324 | $4,263 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 13 | 13 | $153,896 | $20,738 | $21,011 |
| Level 5 Airway EndoscopyAPC 5155 | 12 | 12 | $31,290 | $5,193 | $5,183 |
| Level 8 Urology and Related ServicesAPC 5378 | 12 | 12 | $101,158 | $14,610 | $17,428 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 11 | 11 | $23,849 | $5,660 | $5,682 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 11 | 11 | $82,003 | $16,881 | $17,052 |
| Level 6 Gynecologic ProceduresAPC 5416 | 11 | 11 | $30,668 | $5,733 | $5,836 |
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.