St. Anthony Community Hospital Medicare inpatient and outpatient services

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

280
Medicare inpatient discharges
In 13 published DRGs
1.39
Case mix index
IPPS FY 2027
4%
Surgical stays
74%
Stays with complications
In DRGs with a CC or MCC
543
Medicare outpatient services
In 14 service groups

Inpatient stays by major diagnostic category

Respiratory system84 discharges in 4 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Simple pneumonia and pleurisy with MCCMS-DRG 193, medical	36	$91,743	$9,559	$14,771	1.33
Respiratory infections and inflammations with MCCMS-DRG 177, medical	21	$114,470	$13,118	$18,430	1.70
Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical	15	$64,482	$7,110	$10,382	1.10
Simple pneumonia and pleurisy with CCMS-DRG 194, medical	12	$76,077	$5,438	$12,248	0.82

Infectious and parasitic diseases69 discharges in 2 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	53	$125,962	$14,223	$20,280	1.98
Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical	16	$107,948	$7,021	$17,380	1.03

Circulatory system41 discharges in 1 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Heart failure and shock with MCCMS-DRG 291, medical	41	$89,407	$9,564	$14,395	1.28

Kidney and urinary tract32 discharges in 2 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Kidney and urinary tract infections without MCCMS-DRG 690, medical	17	$81,537	$5,827	$13,127	0.81
Kidney and urinary tract infections with MCCMS-DRG 689, medical	15	$79,037	$8,427	$12,725	1.17

Digestive system29 discharges in 2 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	16	$77,111	$4,463	$12,415	0.79
Gastrointestinal hemorrhage with CCMS-DRG 378, medical	13	$120,576	$6,828	$19,413	0.98

Skin, subcutaneous tissue and breast13 discharges in 1 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Cellulitis without MCCMS-DRG 603, medical	13	$102,124	$6,064	$16,442	0.88

Musculoskeletal system and connective tissue12 discharges in 1 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	12	$156,930	$14,348	$25,266	1.88

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	119	115	$53,889	$2,432	$2,090
Level 5 Musculoskeletal ProceduresAPC 5115	112	110	$109,395	$12,706	$10,772
Level 6 Musculoskeletal ProceduresAPC 5116	60	56	$140,517	$19,288	$15,763
Level 1 Intraocular ProceduresAPC 5491	53	41	$43,021	$2,089	$1,752
Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072	27	22	$15,930	$1,387	$1,220
Level 1 Nerve ProceduresAPC 5431	27	22	$40,883	$1,731	$1,407
Level 2 Upper GI ProceduresAPC 5302	26	25	$35,108	$1,705	$1,445
Level 4 Gynecologic ProceduresAPC 5414	26	26	$47,905	$2,803	$2,389
Level 4 Musculoskeletal ProceduresAPC 5114	21	21	$79,873	$6,419	$5,339
Level 3 Urology and Related ServicesAPC 5373	18	17	$46,617	$1,826	$1,516
Level 2 Musculoskeletal ProceduresAPC 5112	16	16	$38,645	$1,441	$1,196
Level 3 Musculoskeletal ProceduresAPC 5113	13	13	$43,353	$2,679	$2,373
Level 5 Gynecologic ProceduresAPC 5415	13	13	$51,650	$4,460	$3,792
Level 3 Intraocular ProceduresAPC 5493	12	11	$56,224	$4,686	$4,004

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.