St Charles Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for St Charles Hospital, Port Jefferson, NY in 2024, from traditional Medicare claims. Back to the St Charles Hospital profile, with quality ratings, finances and negotiated rates.
1,409
Medicare inpatient discharges
In 45 published DRGs
1.60
Case mix index
IPPS FY 2027
8%
Surgical stays
58%
Stays with complications
In DRGs with a CC or MCC
1,394
Medicare outpatient services
In 18 service groups
Inpatient stays by major diagnostic category
Infectious and parasitic diseases261 discharges in 3 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 | 195 | $84,142 | $16,110 | $17,838 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 42 | $52,762 | $7,455 | $11,185 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 24 | $299,679 | $54,470 | $63,532 | 5.00 |
Kidney and urinary tract241 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 76 | $40,195 | $6,491 | $8,521 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 51 | $47,821 | $9,671 | $10,138 | 1.17 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 43 | $62,449 | $13,760 | $13,239 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 26 | $54,482 | $10,768 | $11,550 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 24 | $50,714 | $7,244 | $10,751 | 0.90 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 21 | $47,089 | $8,364 | $9,983 | 1.02 |
Respiratory system183 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 49 | $76,978 | $13,400 | $16,319 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 38 | $67,628 | $11,120 | $14,337 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 27 | $56,329 | $10,859 | $11,942 | 1.23 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 24 | $38,239 | $6,156 | $8,107 | 0.82 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 16 | $50,321 | $8,885 | $10,668 | 1.10 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 16 | $48,306 | $6,601 | $10,241 | 0.85 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 13 | $47,211 | $7,435 | $10,009 | 0.99 |
Alcohol and drug use156 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Alcohol, drug abuse or dependence with rehabilitation therapyMS-DRG 895, medical | 136 | $90,867 | $12,879 | $19,264 | 1.61 |
| Alcohol, drug abuse or dependence, left amaMS-DRG 894, medical | 20 | $51,280 | $4,359 | $10,871 | 0.57 |
Musculoskeletal system and connective tissue120 discharges in 5 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 | 51 | $79,881 | $16,166 | $16,935 | 1.88 |
| Medical back problems without MCCMS-DRG 552, medical | 30 | $45,824 | $7,692 | $9,715 | 0.97 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 17 | $86,268 | $17,388 | $18,289 | 2.07 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 11 | $161,579 | $28,256 | $34,255 | 3.49 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 11 | $38,809 | $6,774 | $8,227 | 0.90 |
Circulatory system109 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 58 | $65,124 | $10,888 | $13,806 | 1.28 |
| Hypertension without MCCMS-DRG 305, medical | 19 | $46,117 | $5,776 | $9,777 | 0.75 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 17 | $53,487 | $8,951 | $11,339 | 1.07 |
| Syncope and collapseMS-DRG 312, medical | 15 | $52,189 | $7,308 | $11,064 | 0.86 |
Digestive system101 discharges in 5 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 | 38 | $33,577 | $5,838 | $7,118 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 18 | $58,947 | $7,314 | $12,497 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 16 | $90,099 | $13,912 | $19,101 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 16 | $61,097 | $9,933 | $12,952 | 1.28 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 13 | $137,938 | $18,531 | $29,243 | 2.37 |
Nervous system99 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Seizures without MCCMS-DRG 101, medical | 33 | $55,112 | $6,956 | $11,684 | 0.91 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 14 | $97,992 | $16,042 | $20,774 | 2.00 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 14 | $43,749 | $8,926 | $9,275 | 1.03 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 13 | $51,669 | $11,040 | $10,954 | 1.36 |
| Seizures with MCCMS-DRG 100, medical | 13 | $123,151 | $16,596 | $26,108 | 1.98 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 12 | $57,248 | $7,838 | $12,137 | 1.02 |
Endocrine, nutritional and metabolic63 discharges in 3 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 | 30 | $59,115 | $10,458 | $12,532 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 17 | $41,473 | $6,916 | $8,792 | 0.90 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 16 | $39,022 | $6,095 | $8,273 | 0.78 |
Skin, subcutaneous tissue and breast45 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 33 | $35,282 | $6,468 | $7,480 | 0.88 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 12 | $39,391 | $7,140 | $8,351 | 0.91 |
Mental diseases and disorders20 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 | 20 | $37,237 | $13,188 | $7,894 | 1.76 |
Blood and immune system11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 11 | $95,307 | $10,781 | $20,205 | 1.40 |
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 |
|---|---|---|---|---|---|
| Level 5 Musculoskeletal ProceduresAPC 5115 | 284 | 271 | $65,199 | $12,811 | $10,772 |
| Comprehensive Observation ServicesAPC 8011 | 218 | 200 | $25,641 | $2,423 | $2,090 |
| Level 1 Nerve ProceduresAPC 5431 | 133 | 99 | $13,389 | $1,718 | $1,407 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 98 | 98 | $41,911 | $5,135 | $4,358 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 89 | 89 | $33,083 | $6,363 | $5,339 |
| Level 5 Urology and Related ServicesAPC 5375 | 88 | 78 | $26,602 | $4,552 | $3,918 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 79 | 72 | $11,123 | $1,430 | $1,196 |
| Level 4 Urology and Related ServicesAPC 5374 | 79 | 73 | $17,125 | $3,063 | $2,629 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 75 | 45 | $11,644 | $1,422 | $1,220 |
| Level 3 Urology and Related ServicesAPC 5373 | 58 | 54 | $15,007 | $1,813 | $1,516 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 40 | 39 | $20,423 | $2,808 | $2,373 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 35 | 35 | $12,465 | $2,079 | $1,780 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 32 | 28 | $33,304 | $3,077 | $2,636 |
| Level 4 Gynecologic ProceduresAPC 5414 | 24 | 23 | $17,072 | $2,782 | $2,389 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 18 | 18 | $80,256 | $19,130 | $15,763 |
| Level 6 Urology and Related ServicesAPC 5376 | 16 | 16 | $47,141 | $8,648 | $7,291 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 15 | 15 | $15,878 | $2,529 | $2,141 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 13 | 13 | $187,813 | $30,407 | $26,719 |
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.