St. David S Rehabilitation - St. David S Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for St. David S Rehabilitation - St. David S Medical Center, Austin, TX in 2024, from traditional Medicare claims. Back to the St. David S Rehabilitation - St. David S Medical Center profile, with quality ratings, finances and negotiated rates.
5,009
Medicare inpatient discharges
In 140 published DRGs
2.56
Case mix index
IPPS FY 2027
36%
Surgical stays
64%
Stays with complications
In DRGs with a CC or MCC
4,987
Medicare outpatient services
In 38 service groups
Inpatient stays by major diagnostic category
Circulatory system2,164 discharges in 43 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 413 | $69,988 | $8,297 | $6,509 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 349 | $414,612 | $20,846 | $38,559 | 3.24 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 160 | $154,825 | $13,660 | $14,399 | 2.16 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 119 | $496,132 | $42,764 | $46,140 | 6.25 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 83 | $89,294 | $10,263 | $8,304 | 1.59 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 67 | $439,297 | $26,597 | $40,855 | 3.90 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 67 | $104,297 | $6,199 | $9,700 | 1.08 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 57 | $409,216 | $32,481 | $38,057 | 4.88 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 56 | $40,628 | $4,323 | $3,778 | 0.74 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 54 | $46,257 | $3,061 | $4,302 | 0.55 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 49 | $686,000 | $46,822 | $63,798 | 7.71 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 43 | $352,901 | $24,485 | $32,820 | 4.04 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 43 | $213,239 | $10,992 | $19,831 | 1.82 |
| Syncope and collapseMS-DRG 312, medical | 37 | $43,447 | $5,567 | $4,041 | 0.86 |
| Hypertension without MCCMS-DRG 305, medical | 35 | $42,973 | $4,821 | $3,996 | 0.75 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 35 | $85,844 | $7,558 | $7,983 | 1.20 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 34 | $299,030 | $17,785 | $27,810 | 2.87 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 28 | $535,122 | $35,304 | $49,766 | 5.24 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 27 | $155,916 | $12,526 | $14,500 | 2.09 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 24 | $547,691 | $47,746 | $50,935 | 7.80 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 24 | $366,694 | $21,839 | $34,103 | 3.46 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 23 | $445,378 | $33,743 | $41,420 | 5.20 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 23 | $197,199 | $21,652 | $18,340 | 3.35 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 23 | $76,849 | $5,807 | $7,147 | 0.91 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 21 | $575,760 | $27,185 | $53,546 | 4.16 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 20 | $303,023 | $14,848 | $28,181 | 2.28 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 20 | $417,683 | $34,635 | $38,845 | 5.06 |
| Chest painMS-DRG 313, medical | 20 | $47,187 | $4,431 | $4,388 | 0.72 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 18 | $61,887 | $7,040 | $5,755 | 1.07 |
| Other vascular procedures with CCMS-DRG 253, surgical | 17 | $165,877 | $16,926 | $15,427 | 2.55 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 16 | $306,872 | $20,848 | $28,539 | 3.18 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 16 | $64,065 | $4,296 | $5,958 | 0.72 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 16 | $91,833 | $10,014 | $8,540 | 1.58 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 15 | $1,042,068 | $75,996 | $96,912 | 9.71 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 15 | $72,487 | $5,476 | $6,741 | 0.97 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 14 | $374,654 | $36,817 | $34,843 | 5.88 |
| Cardiac defibrillator implant with cardiac catheterization and MCCMS-DRG 275, surgical | 13 | $935,428 | $57,576 | $86,995 | 7.04 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 13 | $423,060 | $18,204 | $39,345 | 2.97 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 12 | $211,616 | $22,553 | $19,680 | 3.27 |
| Cardiac defibrillator implant without MCCMS-DRG 277, surgical | 12 | $705,140 | $36,054 | $65,578 | 4.78 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 11 | $216,270 | $12,317 | $20,113 | 1.83 |
| Atherosclerosis without MCCMS-DRG 303, medical | 11 | $40,031 | $4,459 | $3,723 | 0.66 |
| Coronary intravascular lithotripsy with intraluminal device with MCCMS-DRG 323, surgical | 11 | $444,514 | $27,350 | $41,340 | 4.14 |
Infectious and parasitic diseases532 discharges in 4 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 | 390 | $126,661 | $12,334 | $11,779 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 65 | $63,020 | $6,146 | $5,861 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 52 | $375,836 | $31,922 | $34,953 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 25 | $617,548 | $41,250 | $57,432 | 6.96 |
Digestive system401 discharges in 16 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 | 73 | $54,855 | $4,874 | $5,102 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 49 | $57,699 | $6,107 | $5,366 | 0.98 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 31 | $68,972 | $9,952 | $6,414 | 1.62 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 30 | $218,090 | $14,896 | $20,282 | 2.37 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 28 | $136,782 | $11,537 | $12,721 | 1.79 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 27 | $272,783 | $22,793 | $25,369 | 4.52 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 26 | $85,969 | $8,334 | $7,995 | 1.28 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 25 | $42,784 | $4,655 | $3,979 | 0.80 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 24 | $56,232 | $5,401 | $5,230 | 0.94 |
| Digestive malignancy with MCCMS-DRG 374, medical | 16 | $142,676 | $13,898 | $13,269 | 2.10 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 13 | $266,457 | $11,455 | $24,781 | 2.50 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 13 | $155,909 | $11,824 | $14,500 | 1.75 |
| Digestive malignancy with CCMS-DRG 375, medical | 12 | $82,174 | $8,055 | $7,642 | 1.20 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 12 | $47,259 | $3,262 | $4,395 | 0.56 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 11 | $369,832 | $32,948 | $34,394 | 5.08 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 11 | $81,312 | $9,446 | $7,562 | 1.45 |
Nervous system395 discharges in 17 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 79 | $116,854 | $11,818 | $10,867 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 45 | $54,715 | $6,424 | $5,089 | 1.02 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 35 | $210,411 | $10,932 | $19,568 | 1.81 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 24 | $277,920 | $27,877 | $25,847 | 4.42 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 24 | $49,547 | $6,708 | $4,608 | 1.03 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 22 | $48,227 | $8,242 | $4,485 | 1.36 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 20 | $620,307 | $41,705 | $57,689 | 5.67 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 19 | $259,943 | $18,015 | $24,175 | 2.95 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 18 | $43,937 | $4,452 | $4,086 | 0.80 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 16 | $124,460 | $11,831 | $11,575 | 1.79 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 15 | $209,671 | $15,594 | $19,499 | 2.30 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 15 | $60,900 | $6,851 | $5,664 | 1.06 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 14 | $292,751 | $13,987 | $27,226 | 2.43 |
| Seizures without MCCMS-DRG 101, medical | 14 | $53,646 | $5,736 | $4,989 | 0.91 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 13 | $47,504 | $3,758 | $4,418 | 0.69 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 11 | $52,544 | $6,600 | $4,887 | 1.03 |
| Headaches without MCCMS-DRG 103, medical | 11 | $47,740 | $4,844 | $4,440 | 0.84 |
Respiratory system370 discharges in 12 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 121 | $78,026 | $8,391 | $7,256 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 74 | $88,320 | $10,486 | $8,214 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 44 | $76,688 | $7,998 | $7,132 | 1.23 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 20 | $207,732 | $18,019 | $19,319 | 2.70 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 19 | $56,959 | $4,636 | $5,297 | 0.82 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 16 | $111,888 | $9,051 | $10,406 | 1.40 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 14 | $81,264 | $11,179 | $7,558 | 1.74 |
| Major chest procedures with CCMS-DRG 164, surgical | 13 | $168,397 | $16,318 | $15,661 | 2.55 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 13 | $86,290 | $10,672 | $8,025 | 1.81 |
| Major chest procedures with MCCMS-DRG 163, surgical | 12 | $429,149 | $37,094 | $39,911 | 4.71 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 12 | $47,849 | $5,747 | $4,450 | 0.99 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 12 | $82,820 | $12,529 | $7,702 | 1.90 |
Musculoskeletal system and connective tissue327 discharges in 13 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 62 | $455,927 | $36,011 | $42,401 | 6.12 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 43 | $205,599 | $11,890 | $19,121 | 1.88 |
| Medical back problems without MCCMS-DRG 552, medical | 40 | $55,456 | $6,141 | $5,157 | 0.97 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 30 | $263,369 | $16,677 | $24,493 | 2.67 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 28 | $309,909 | $19,684 | $28,822 | 3.49 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 26 | $204,086 | $19,019 | $18,980 | 2.96 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 19 | $140,444 | $13,178 | $13,061 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 19 | $173,040 | $12,773 | $16,093 | 2.11 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 14 | $378,810 | $22,149 | $35,229 | 3.66 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 13 | $103,677 | $9,062 | $9,642 | 1.59 |
| Combined anterior and posterior spinal fusion with MCCMS-DRG 453, surgical | 11 | $707,920 | $61,965 | $65,837 | 8.86 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 457, surgical | 11 | $566,662 | $33,024 | $52,700 | 6.08 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 11 | $47,453 | $5,526 | $4,413 | 0.90 |
Kidney and urinary tract250 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with MCCMS-DRG 682, medical | 49 | $73,982 | $9,304 | $6,880 | 1.50 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 42 | $47,885 | $4,833 | $4,453 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 41 | $61,635 | $7,287 | $5,732 | 1.17 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 39 | $90,897 | $11,092 | $8,453 | 1.65 |
| Renal failure with CCMS-DRG 683, medical | 38 | $53,540 | $5,706 | $4,979 | 0.90 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 25 | $50,595 | $6,621 | $4,705 | 1.02 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 16 | $249,616 | $23,391 | $23,214 | 3.70 |
Endocrine, nutritional and metabolic147 discharges in 6 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 | 55 | $66,568 | $8,355 | $6,191 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 37 | $43,389 | $4,689 | $4,035 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 15 | $69,371 | $9,188 | $6,451 | 1.45 |
| Diabetes with CCMS-DRG 638, medical | 15 | $50,083 | $4,984 | $4,658 | 0.90 |
| Endocrine disorders with MCCMS-DRG 643, medical | 13 | $83,873 | $11,159 | $7,800 | 1.65 |
| O.r. procedures for obesity without cc/mccMS-DRG 621, surgical | 12 | $154,564 | $7,246 | $14,374 | 1.52 |
Liver, gallbladder and pancreas104 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 24 | $274,046 | $17,033 | $25,486 | 2.89 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 16 | $150,750 | $9,873 | $14,020 | 1.63 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 15 | $110,936 | $11,418 | $10,317 | 1.92 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 13 | $124,297 | $11,870 | $11,560 | 1.76 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 13 | $146,366 | $13,736 | $13,612 | 1.83 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 12 | $54,352 | $5,288 | $5,055 | 0.86 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 11 | $136,824 | $8,245 | $12,725 | 1.31 |
Other88 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Concomitant left atrial appendage closure and cardiac ablationMS-DRG 317 | 41 | $787,767 | $45,557 | $73,262 | |
| Multiple level combined anterior and posterior spinal fusion except cervical with CCMS-DRG 427 | 17 | $648,010 | $44,049 | $60,265 | |
| Extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 981, surgical | 17 | $338,571 | $30,578 | $31,487 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 13 | $260,707 | $16,165 | $24,246 | 2.49 |
Blood and immune system74 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 34 | $74,534 | $8,984 | $6,932 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 23 | $52,058 | $5,598 | $4,841 | 0.90 |
| Coagulation disordersMS-DRG 813, medical | 17 | $72,373 | $10,642 | $6,731 | 1.56 |
Skin, subcutaneous tissue and breast54 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 35 | $47,937 | $5,303 | $4,458 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 19 | $70,272 | $9,205 | $6,535 | 1.49 |
Mental diseases and disorders32 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 | 32 | $57,469 | $10,775 | $5,345 | 1.76 |
Transplants, ECMO and tracheostomy (pre-MDC)26 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 | 14 | $1,864,517 | $150,340 | $173,400 | 21.32 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 12 | $720,983 | $70,566 | $67,051 | 14.70 |
Factors influencing health status17 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Rehabilitation with cc/mccMS-DRG 945, medical | 17 | $56,149 | $9,715 | $5,222 | 1.51 |
Ear, nose, mouth and throat14 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 14 | $58,160 | $4,222 | $5,409 | 0.74 |
Injuries, poisonings and toxic effects of drugs14 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with CCMS-DRG 920, medical | 14 | $45,443 | $6,985 | $4,226 | 1.03 |
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 3 Electrophysiologic ProceduresAPC 5213 | 851 | 818 | $420,748 | $19,111 | $21,117 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 717 | 680 | $191,676 | $9,840 | $10,772 |
| Level 1 Endovascular ProceduresAPC 5191 | 608 | 596 | $59,191 | $2,029 | $2,208 |
| Comprehensive Observation ServicesAPC 8011 | 336 | 319 | $31,267 | $1,900 | $2,090 |
| Level 3 Vascular ProceduresAPC 5183 | 261 | 254 | $32,045 | $2,209 | $2,405 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 179 | 174 | $77,394 | $3,975 | $4,358 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 178 | 172 | $90,857 | $4,960 | $5,339 |
| Level 3 Endovascular ProceduresAPC 5193 | 170 | 159 | $174,666 | $7,854 | $8,874 |
| Level 4 Vascular ProceduresAPC 5184 | 158 | 134 | $58,836 | $3,803 | $3,946 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 157 | 156 | $151,523 | $7,661 | $8,569 |
| Level 2 Upper GI ProceduresAPC 5302 | 146 | 125 | $20,923 | $1,328 | $1,445 |
| Level 4 Endovascular ProceduresAPC 5194 | 118 | 109 | $246,769 | $13,530 | $14,606 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 104 | 101 | $22,402 | $1,126 | $1,220 |
| Level 2 Endovascular ProceduresAPC 5192 | 102 | 102 | $100,265 | $3,965 | $4,338 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 99 | 98 | $491,572 | $26,687 | $29,375 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 74 | 71 | $82,166 | $4,573 | $4,982 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 64 | 64 | $299,937 | $15,481 | $17,052 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 57 | 57 | $111,842 | $5,955 | $6,514 |
| Level 5 Urology and Related ServicesAPC 5375 | 52 | 51 | $65,371 | $3,627 | $3,918 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 50 | 48 | $45,273 | $2,673 | $2,930 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 47 | 46 | $54,053 | $1,991 | $2,141 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 43 | 42 | $42,130 | $2,268 | $2,373 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 38 | 38 | $18,931 | $1,119 | $1,196 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 37 | 36 | $120,843 | $7,424 | $8,164 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 36 | 35 | $387,463 | $25,615 | $26,719 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 35 | 34 | $321,833 | $14,737 | $15,763 |
| Level 2 Vascular ProceduresAPC 5182 | 34 | 34 | $23,203 | $1,122 | $1,204 |
| Level 3 Lower GI ProceduresAPC 5313 | 29 | 29 | $29,459 | $1,903 | $2,176 |
| Level 4 Urology and Related ServicesAPC 5374 | 29 | 23 | $36,621 | $2,445 | $2,629 |
| Implantation Wireless PA Pressure MonitorAPC 5200 | 26 | 26 | $160,761 | $23,878 | $26,955 |
| Level 4 Airway EndoscopyAPC 5154 | 24 | 23 | $36,358 | $2,626 | $2,833 |
| Level 3 Upper GI ProceduresAPC 5303 | 24 | 24 | $40,290 | $2,679 | $2,888 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 22 | 22 | $69,171 | $2,418 | $2,636 |
| Complex GI ProceduresAPC 5331 | 21 | 15 | $68,634 | $3,997 | $4,263 |
| Level 3 Airway EndoscopyAPC 5153 | 19 | 18 | $20,841 | $1,190 | $1,264 |
| Level 3 Urology and Related ServicesAPC 5373 | 15 | 14 | $31,463 | $1,428 | $1,516 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 14 | 14 | $307,850 | $19,063 | $21,011 |
| Level 3 Breast/Lymphatic Surgery and Related ProceduresAPC 5093 | 13 | 12 | $184,515 | $6,657 | $7,546 |
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.