St Joseph Mercy Hospital Ann Arbor Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for St Joseph Mercy Hospital Ann Arbor, Ypsilanti, MI in 2024, from traditional Medicare claims. Back to the St Joseph Mercy Hospital Ann Arbor profile, with quality ratings, finances and negotiated rates.
6,355
Medicare inpatient discharges
In 175 published DRGs
1.88
Case mix index
IPPS FY 2027
26%
Surgical stays
64%
Stays with complications
In DRGs with a CC or MCC
4,290
Medicare outpatient services
In 46 service groups
Inpatient stays by major diagnostic category
Circulatory system1,506 discharges in 39 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 342 | $34,490 | $8,902 | $8,657 | 1.28 |
| Syncope and collapseMS-DRG 312, medical | 91 | $26,238 | $5,751 | $6,586 | 0.86 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 73 | $24,732 | $4,504 | $6,208 | 0.74 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 68 | $45,098 | $11,358 | $11,320 | 1.59 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 64 | $84,708 | $23,846 | $21,262 | 3.24 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 63 | $113,443 | $20,605 | $28,474 | 2.87 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 56 | $75,488 | $11,802 | $18,948 | 1.82 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 53 | $165,237 | $46,689 | $41,475 | 6.25 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 52 | $127,595 | $35,977 | $32,026 | 4.88 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 49 | $51,776 | $14,625 | $12,996 | 2.16 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 39 | $35,031 | $8,250 | $8,793 | 1.20 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 35 | $157,473 | $35,168 | $39,526 | 5.24 |
| Other vascular procedures with CCMS-DRG 253, surgical | 33 | $79,964 | $18,138 | $20,071 | 2.55 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 29 | $63,733 | $15,611 | $15,997 | 2.28 |
| Chest painMS-DRG 313, medical | 29 | $23,270 | $4,832 | $5,841 | 0.72 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 28 | $41,713 | $13,575 | $10,470 | 2.09 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 27 | $20,507 | $3,144 | $5,147 | 0.55 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 25 | $24,785 | $6,795 | $6,221 | 1.07 |
| Hypertension with MCCMS-DRG 304, medical | 25 | $35,831 | $7,642 | $8,993 | 1.15 |
| Hypertension without MCCMS-DRG 305, medical | 25 | $25,598 | $4,969 | $6,425 | 0.75 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 24 | $95,305 | $25,625 | $23,922 | 3.46 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 24 | $38,470 | $6,787 | $9,656 | 1.08 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 22 | $123,806 | $26,049 | $31,075 | 4.04 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 22 | $29,521 | $5,699 | $7,410 | 0.91 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 19 | $163,256 | $40,269 | $40,977 | 5.06 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 17 | $171,421 | $30,444 | $43,027 | 5.20 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 16 | $92,784 | $22,998 | $23,289 | 3.46 |
| Heart failure and shock with CCMS-DRG 292, medical | 16 | $32,835 | $5,887 | $8,241 | 0.86 |
| Other vascular procedures without cc/mccMS-DRG 254, surgical | 15 | $64,441 | $11,940 | $16,175 | 1.74 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 15 | $112,688 | $28,091 | $28,285 | 3.90 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 14 | $25,368 | $4,231 | $6,367 | 0.72 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 14 | $34,522 | $5,686 | $8,665 | 0.97 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 13 | $135,838 | $33,220 | $34,095 | 4.16 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 13 | $27,254 | $11,217 | $6,841 | 1.58 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 12 | $167,201 | $55,795 | $41,967 | 7.71 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 11 | $91,124 | $19,314 | $22,872 | 3.18 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 11 | $228,129 | $41,203 | $57,260 | 7.80 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 11 | $53,263 | $12,983 | $13,369 | 1.83 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 11 | $84,235 | $27,457 | $21,143 | 3.27 |
Respiratory system826 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 147 | $37,226 | $8,960 | $9,344 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 126 | $43,743 | $11,368 | $10,979 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 109 | $38,716 | $8,451 | $9,718 | 1.23 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 72 | $35,644 | $7,757 | $8,947 | 1.10 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 59 | $24,427 | $5,248 | $6,131 | 0.82 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 47 | $28,217 | $6,338 | $7,082 | 0.99 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 40 | $26,205 | $5,758 | $6,577 | 0.85 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 32 | $34,351 | $8,957 | $8,622 | 1.40 |
| Major chest trauma with CCMS-DRG 184, medical | 30 | $33,598 | $7,146 | $8,433 | 1.05 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 27 | $90,246 | $15,917 | $22,652 | 2.70 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 23 | $21,760 | $4,755 | $5,462 | 0.82 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 19 | $61,245 | $12,368 | $15,373 | 1.88 |
| Major chest procedures with CCMS-DRG 164, surgical | 16 | $78,912 | $16,345 | $19,807 | 2.55 |
| Major chest procedures with MCCMS-DRG 163, surgical | 15 | $113,943 | $27,347 | $28,600 | 4.71 |
| Major chest trauma with MCCMS-DRG 183, medical | 15 | $46,502 | $9,874 | $11,672 | 1.57 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 13 | $71,690 | $12,978 | $17,994 | 1.74 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 13 | $31,390 | $5,930 | $7,879 | 0.96 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 12 | $76,877 | $25,373 | $19,296 | 4.06 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 11 | $45,011 | $11,428 | $11,298 | 1.81 |
Musculoskeletal system and connective tissue733 discharges in 20 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 | 249 | $56,681 | $12,843 | $14,227 | 1.88 |
| Medical back problems without MCCMS-DRG 552, medical | 89 | $31,495 | $6,042 | $7,905 | 0.97 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 52 | $74,778 | $15,032 | $18,769 | 2.07 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 38 | $28,342 | $5,973 | $7,114 | 0.90 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 34 | $63,899 | $17,574 | $16,039 | 2.48 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 31 | $78,566 | $14,920 | $19,720 | 2.11 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 26 | $95,279 | $20,520 | $23,915 | 2.95 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 23 | $40,766 | $7,217 | $10,232 | 1.09 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 22 | $19,476 | $5,752 | $4,888 | 0.82 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 21 | $24,518 | $5,386 | $6,154 | 0.79 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 20 | $22,808 | $5,943 | $5,725 | 0.82 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 19 | $100,083 | $29,377 | $25,121 | 4.61 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 18 | $79,297 | $20,201 | $19,904 | 3.49 |
| Medical back problems with MCCMS-DRG 551, medical | 16 | $53,064 | $10,373 | $13,319 | 1.70 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 14 | $95,274 | $18,958 | $23,914 | 2.96 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 13 | $114,097 | $21,095 | $28,638 | 3.66 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 13 | $50,059 | $12,736 | $12,565 | 1.82 |
| Tendonitis, myositis and bursitis without MCCMS-DRG 558, medical | 13 | $27,426 | $6,026 | $6,884 | 0.88 |
| Major hip and knee joint replacement or reattachment of lower extremity with MCC or totaMS-DRG 469, surgical | 11 | $79,525 | $19,396 | $19,961 | 3.33 |
| Fractures of hip and pelvis with MCCMS-DRG 535, medical | 11 | $51,649 | $9,012 | $12,964 | 1.30 |
Digestive system658 discharges in 17 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 | 138 | $24,955 | $4,904 | $6,264 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 75 | $29,114 | $6,375 | $7,308 | 0.98 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 65 | $82,947 | $16,367 | $20,820 | 2.37 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 56 | $31,048 | $8,557 | $7,793 | 1.28 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 43 | $160,295 | $28,098 | $40,234 | 4.52 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 40 | $24,596 | $5,125 | $6,174 | 0.80 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 39 | $28,264 | $6,100 | $7,094 | 0.94 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 33 | $47,276 | $12,005 | $11,866 | 1.79 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 32 | $65,098 | $10,366 | $16,340 | 1.67 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 26 | $37,689 | $11,451 | $9,460 | 1.62 |
| Digestive malignancy with CCMS-DRG 375, medical | 24 | $40,089 | $7,050 | $10,062 | 1.20 |
| Digestive malignancy with MCCMS-DRG 374, medical | 18 | $54,700 | $14,377 | $13,730 | 2.10 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 16 | $81,445 | $17,478 | $20,443 | 2.50 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 16 | $28,970 | $7,201 | $7,272 | 1.04 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 15 | $19,401 | $3,182 | $4,870 | 0.56 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 11 | $197,546 | $34,947 | $49,584 | 5.08 |
| Inflammatory bowel disease with CCMS-DRG 386, medical | 11 | $30,562 | $6,908 | $7,671 | 0.97 |
Infectious and parasitic diseases652 discharges in 7 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 | 444 | $53,594 | $13,392 | $13,452 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 76 | $123,377 | $32,312 | $30,968 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 61 | $32,705 | $6,660 | $8,209 | 1.03 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 24 | $145,416 | $46,595 | $36,499 | 6.96 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 18 | $49,310 | $11,271 | $12,377 | 1.84 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 16 | $60,117 | $13,146 | $15,089 | 2.04 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 13 | $31,207 | $6,658 | $7,833 | 1.01 |
Nervous system603 discharges in 24 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 | 83 | $36,637 | $6,179 | $9,196 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 45 | $69,228 | $13,491 | $17,376 | 2.00 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 43 | $30,981 | $5,047 | $7,776 | 0.80 |
| Seizures without MCCMS-DRG 101, medical | 40 | $26,022 | $6,203 | $6,531 | 0.91 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 33 | $31,462 | $9,314 | $7,897 | 1.36 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 27 | $135,218 | $29,700 | $33,940 | 4.42 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 27 | $32,301 | $6,814 | $8,108 | 1.03 |
| Seizures with MCCMS-DRG 100, medical | 27 | $57,381 | $12,971 | $14,403 | 1.98 |
| Extracranial procedures with CCMS-DRG 038, surgical | 24 | $54,771 | $11,103 | $13,747 | 1.60 |
| Headaches without MCCMS-DRG 103, medical | 24 | $28,008 | $5,058 | $7,030 | 0.84 |
| Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurMS-DRG 041, surgical | 22 | $67,880 | $14,847 | $17,038 | 2.23 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 21 | $26,882 | $3,995 | $6,747 | 0.69 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 21 | $51,838 | $12,089 | $13,011 | 1.79 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 21 | $36,051 | $9,700 | $9,049 | 1.36 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 19 | $32,797 | $6,402 | $8,232 | 1.06 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 18 | $41,000 | $11,580 | $10,291 | 1.79 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 16 | $51,923 | $7,228 | $13,033 | 1.14 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 15 | $113,985 | $42,342 | $28,610 | 5.67 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 15 | $50,931 | $15,489 | $12,784 | 2.39 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 15 | $28,914 | $6,691 | $7,257 | 1.03 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 13 | $56,280 | $16,223 | $14,126 | 2.28 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 12 | $93,788 | $26,450 | $23,541 | 3.79 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 11 | $58,318 | $15,523 | $14,638 | 2.30 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 11 | $42,578 | $7,870 | $10,687 | 1.32 |
Kidney and urinary tract422 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 105 | $22,627 | $5,277 | $5,679 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 95 | $33,554 | $8,255 | $8,422 | 1.17 |
| Renal failure with CCMS-DRG 683, medical | 67 | $22,066 | $6,176 | $5,539 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 48 | $34,692 | $11,809 | $8,708 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 40 | $58,244 | $10,481 | $14,619 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 26 | $21,350 | $7,116 | $5,359 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 18 | $83,597 | $18,464 | $20,983 | 2.59 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 12 | $49,526 | $8,890 | $12,431 | 1.35 |
| Kidney and urinary tract signs and symptoms without MCCMS-DRG 696, medical | 11 | $20,430 | $4,665 | $5,128 | 0.69 |
Endocrine, nutritional and metabolic278 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 without MCCMS-DRG 641, medical | 78 | $25,600 | $5,048 | $6,426 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 72 | $41,497 | $9,529 | $10,416 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 42 | $29,338 | $5,607 | $7,364 | 0.90 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 29 | $51,846 | $11,942 | $13,013 | 1.98 |
| Diabetes with MCCMS-DRG 637, medical | 28 | $39,062 | $9,996 | $9,804 | 1.45 |
| Endocrine disorders with CCMS-DRG 644, medical | 16 | $36,904 | $7,481 | $9,263 | 1.06 |
| Endocrine disorders with MCCMS-DRG 643, medical | 13 | $39,826 | $9,448 | $9,996 | 1.65 |
Liver, gallbladder and pancreas189 discharges in 12 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 | 27 | $67,975 | $10,811 | $17,062 | 1.63 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 27 | $39,966 | $7,148 | $10,031 | 1.09 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 22 | $49,503 | $11,207 | $12,425 | 1.76 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 16 | $42,098 | $11,923 | $10,567 | 1.63 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 15 | $40,856 | $13,825 | $10,255 | 1.83 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 14 | $28,632 | $5,711 | $7,187 | 0.86 |
| Malignancy of hepatobiliary system or pancreas with CCMS-DRG 436, medical | 12 | $43,783 | $6,811 | $10,990 | 1.10 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 12 | $28,232 | $12,392 | $7,086 | 1.67 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 11 | $102,960 | $14,094 | $25,843 | 2.32 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 11 | $66,649 | $9,029 | $16,729 | 1.31 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 11 | $38,897 | $5,466 | $9,763 | 1.03 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 11 | $25,816 | $4,265 | $6,480 | 0.95 |
Skin, subcutaneous tissue and breast132 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 78 | $19,595 | $5,819 | $4,918 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 21 | $27,322 | $9,612 | $6,858 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 20 | $27,006 | $6,005 | $6,779 | 0.91 |
| Other skin, subcutaneous tissue and breast procedures with CCMS-DRG 580, surgical | 13 | $44,823 | $12,510 | $11,250 | 1.75 |
Alcohol and drug use73 discharges in 3 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 | 44 | $20,858 | $5,822 | $5,235 | 0.86 |
| Alcohol, drug abuse or dependence without rehabilitation therapy with MCCMS-DRG 896, medical | 15 | $47,050 | $13,215 | $11,810 | 1.78 |
| Alcohol, drug abuse or dependence, left amaMS-DRG 894, medical | 14 | $13,988 | $4,264 | $3,511 | 0.57 |
Blood and immune system66 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 | 38 | $21,709 | $6,475 | $5,449 | 0.90 |
| Coagulation disordersMS-DRG 813, medical | 15 | $32,367 | $11,182 | $8,124 | 1.56 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 13 | $28,505 | $9,674 | $7,155 | 1.40 |
Factors influencing health status52 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 | 40 | $21,753 | $5,446 | $5,460 | 0.80 |
| Signs and symptoms with MCCMS-DRG 947, medical | 12 | $36,550 | $8,593 | $9,174 | 1.25 |
Injuries, poisonings and toxic effects of drugs43 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 15 | $57,835 | $12,956 | $14,517 | 1.82 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 14 | $37,627 | $11,244 | $9,444 | 1.60 |
| Complications of treatment with CCMS-DRG 920, medical | 14 | $24,637 | $6,515 | $6,184 | 1.03 |
Mental diseases and disorders40 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 25 | $32,329 | $10,249 | $8,115 | 1.76 |
| PsychosesMS-DRG 885, medical | 15 | $37,237 | $10,430 | $9,346 | 1.37 |
Other39 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 | 25 | $108,555 | $29,344 | $27,247 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 14 | $78,539 | $17,590 | $19,713 | 2.49 |
Ear, nose, mouth and throat27 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 27 | $27,408 | $4,938 | $6,879 | 0.74 |
Blood cancers and poorly differentiated neoplasms16 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Chemotherapy without acute leukemia as secondary diagnosis with CCMS-DRG 847, medical | 16 | $37,766 | $8,676 | $9,479 | 1.21 |
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 | 596 | 558 | $12,859 | $1,912 | $2,090 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 325 | 302 | $5,836 | $1,175 | $1,220 |
| Level 2 Upper GI ProceduresAPC 5302 | 244 | 202 | $8,955 | $1,386 | $1,445 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 213 | 208 | $96,364 | $19,935 | $21,117 |
| Level 1 Endovascular ProceduresAPC 5191 | 200 | 200 | $21,041 | $2,144 | $2,208 |
| Level 1 Nerve ProceduresAPC 5431 | 198 | 166 | $10,172 | $1,390 | $1,407 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 170 | 167 | $52,814 | $10,228 | $10,772 |
| Level 3 Vascular ProceduresAPC 5183 | 161 | 157 | $11,616 | $2,317 | $2,405 |
| Level 4 Urology and Related ServicesAPC 5374 | 132 | 109 | $21,793 | $2,509 | $2,629 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 128 | 126 | $37,930 | $5,198 | $5,339 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 126 | 125 | $39,047 | $4,253 | $4,358 |
| Level 5 Urology and Related ServicesAPC 5375 | 125 | 113 | $30,234 | $3,729 | $3,918 |
| Level 3 Urology and Related ServicesAPC 5373 | 113 | 80 | $13,687 | $1,491 | $1,516 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 97 | 87 | $25,162 | $2,124 | $2,373 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 91 | 90 | $14,351 | $1,172 | $1,196 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 88 | 86 | $12,461 | $2,036 | $2,141 |
| Level 3 Endovascular ProceduresAPC 5193 | 79 | 75 | $46,302 | $8,423 | $8,874 |
| Level 2 Urology and Related ServicesAPC 5372 | 77 | 19 | $2,946 | $503 | $502 |
| Level 4 Airway EndoscopyAPC 5154 | 76 | 73 | $18,582 | $2,760 | $2,833 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 75 | 75 | $61,213 | $15,562 | $15,763 |
| Level 4 Vascular ProceduresAPC 5184 | 69 | 48 | $23,599 | $2,942 | $3,946 |
| Level 3 Lower GI ProceduresAPC 5313 | 64 | 58 | $11,994 | $2,062 | $2,176 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 56 | 56 | $22,281 | $6,259 | $6,514 |
| Level 2 Intraocular ProceduresAPC 5492 | 56 | 54 | $27,020 | $2,889 | $3,116 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 55 | 47 | $19,358 | $2,546 | $2,636 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 55 | 55 | $57,285 | $7,741 | $8,164 |
| Level 5 Airway EndoscopyAPC 5155 | 54 | 51 | $25,600 | $5,045 | $5,183 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 51 | 50 | $23,188 | $2,809 | $2,930 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 50 | 50 | $31,010 | $8,239 | $8,569 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 49 | 49 | $35,447 | $4,708 | $4,982 |
| Level 2 Vascular ProceduresAPC 5182 | 48 | 47 | $2,945 | $1,180 | $1,204 |
| Level 4 Gynecologic ProceduresAPC 5414 | 48 | 47 | $22,026 | $2,255 | $2,389 |
| Level 4 Endovascular ProceduresAPC 5194 | 40 | 39 | $73,964 | $14,556 | $14,606 |
| Level 3 Upper GI ProceduresAPC 5303 | 40 | 40 | $16,033 | $2,752 | $2,888 |
| Level 5 ENT ProceduresAPC 5165 | 34 | 32 | $31,876 | $4,189 | $4,436 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 32 | 32 | $91,784 | $28,710 | $29,375 |
| Complex GI ProceduresAPC 5331 | 25 | 18 | $21,688 | $3,865 | $4,263 |
| Level 5 Gynecologic ProceduresAPC 5415 | 23 | 23 | $38,585 | $3,637 | $3,792 |
| Level 3 Airway EndoscopyAPC 5153 | 20 | 20 | $15,500 | $1,251 | $1,264 |
| Level 6 Urology and Related ServicesAPC 5376 | 19 | 18 | $46,778 | $6,888 | $7,291 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 17 | 17 | $56,810 | $16,352 | $17,052 |
| Level 2 Endovascular ProceduresAPC 5192 | 16 | 16 | $27,422 | $4,213 | $4,338 |
| Level 4 ENT ProceduresAPC 5164 | 15 | 14 | $22,043 | $2,215 | $2,217 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 14 | 14 | $16,506 | $5,041 | $4,524 |
| Level 7 Radiation TherapyAPC 5627 | 14 | 12 | $29,638 | $5,740 | $6,121 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 12 | 12 | $66,448 | $27,008 | $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.