St Lukes University Hospital - Bethlehem Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for St Lukes University Hospital - Bethlehem, Bethlehem, PA in 2024, from traditional Medicare claims. Back to the St Lukes University Hospital - Bethlehem profile, with quality ratings, finances and negotiated rates.
6,633
Medicare inpatient discharges
In 178 published DRGs
2.06
Case mix index
IPPS FY 2027
33%
Surgical stays
69%
Stays with complications
In DRGs with a CC or MCC
6,162
Medicare outpatient services
In 44 service groups
Inpatient stays by major diagnostic category
Circulatory system1,779 discharges in 40 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 360 | $102,984 | $10,320 | $9,680 | 1.28 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 158 | $463,112 | $40,790 | $43,533 | 4.88 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 83 | $57,306 | $5,319 | $5,387 | 0.74 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 80 | $265,602 | $26,738 | $24,967 | 3.24 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 79 | $138,835 | $19,275 | $13,051 | 2.28 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 68 | $130,410 | $13,164 | $12,259 | 1.82 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 66 | $553,920 | $52,230 | $52,068 | 6.25 |
| Syncope and collapseMS-DRG 312, medical | 55 | $63,902 | $6,673 | $6,007 | 0.86 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 49 | $203,781 | $15,900 | $19,155 | 2.16 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 45 | $90,743 | $7,728 | $8,530 | 1.08 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 44 | $61,697 | $8,109 | $5,799 | 1.07 |
| Other vascular procedures with CCMS-DRG 253, surgical | 43 | $226,890 | $20,813 | $21,328 | 2.55 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 43 | $110,585 | $8,987 | $10,395 | 1.20 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 36 | $44,224 | $3,501 | $4,157 | 0.55 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 34 | $175,849 | $28,308 | $16,530 | 3.46 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 34 | $261,236 | $27,493 | $24,556 | 3.35 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 32 | $511,761 | $57,353 | $48,106 | 7.71 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 31 | $358,175 | $37,927 | $33,668 | 5.06 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 31 | $273,472 | $29,651 | $25,706 | 3.46 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 30 | $236,592 | $23,381 | $22,240 | 2.87 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 29 | $453,333 | $35,336 | $42,613 | 5.88 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 29 | $94,064 | $6,523 | $8,842 | 0.91 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 29 | $109,755 | $15,772 | $10,317 | 2.09 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 26 | $70,136 | $7,920 | $6,593 | 0.97 |
| Hypertension without MCCMS-DRG 305, medical | 24 | $69,502 | $5,736 | $6,533 | 0.75 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 19 | $535,247 | $64,082 | $50,313 | 7.80 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 19 | $136,845 | $14,313 | $12,863 | 1.83 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 19 | $272,831 | $30,800 | $25,646 | 3.90 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 18 | $275,612 | $27,961 | $25,908 | 3.18 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 18 | $339,460 | $27,857 | $31,909 | 4.04 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 18 | $377,234 | $35,641 | $35,460 | 4.16 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 18 | $79,617 | $12,656 | $7,484 | 1.58 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 17 | $403,839 | $44,303 | $37,961 | 4.81 |
| Cardiac defibrillator implant without MCCMS-DRG 277, surgical | 17 | $353,055 | $38,937 | $33,187 | 4.78 |
| Cardiac congenital and valvular disorders with MCCMS-DRG 306, medical | 15 | $86,754 | $11,943 | $8,155 | 1.54 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 14 | $132,328 | $13,450 | $12,439 | 1.59 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 13 | $354,158 | $44,086 | $33,291 | 5.04 |
| Heart failure and shock with CCMS-DRG 292, medical | 13 | $56,392 | $7,306 | $5,301 | 0.86 |
| Amputation for circulatory system disorders except upper limb and toe with CCMS-DRG 240, surgical | 12 | $232,536 | $22,143 | $21,858 | 2.81 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 11 | $130,775 | $27,020 | $12,293 | 3.27 |
Infectious and parasitic diseases755 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 | 457 | $137,361 | $15,742 | $12,912 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 121 | $395,964 | $39,297 | $37,221 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 112 | $79,507 | $7,581 | $7,474 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 37 | $151,451 | $13,637 | $14,236 | 2.04 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 16 | $268,813 | $34,701 | $25,268 | 4.43 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 12 | $105,208 | $14,560 | $9,890 | 1.84 |
Nervous system742 discharges in 25 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 89 | $211,199 | $16,082 | $19,853 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 72 | $95,831 | $7,817 | $9,008 | 1.02 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 67 | $87,129 | $10,943 | $8,190 | 1.36 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 60 | $66,439 | $8,087 | $6,245 | 1.03 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 39 | $336,268 | $32,007 | $31,609 | 4.42 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 38 | $474,266 | $47,197 | $44,581 | 5.67 |
| Seizures without MCCMS-DRG 101, medical | 33 | $106,548 | $6,876 | $10,015 | 0.91 |
| Seizures with MCCMS-DRG 100, medical | 31 | $192,561 | $15,594 | $18,101 | 1.98 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 26 | $69,092 | $9,809 | $6,495 | 1.32 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 25 | $168,148 | $14,004 | $15,806 | 1.79 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 24 | $82,444 | $10,974 | $7,750 | 1.36 |
| Extracranial procedures with CCMS-DRG 038, surgical | 22 | $149,086 | $12,992 | $14,014 | 1.60 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 22 | $74,367 | $7,560 | $6,991 | 1.03 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 20 | $128,249 | $10,848 | $12,055 | 1.79 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 19 | $192,162 | $15,265 | $18,063 | 2.30 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 19 | $123,613 | $9,120 | $11,620 | 1.14 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 19 | $237,916 | $18,723 | $22,364 | 2.39 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 18 | $166,558 | $18,745 | $15,656 | 2.28 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 17 | $132,028 | $16,165 | $12,411 | 2.27 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 16 | $79,976 | $8,467 | $7,518 | 1.06 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 15 | $74,577 | $5,905 | $7,010 | 0.80 |
| Other disorders of nervous system without cc/mccMS-DRG 093, medical | 14 | $69,587 | $6,007 | $6,541 | 0.77 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 13 | $195,649 | $13,975 | $18,391 | 1.47 |
| Headaches without MCCMS-DRG 103, medical | 13 | $80,068 | $6,181 | $7,526 | 0.84 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 11 | $200,933 | $18,746 | $18,888 | 2.43 |
Respiratory system715 discharges in 21 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 89 | $85,190 | $9,724 | $8,008 | 1.23 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 85 | $116,657 | $13,376 | $10,966 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 53 | $91,242 | $9,288 | $8,577 | 1.33 |
| Major chest procedures with MCCMS-DRG 163, surgical | 46 | $294,390 | $35,102 | $27,673 | 4.71 |
| Major chest procedures with CCMS-DRG 164, surgical | 45 | $201,252 | $20,048 | $18,918 | 2.55 |
| Major chest trauma with CCMS-DRG 184, medical | 42 | $85,529 | $7,956 | $8,040 | 1.05 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 32 | $110,784 | $11,686 | $10,414 | 1.40 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 32 | $72,666 | $7,338 | $6,831 | 0.99 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 30 | $76,821 | $7,790 | $7,221 | 1.10 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 29 | $62,402 | $5,793 | $5,866 | 0.82 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 28 | $210,049 | $21,854 | $19,745 | 2.70 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 27 | $55,956 | $7,055 | $5,260 | 0.85 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 26 | $80,617 | $5,022 | $7,578 | 0.82 |
| Major chest trauma with MCCMS-DRG 183, medical | 25 | $110,849 | $12,647 | $10,420 | 1.57 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 25 | $72,215 | $7,507 | $6,788 | 0.96 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 23 | $122,124 | $13,747 | $11,480 | 1.74 |
| Pleural effusion with MCCMS-DRG 186, medical | 21 | $107,156 | $11,740 | $10,073 | 1.55 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 19 | $137,506 | $15,599 | $12,926 | 1.88 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 15 | $277,191 | $33,157 | $26,056 | 4.06 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 12 | $113,229 | $15,009 | $10,644 | 1.90 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 11 | $80,881 | $13,098 | $7,603 | 1.81 |
Musculoskeletal system and connective tissue584 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 95 | $70,369 | $7,285 | $6,615 | 0.97 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 81 | $128,396 | $14,159 | $12,069 | 1.88 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 62 | $161,499 | $15,796 | $15,181 | 2.07 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 38 | $267,554 | $28,687 | $25,150 | 3.49 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 36 | $76,740 | $8,367 | $7,214 | 1.09 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 33 | $69,614 | $6,287 | $6,544 | 0.90 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 29 | $279,020 | $26,744 | $26,228 | 3.66 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 27 | $176,855 | $17,003 | $16,624 | 2.11 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 23 | $224,236 | $22,683 | $21,078 | 2.95 |
| Medical back problems with MCCMS-DRG 551, medical | 19 | $94,091 | $12,299 | $8,845 | 1.70 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 19 | $66,449 | $6,283 | $6,246 | 0.82 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 16 | $60,111 | $6,282 | $5,650 | 0.82 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 16 | $74,221 | $7,603 | $6,977 | 1.00 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 15 | $191,372 | $18,305 | $17,989 | 2.48 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 14 | $58,950 | $5,969 | $5,541 | 0.79 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 13 | $194,155 | $18,985 | $18,251 | 2.67 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 13 | $175,931 | $15,461 | $16,538 | 2.40 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 12 | $167,678 | $17,931 | $15,762 | 3.00 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 12 | $160,744 | $15,930 | $15,110 | 2.04 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 11 | $84,691 | $11,313 | $7,961 | 1.82 |
Kidney and urinary tract564 discharges in 12 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with MCCMS-DRG 682, medical | 95 | $112,591 | $11,385 | $10,584 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 84 | $76,247 | $7,289 | $7,167 | 0.90 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 72 | $84,402 | $9,220 | $7,934 | 1.17 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 69 | $61,656 | $6,343 | $5,796 | 0.81 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 64 | $115,544 | $13,556 | $10,861 | 1.65 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 48 | $95,747 | $8,862 | $9,000 | 1.35 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 34 | $84,114 | $8,054 | $7,907 | 1.02 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 31 | $76,025 | $7,483 | $7,146 | 1.05 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 25 | $201,162 | $19,215 | $18,909 | 2.59 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 20 | $156,518 | $14,711 | $14,713 | 1.84 |
| Transurethral procedures with CCMS-DRG 669, surgical | 11 | $115,284 | $13,423 | $10,837 | 1.53 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 11 | $236,664 | $26,877 | $22,246 | 3.70 |
Digestive system561 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 | 84 | $68,433 | $5,784 | $6,433 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 70 | $81,905 | $8,109 | $7,699 | 0.98 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 66 | $195,544 | $17,059 | $18,381 | 2.37 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 58 | $172,040 | $15,272 | $16,172 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 45 | $73,124 | $10,049 | $6,874 | 1.28 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 30 | $309,345 | $37,117 | $29,078 | 4.52 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 30 | $144,604 | $10,546 | $13,593 | 1.67 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 30 | $122,007 | $13,152 | $11,469 | 1.62 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 30 | $87,221 | $6,965 | $8,199 | 0.94 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 24 | $56,946 | $5,752 | $5,353 | 0.80 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 22 | $229,528 | $19,964 | $21,576 | 2.50 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 18 | $131,659 | $11,455 | $12,376 | 1.60 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 16 | $334,434 | $41,993 | $31,437 | 5.08 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 14 | $97,513 | $10,414 | $9,166 | 1.45 |
| Inflammatory bowel disease with CCMS-DRG 386, medical | 13 | $82,939 | $6,861 | $7,796 | 0.97 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 11 | $88,663 | $8,953 | $8,334 | 1.04 |
Endocrine, nutritional and metabolic249 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 | 62 | $60,296 | $5,755 | $5,668 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 60 | $84,315 | $10,571 | $7,926 | 1.32 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 31 | $151,667 | $15,512 | $14,257 | 1.98 |
| Diabetes with MCCMS-DRG 637, medical | 29 | $85,696 | $11,918 | $8,055 | 1.45 |
| Diabetes with CCMS-DRG 638, medical | 28 | $63,221 | $6,722 | $5,943 | 0.90 |
| Endocrine disorders with CCMS-DRG 644, medical | 21 | $88,925 | $8,818 | $8,359 | 1.06 |
| Endocrine disorders with MCCMS-DRG 643, medical | 18 | $124,294 | $13,975 | $11,684 | 1.65 |
Liver, gallbladder and pancreas131 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 20 | $136,574 | $12,635 | $12,838 | 1.63 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 20 | $97,277 | $8,188 | $9,144 | 1.09 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 18 | $155,350 | $15,738 | $14,603 | 1.76 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 15 | $184,232 | $14,425 | $17,318 | 1.83 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 13 | $112,055 | $13,822 | $10,533 | 1.92 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 12 | $147,304 | $13,673 | $13,847 | 1.63 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 11 | $462,351 | $45,840 | $43,461 | 5.51 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 11 | $250,334 | $24,599 | $23,531 | 2.89 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 11 | $80,281 | $7,965 | $7,546 | 1.03 |
Mental diseases and disorders125 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| PsychosesMS-DRG 885, medical | 92 | $200,947 | $10,096 | $18,889 | 1.37 |
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 21 | $167,081 | $13,450 | $15,706 | 1.76 |
| Acute adjustment reaction and psychosocial dysfunctionMS-DRG 880, medical | 12 | $77,861 | $6,453 | $7,319 | 0.95 |
Skin, subcutaneous tissue and breast110 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 62 | $53,993 | $6,411 | $5,075 | 0.88 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 34 | $57,767 | $7,082 | $5,430 | 0.91 |
| Cellulitis with MCCMS-DRG 602, medical | 14 | $103,000 | $11,643 | $9,682 | 1.49 |
Blood and immune system81 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 | 35 | $109,321 | $11,710 | $10,276 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 26 | $57,426 | $6,621 | $5,398 | 0.90 |
| Coagulation disordersMS-DRG 813, medical | 20 | $74,967 | $13,207 | $7,047 | 1.56 |
Injuries, poisonings and toxic effects of drugs62 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with CCMS-DRG 920, medical | 23 | $91,281 | $8,165 | $8,580 | 1.03 |
| Complications of treatment with MCCMS-DRG 919, medical | 14 | $153,293 | $14,926 | $14,410 | 1.82 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 13 | $348,846 | $27,949 | $32,791 | 3.72 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 12 | $127,769 | $15,703 | $12,010 | 2.00 |
Other50 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 | 26 | $280,479 | $36,375 | $26,365 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 24 | $171,183 | $17,330 | $16,091 | 2.49 |
Alcohol and drug use44 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 | 44 | $42,004 | $6,277 | $3,948 | 0.86 |
Factors influencing health status17 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 | 17 | $61,388 | $6,333 | $5,770 | 0.80 |
Ear, nose, mouth and throat16 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 16 | $65,180 | $5,752 | $6,127 | 0.74 |
Male reproductive system13 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Transurethral prostatectomy with cc/mccMS-DRG 713, surgical | 13 | $91,713 | $12,069 | $8,621 | 1.45 |
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 | $234,558 | $26,320 | $22,048 | 3.88 |
Transplants, ECMO and tracheostomy (pre-MDC)11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 11 | $881,002 | $108,637 | $82,814 | 14.70 |
Blood cancers and poorly differentiated neoplasms11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 11 | $160,540 | $23,728 | $15,091 | 3.13 |
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 2 Upper GI ProceduresAPC 5302 | 470 | 415 | $18,570 | $1,472 | $1,445 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 441 | 411 | $15,697 | $1,250 | $1,220 |
| Level 1 Nerve ProceduresAPC 5431 | 401 | 270 | $14,378 | $1,471 | $1,407 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 372 | 351 | $90,665 | $10,843 | $10,772 |
| Level 3 Urology and Related ServicesAPC 5373 | 370 | 310 | $28,351 | $1,571 | $1,516 |
| Comprehensive Observation ServicesAPC 8011 | 363 | 342 | $32,554 | $2,056 | $2,090 |
| Level 1 Endovascular ProceduresAPC 5191 | 269 | 269 | $39,672 | $2,242 | $2,208 |
| Level 5 Urology and Related ServicesAPC 5375 | 261 | 246 | $55,966 | $3,943 | $3,918 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 191 | 184 | $36,432 | $2,115 | $2,141 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 190 | 186 | $71,747 | $5,481 | $5,339 |
| Level 3 Vascular ProceduresAPC 5183 | 182 | 163 | $29,055 | $2,402 | $2,405 |
| Level 4 Urology and Related ServicesAPC 5374 | 172 | 149 | $39,655 | $2,645 | $2,629 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 164 | 160 | $199,367 | $21,340 | $21,117 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 158 | 144 | $12,785 | $1,222 | $1,196 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 155 | 153 | $64,045 | $4,454 | $4,358 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 148 | 146 | $99,309 | $8,258 | $8,164 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 136 | 128 | $36,282 | $2,402 | $2,373 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 125 | 124 | $68,988 | $6,591 | $6,514 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 116 | 96 | $38,262 | $2,663 | $2,636 |
| Level 4 Airway EndoscopyAPC 5154 | 106 | 102 | $53,486 | $2,883 | $2,833 |
| Level 3 Endovascular ProceduresAPC 5193 | 102 | 100 | $93,041 | $8,909 | $8,874 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 102 | 102 | $65,295 | $8,773 | $8,569 |
| Level 2 Endovascular ProceduresAPC 5192 | 88 | 77 | $56,813 | $4,389 | $4,338 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 79 | 78 | $143,374 | $16,085 | $15,763 |
| Level 2 Urology and Related ServicesAPC 5372 | 73 | 25 | $4,989 | $499 | $502 |
| Level 4 Gynecologic ProceduresAPC 5414 | 71 | 71 | $37,626 | $2,361 | $2,389 |
| Complex GI ProceduresAPC 5331 | 65 | 50 | $50,399 | $3,816 | $4,263 |
| Level 3 Upper GI ProceduresAPC 5303 | 64 | 62 | $32,861 | $2,883 | $2,888 |
| Level 6 Gynecologic ProceduresAPC 5416 | 61 | 61 | $76,008 | $5,867 | $5,836 |
| Level 5 ENT ProceduresAPC 5165 | 59 | 58 | $71,739 | $4,548 | $4,436 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 56 | 54 | $47,105 | $2,962 | $2,930 |
| Level 4 Vascular ProceduresAPC 5184 | 56 | 56 | $72,358 | $4,194 | $3,946 |
| Level 2 Vascular ProceduresAPC 5182 | 54 | 52 | $8,748 | $1,129 | $1,204 |
| Level 3 Lower GI ProceduresAPC 5313 | 53 | 53 | $31,207 | $2,132 | $2,176 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 51 | 51 | $217,527 | $29,168 | $29,375 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 49 | 48 | $78,652 | $4,962 | $4,982 |
| Level 5 Airway EndoscopyAPC 5155 | 48 | 48 | $70,913 | $5,319 | $5,183 |
| Level 4 Endovascular ProceduresAPC 5194 | 43 | 40 | $140,406 | $15,249 | $14,606 |
| Level 3 Airway EndoscopyAPC 5153 | 41 | 41 | $29,517 | $1,313 | $1,264 |
| Level 5 Gynecologic ProceduresAPC 5415 | 39 | 39 | $51,436 | $3,853 | $3,792 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 39 | 39 | $232,106 | $27,832 | $26,719 |
| Level 4 ENT ProceduresAPC 5164 | 27 | 26 | $49,581 | $2,404 | $2,217 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 26 | 26 | $126,912 | $17,328 | $17,052 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 26 | 25 | $214,185 | $19,650 | $18,465 |
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.