Staten Island University Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Staten Island University Hospital, Staten Island, NY in 2024, from traditional Medicare claims. Back to the Staten Island University Hospital profile, with quality ratings, finances and negotiated rates.
7,127
Medicare inpatient discharges
In 168 published DRGs
1.91
Case mix index
IPPS FY 2027
18%
Surgical stays
68%
Stays with complications
In DRGs with a CC or MCC
4,616
Medicare outpatient services
In 41 service groups
Inpatient stays by major diagnostic category
Circulatory system1,563 discharges in 35 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 375 | $93,853 | $13,130 | $19,897 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 119 | $105,412 | $16,033 | $22,347 | 1.59 |
| Syncope and collapseMS-DRG 312, medical | 114 | $59,218 | $8,207 | $12,554 | 0.86 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 74 | $62,588 | $6,971 | $13,269 | 0.74 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 73 | $129,696 | $17,292 | $27,496 | 1.82 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 55 | $130,386 | $22,097 | $27,642 | 2.09 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 42 | $182,292 | $32,702 | $38,646 | 3.24 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 41 | $217,911 | $52,212 | $46,197 | 4.88 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 40 | $199,963 | $38,459 | $42,392 | 3.18 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 40 | $98,880 | $13,040 | $20,963 | 1.20 |
| Chest painMS-DRG 313, medical | 40 | $48,017 | $6,502 | $10,180 | 0.72 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 39 | $97,110 | $10,627 | $20,587 | 1.08 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 39 | $53,952 | $10,611 | $11,438 | 1.07 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 36 | $180,085 | $35,559 | $38,178 | 3.27 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 36 | $74,692 | $9,161 | $15,835 | 0.91 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 31 | $267,161 | $59,740 | $56,638 | 5.06 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 30 | $49,991 | $4,661 | $10,598 | 0.55 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 29 | $161,594 | $21,332 | $34,258 | 2.16 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 27 | $56,353 | $9,069 | $11,947 | 0.97 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 26 | $214,158 | $42,026 | $45,402 | 3.35 |
| Other vascular procedures with CCMS-DRG 253, surgical | 26 | $118,793 | $26,095 | $25,184 | 2.55 |
| Hypertension without MCCMS-DRG 305, medical | 24 | $51,796 | $7,198 | $10,981 | 0.75 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 23 | $316,619 | $60,123 | $67,123 | 5.04 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 20 | $137,506 | $21,033 | $29,151 | 1.97 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 19 | $171,971 | $30,614 | $36,458 | 2.87 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 18 | $92,101 | $15,778 | $19,525 | 1.58 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 16 | $172,066 | $33,695 | $36,478 | 3.46 |
| Cardiac defibrillator implant without MCCMS-DRG 277, surgical | 16 | $243,696 | $50,617 | $51,664 | 4.78 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 15 | $341,218 | $76,262 | $72,338 | 7.80 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 15 | $265,934 | $53,596 | $56,378 | 5.20 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 14 | $133,733 | $22,081 | $28,351 | 2.28 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 14 | $192,223 | $44,522 | $40,751 | 4.16 |
| Heart failure and shock with CCMS-DRG 292, medical | 14 | $63,355 | $9,012 | $13,431 | 0.86 |
| Hypertension with MCCMS-DRG 304, medical | 12 | $72,104 | $12,076 | $15,286 | 1.15 |
| Cardiac pacemaker revision except device replacement with MCCMS-DRG 260, surgical | 11 | $167,683 | $36,025 | $35,549 | 3.32 |
Infectious and parasitic diseases1,166 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 | 814 | $107,086 | $20,273 | $22,702 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 134 | $52,186 | $10,092 | $11,064 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 116 | $246,897 | $53,313 | $52,342 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 65 | $362,485 | $79,805 | $76,847 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 26 | $87,785 | $18,983 | $18,611 | 2.04 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 11 | $76,437 | $15,499 | $16,205 | 1.84 |
Respiratory system849 discharges in 22 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 162 | $93,510 | $17,234 | $19,824 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 95 | $89,681 | $12,984 | $19,012 | 1.23 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 95 | $66,412 | $12,416 | $14,079 | 1.33 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 58 | $73,907 | $11,105 | $15,668 | 1.10 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 47 | $52,120 | $7,992 | $11,050 | 0.82 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 42 | $284,180 | $69,748 | $60,246 | 6.91 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 41 | $60,459 | $9,439 | $12,817 | 0.99 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 36 | $51,907 | $9,659 | $11,004 | 0.96 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 35 | $176,097 | $28,974 | $37,333 | 2.70 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 32 | $84,342 | $14,387 | $17,880 | 1.40 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 26 | $46,800 | $7,999 | $9,922 | 0.85 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 25 | $59,748 | $7,448 | $12,667 | 0.82 |
| Major chest trauma with CCMS-DRG 184, medical | 22 | $59,788 | $10,373 | $12,675 | 1.05 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 21 | $90,231 | $17,509 | $19,129 | 1.74 |
| Major chest procedures with CCMS-DRG 164, surgical | 20 | $140,516 | $26,195 | $29,789 | 2.55 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 16 | $236,085 | $44,974 | $50,050 | 4.06 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 15 | $95,226 | $17,094 | $20,188 | 1.81 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 14 | $91,143 | $19,562 | $19,322 | 1.90 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 13 | $102,899 | $16,313 | $21,815 | 1.88 |
| Major chest trauma with MCCMS-DRG 183, medical | 12 | $74,745 | $15,128 | $15,846 | 1.57 |
| Major chest procedures with MCCMS-DRG 163, surgical | 11 | $187,242 | $48,807 | $39,695 | 4.71 |
| Respiratory signs and symptomsMS-DRG 204, medical | 11 | $46,232 | $8,369 | $9,801 | 0.82 |
Digestive system685 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 | 140 | $48,611 | $7,368 | $10,306 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 73 | $68,538 | $9,754 | $14,530 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 62 | $142,859 | $18,236 | $30,286 | 1.79 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 59 | $62,729 | $9,405 | $13,298 | 0.94 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 51 | $79,189 | $12,932 | $16,788 | 1.28 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 43 | $55,842 | $7,437 | $11,838 | 0.80 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 41 | $192,681 | $38,915 | $40,848 | 4.52 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 40 | $94,594 | $16,960 | $20,054 | 1.62 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 31 | $113,781 | $22,973 | $24,122 | 2.37 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 25 | $62,936 | $10,641 | $13,342 | 1.04 |
| Digestive malignancy with MCCMS-DRG 374, medical | 21 | $132,822 | $21,988 | $28,158 | 2.10 |
| Digestive malignancy with CCMS-DRG 375, medical | 20 | $91,432 | $12,301 | $19,384 | 1.20 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 19 | $28,703 | $4,356 | $6,085 | 0.56 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 18 | $142,350 | $15,792 | $30,178 | 1.45 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 16 | $85,600 | $17,261 | $18,147 | 1.67 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 13 | $254,793 | $45,468 | $54,016 | 5.08 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 13 | $90,776 | $16,626 | $19,245 | 1.75 |
Kidney and urinary tract624 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 | 135 | $43,182 | $7,907 | $9,155 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 116 | $67,981 | $11,875 | $14,412 | 1.17 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 98 | $111,386 | $19,055 | $23,614 | 1.65 |
| Renal failure with CCMS-DRG 683, medical | 89 | $61,892 | $8,777 | $13,121 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 85 | $88,298 | $14,888 | $18,719 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 50 | $50,795 | $10,554 | $10,769 | 1.02 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 21 | $263,292 | $42,193 | $55,818 | 3.70 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 17 | $80,821 | $13,021 | $17,134 | 1.35 |
| Urinary stones without MCCMS-DRG 694, medical | 13 | $46,653 | $7,508 | $9,890 | 0.78 |
Nervous system577 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 74 | $136,809 | $19,786 | $29,004 | 2.00 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 59 | $70,548 | $14,092 | $14,956 | 1.36 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 57 | $60,993 | $10,071 | $12,931 | 1.03 |
| Seizures without MCCMS-DRG 101, medical | 56 | $79,847 | $8,772 | $16,928 | 0.91 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 46 | $88,971 | $9,905 | $18,862 | 1.02 |
| Seizures with MCCMS-DRG 100, medical | 36 | $142,706 | $22,177 | $30,254 | 1.98 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 26 | $328,579 | $52,324 | $69,659 | 4.42 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 26 | $95,830 | $18,619 | $20,316 | 1.79 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 24 | $85,243 | $22,822 | $18,071 | 2.39 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 24 | $63,972 | $6,952 | $13,562 | 0.80 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 24 | $55,867 | $9,417 | $11,844 | 1.03 |
| Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurMS-DRG 041, surgical | 23 | $126,386 | $20,528 | $26,794 | 2.23 |
| Peripheral, cranial nerve and other nervous system procedures with MCCMS-DRG 040, surgical | 16 | $187,315 | $36,393 | $39,711 | 3.85 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 14 | $375,209 | $61,229 | $79,544 | 5.67 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 14 | $138,462 | $25,496 | $29,354 | 2.27 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 13 | $182,567 | $22,247 | $38,704 | 2.28 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 12 | $118,176 | $15,232 | $25,053 | 1.47 |
| Extracranial procedures with CCMS-DRG 038, surgical | 11 | $63,016 | $16,311 | $13,359 | 1.60 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 11 | $102,988 | $17,648 | $21,834 | 1.79 |
| Other disorders of nervous system without cc/mccMS-DRG 093, medical | 11 | $37,587 | $7,495 | $7,968 | 0.77 |
Musculoskeletal system and connective tissue568 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 78 | $48,389 | $9,524 | $10,258 | 0.97 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 72 | $111,214 | $20,010 | $23,577 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 46 | $117,224 | $20,805 | $24,852 | 2.11 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 45 | $51,012 | $10,684 | $10,815 | 1.09 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 41 | $49,428 | $8,446 | $10,479 | 0.90 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 33 | $190,896 | $32,519 | $40,470 | 2.95 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 32 | $80,014 | $18,806 | $16,963 | 1.88 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 32 | $43,473 | $7,750 | $9,216 | 0.82 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 29 | $43,401 | $7,539 | $9,201 | 0.79 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 26 | $35,335 | $7,929 | $7,491 | 0.82 |
| Medical back problems with MCCMS-DRG 551, medical | 22 | $66,978 | $16,185 | $14,199 | 1.70 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 17 | $140,807 | $24,342 | $29,851 | 2.40 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 16 | $161,224 | $28,439 | $34,180 | 2.99 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 16 | $81,822 | $16,993 | $17,346 | 1.82 |
| Tendonitis, myositis and bursitis without MCCMS-DRG 558, medical | 15 | $35,954 | $8,566 | $7,622 | 0.88 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCMS-DRG 562, medical | 14 | $52,505 | $15,018 | $11,131 | 1.52 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 12 | $96,039 | $20,349 | $20,360 | 1.97 |
| Pathological fractures and musculoskeletal and connective tissue malignancy without cc/mMS-DRG 544, medical | 11 | $36,421 | $7,289 | $7,721 | 0.77 |
| Connective tissue disorders with MCCMS-DRG 545, medical | 11 | $185,629 | $31,567 | $39,353 | 2.49 |
Endocrine, nutritional and metabolic262 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 | 82 | $93,587 | $14,936 | $19,840 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 78 | $49,152 | $7,785 | $10,420 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 43 | $48,129 | $8,780 | $10,203 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 30 | $106,037 | $14,287 | $22,480 | 1.45 |
| Endocrine disorders with CCMS-DRG 644, medical | 15 | $61,376 | $10,672 | $13,012 | 1.06 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 14 | $74,833 | $17,147 | $15,865 | 1.98 |
Skin, subcutaneous tissue and breast182 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 105 | $39,068 | $8,392 | $8,282 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 27 | $82,477 | $14,960 | $17,485 | 1.49 |
| Skin debridement with CCMS-DRG 571, surgical | 21 | $78,236 | $16,639 | $16,586 | 1.69 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 17 | $52,156 | $9,373 | $11,057 | 0.91 |
| Minor skin disorders without MCCMS-DRG 607, medical | 12 | $42,487 | $8,712 | $9,007 | 0.89 |
Liver, gallbladder and pancreas115 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 22 | $159,813 | $22,917 | $33,880 | 1.76 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 18 | $110,893 | $20,724 | $23,509 | 1.92 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 18 | $132,769 | $20,979 | $28,147 | 1.83 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 18 | $51,024 | $9,936 | $10,817 | 1.09 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 14 | $45,380 | $8,302 | $9,621 | 0.86 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 14 | $74,320 | $16,261 | $15,756 | 1.63 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 11 | $143,750 | $21,278 | $30,475 | 2.32 |
Blood and immune system98 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 | 51 | $59,423 | $8,815 | $12,598 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 33 | $106,699 | $14,923 | $22,620 | 1.40 |
| Coagulation disordersMS-DRG 813, medical | 14 | $127,690 | $17,711 | $27,070 | 1.56 |
Injuries, poisonings and toxic effects of drugs95 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with CCMS-DRG 920, medical | 28 | $67,450 | $10,381 | $14,299 | 1.03 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 21 | $95,940 | $16,141 | $20,339 | 1.60 |
| Poisoning and toxic effects of drugs without MCCMS-DRG 918, medical | 20 | $47,448 | $8,868 | $10,059 | 0.86 |
| Complications of treatment with MCCMS-DRG 919, medical | 15 | $103,490 | $19,422 | $21,940 | 1.82 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 11 | $160,925 | $41,451 | $34,116 | 3.72 |
Mental diseases and disorders86 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 | 72 | $79,260 | $18,231 | $16,803 | 1.76 |
| PsychosesMS-DRG 885, medical | 14 | $97,925 | $13,672 | $20,760 | 1.37 |
Other77 discharges in 4 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 | 38 | $283,364 | $50,394 | $60,073 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 17 | $118,429 | $24,067 | $25,107 | 2.49 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 11 | $247,523 | $28,207 | $52,475 | 3.38 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 988, surgical | 11 | $61,734 | $17,421 | $13,088 | 1.70 |
Factors influencing health status55 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other factors influencing health statusMS-DRG 951, medical | 33 | $37,743 | $5,676 | $8,002 | 0.59 |
| Signs and symptoms without MCCMS-DRG 948, medical | 22 | $43,325 | $8,103 | $9,185 | 0.80 |
Ear, nose, mouth and throat49 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 34 | $55,424 | $6,366 | $11,750 | 0.74 |
| Otitis media and uri without MCCMS-DRG 153, medical | 15 | $40,355 | $6,972 | $8,555 | 0.73 |
Transplants, ECMO and tracheostomy (pre-MDC)30 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 | 15 | $874,651 | $206,549 | $185,426 | 21.32 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 15 | $719,765 | $134,253 | $152,590 | 14.70 |
Alcohol and drug use25 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 | 25 | $57,147 | $8,531 | $12,115 | 0.86 |
Blood cancers and poorly differentiated neoplasms21 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 | 21 | $205,811 | $39,625 | $43,632 | 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 1 Intraocular ProceduresAPC 5491 | 990 | 644 | $14,573 | $2,034 | $1,752 |
| Comprehensive Observation ServicesAPC 8011 | 352 | 336 | $22,980 | $2,430 | $2,090 |
| Level 1 Endovascular ProceduresAPC 5191 | 265 | 263 | $29,492 | $2,584 | $2,208 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 212 | 198 | $10,545 | $1,406 | $1,220 |
| Level 3 Endovascular ProceduresAPC 5193 | 197 | 186 | $82,039 | $10,702 | $8,874 |
| Level 4 Urology and Related ServicesAPC 5374 | 183 | 166 | $18,248 | $3,091 | $2,629 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 174 | 174 | $30,287 | $5,109 | $4,358 |
| Level 2 Upper GI ProceduresAPC 5302 | 158 | 149 | $14,338 | $1,687 | $1,445 |
| Level 2 Urology and Related ServicesAPC 5372 | 153 | 66 | $7,086 | $618 | $502 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 148 | 140 | $53,206 | $12,866 | $10,772 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 130 | 130 | $20,439 | $3,015 | $2,636 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 125 | 121 | $12,932 | $1,443 | $1,196 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 109 | 105 | $32,439 | $6,389 | $5,339 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 107 | 97 | $17,158 | $2,605 | $2,373 |
| Level 2 Endovascular ProceduresAPC 5192 | 107 | 87 | $31,919 | $5,131 | $4,338 |
| Level 3 Vascular ProceduresAPC 5183 | 98 | 89 | $14,626 | $2,799 | $2,405 |
| Level 5 Urology and Related ServicesAPC 5375 | 95 | 88 | $24,909 | $4,592 | $3,918 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 88 | 85 | $23,107 | $2,423 | $2,141 |
| Level 1 Nerve ProceduresAPC 5431 | 80 | 72 | $15,483 | $1,702 | $1,407 |
| Level 4 Endovascular ProceduresAPC 5194 | 77 | 68 | $87,659 | $17,795 | $14,606 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 72 | 70 | $24,502 | $3,312 | $2,930 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 68 | 68 | $56,082 | $7,908 | $6,514 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 64 | 64 | $45,752 | $10,063 | $8,164 |
| Level 3 Urology and Related ServicesAPC 5373 | 64 | 54 | $14,652 | $1,803 | $1,516 |
| Level 3 Lower GI ProceduresAPC 5313 | 52 | 50 | $19,127 | $2,472 | $2,176 |
| Level 4 Gynecologic ProceduresAPC 5414 | 52 | 52 | $18,795 | $2,671 | $2,389 |
| Level 2 Vascular ProceduresAPC 5182 | 50 | 45 | $9,307 | $1,419 | $1,204 |
| Level 4 Vascular ProceduresAPC 5184 | 46 | 45 | $28,308 | $4,763 | $3,946 |
| Level 4 Airway EndoscopyAPC 5154 | 41 | 41 | $22,844 | $3,271 | $2,833 |
| Complex GI ProceduresAPC 5331 | 31 | 30 | $29,326 | $5,167 | $4,263 |
| Level 3 Upper GI ProceduresAPC 5303 | 28 | 28 | $17,867 | $3,348 | $2,888 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 27 | 25 | $32,744 | $5,693 | $4,982 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 26 | 26 | $46,626 | $10,499 | $8,569 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 26 | 26 | $147,887 | $32,300 | $26,719 |
| Level 2 Intraocular ProceduresAPC 5492 | 22 | 19 | $23,173 | $3,519 | $3,116 |
| Level 3 Airway EndoscopyAPC 5153 | 21 | 21 | $13,189 | $1,539 | $1,264 |
| Level 5 ENT ProceduresAPC 5165 | 21 | 21 | $27,569 | $5,006 | $4,436 |
| Level 3 Intraocular ProceduresAPC 5493 | 20 | 15 | $28,145 | $4,739 | $4,004 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 13 | 13 | $93,215 | $19,521 | $15,763 |
| Level 6 Urology and Related ServicesAPC 5376 | 13 | 11 | $31,527 | $8,841 | $7,291 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 11 | 11 | $142,397 | $35,685 | $29,375 |
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.