Sutter Roseville Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Sutter Roseville Medical Center, Roseville, CA in 2024, from traditional Medicare claims. Back to the Sutter Roseville Medical Center profile, with quality ratings, finances and negotiated rates.
7,270
Medicare inpatient discharges
In 170 published DRGs
1.78
Case mix index
IPPS FY 2027
19%
Surgical stays
71%
Stays with complications
In DRGs with a CC or MCC
4,783
Medicare outpatient services
In 36 service groups
Inpatient stays by major diagnostic category
Infectious and parasitic diseases1,546 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 | 1,040 | $94,165 | $18,382 | $23,353 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 283 | $57,256 | $9,060 | $14,200 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 129 | $216,720 | $46,041 | $53,747 | 5.00 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 43 | $84,763 | $16,796 | $21,021 | 2.04 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 33 | $392,453 | $68,228 | $97,328 | 6.96 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 18 | $118,885 | $17,488 | $29,484 | 1.84 |
Circulatory system1,217 discharges in 25 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 331 | $69,302 | $12,141 | $17,187 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 90 | $85,421 | $14,212 | $21,184 | 1.59 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 77 | $137,762 | $16,816 | $34,165 | 1.82 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 75 | $46,447 | $6,608 | $11,519 | 0.74 |
| Syncope and collapseMS-DRG 312, medical | 75 | $66,368 | $7,822 | $16,459 | 0.86 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 63 | $75,957 | $11,197 | $18,837 | 1.20 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 53 | $68,517 | $7,929 | $16,992 | 0.91 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 50 | $37,349 | $4,304 | $9,263 | 0.55 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 44 | $184,101 | $27,023 | $45,657 | 2.87 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 40 | $115,605 | $21,583 | $28,670 | 2.28 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 39 | $102,379 | $19,262 | $25,390 | 2.09 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 37 | $80,121 | $9,626 | $19,870 | 1.08 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 36 | $146,947 | $21,397 | $36,443 | 2.16 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 23 | $80,412 | $15,084 | $19,942 | 1.58 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 21 | $192,335 | $34,240 | $47,699 | 3.35 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 21 | $63,894 | $5,961 | $15,846 | 0.72 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 20 | $72,193 | $9,663 | $17,904 | 1.07 |
| Chest painMS-DRG 313, medical | 20 | $49,550 | $6,537 | $12,288 | 0.72 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 18 | $98,245 | $16,980 | $24,365 | 1.83 |
| Hypertension without MCCMS-DRG 305, medical | 18 | $55,589 | $6,104 | $13,786 | 0.75 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 17 | $54,391 | $9,136 | $13,489 | 0.97 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 14 | $181,350 | $33,741 | $44,975 | 3.46 |
| Other vascular procedures with CCMS-DRG 253, surgical | 12 | $168,182 | $26,581 | $41,709 | 2.55 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 12 | $239,969 | $49,062 | $59,512 | 5.06 |
| Heart failure and shock with CCMS-DRG 292, medical | 11 | $49,897 | $7,517 | $12,374 | 0.86 |
Respiratory system897 discharges in 22 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 152 | $77,260 | $12,215 | $19,160 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 142 | $88,882 | $15,561 | $22,043 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 99 | $81,849 | $11,197 | $20,299 | 1.23 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 46 | $78,843 | $13,019 | $19,553 | 1.40 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 46 | $54,086 | $6,944 | $13,413 | 0.82 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 43 | $182,145 | $26,822 | $45,172 | 2.70 |
| Major chest trauma with CCMS-DRG 184, medical | 40 | $80,613 | $9,495 | $19,992 | 1.05 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 39 | $58,191 | $9,856 | $14,431 | 1.10 |
| Major chest procedures with CCMS-DRG 164, surgical | 35 | $111,776 | $23,998 | $27,721 | 2.55 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 32 | $61,991 | $8,831 | $15,374 | 0.99 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 29 | $61,554 | $7,303 | $15,265 | 0.82 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 29 | $59,098 | $8,817 | $14,656 | 0.96 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 28 | $80,394 | $17,091 | $19,938 | 1.88 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 27 | $76,868 | $17,367 | $19,063 | 1.74 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 17 | $86,688 | $17,153 | $21,499 | 1.90 |
| Pneumothorax with CCMS-DRG 200, medical | 17 | $95,120 | $10,311 | $23,590 | 1.08 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 16 | $342,464 | $60,196 | $84,931 | 6.91 |
| Pleural effusion with MCCMS-DRG 186, medical | 13 | $80,093 | $11,570 | $19,863 | 1.55 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 12 | $179,734 | $39,197 | $44,574 | 4.06 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 12 | $62,100 | $7,479 | $15,401 | 0.85 |
| Pneumothorax with MCCMS-DRG 199, medical | 12 | $63,068 | $17,434 | $15,641 | 1.77 |
| Major chest trauma with MCCMS-DRG 183, medical | 11 | $119,600 | $12,359 | $29,661 | 1.57 |
Musculoskeletal system and connective tissue720 discharges in 24 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 113 | $107,768 | $19,349 | $26,726 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 107 | $71,044 | $8,544 | $17,619 | 0.97 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 51 | $175,826 | $35,955 | $43,605 | 3.66 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 47 | $121,541 | $20,310 | $30,142 | 2.11 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 38 | $163,955 | $28,828 | $40,661 | 2.95 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 32 | $123,066 | $18,979 | $30,520 | 2.04 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 31 | $59,413 | $7,660 | $14,734 | 0.90 |
| Medical back problems with MCCMS-DRG 551, medical | 28 | $106,396 | $15,926 | $26,386 | 1.70 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 25 | $179,127 | $26,604 | $44,423 | 2.96 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 25 | $113,569 | $23,250 | $28,165 | 2.40 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 24 | $167,471 | $28,245 | $41,533 | 2.99 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 20 | $204,807 | $41,148 | $50,792 | 4.61 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 19 | $131,967 | $21,380 | $32,728 | 2.38 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 19 | $51,393 | $6,875 | $12,745 | 0.79 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 17 | $82,584 | $17,628 | $20,481 | 1.87 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 16 | $69,105 | $9,974 | $17,138 | 1.09 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 15 | $321,284 | $60,711 | $79,678 | 6.12 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 15 | $81,788 | $13,256 | $20,283 | 1.49 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 15 | $101,475 | $17,979 | $25,166 | 1.97 |
| Biopsies of musculoskeletal system and connective tissue with MCCMS-DRG 477, surgical | 13 | $139,554 | $29,954 | $34,609 | 3.37 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 13 | $177,455 | $24,017 | $44,009 | 2.48 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 13 | $155,195 | $33,266 | $38,488 | 3.46 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 13 | $71,757 | $9,056 | $17,796 | 1.00 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 11 | $78,475 | $14,978 | $19,462 | 1.59 |
Nervous system695 discharges in 27 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 | 100 | $74,899 | $9,348 | $18,575 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 86 | $104,678 | $17,770 | $25,960 | 2.00 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 37 | $336,137 | $54,934 | $83,362 | 5.67 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 35 | $244,636 | $41,821 | $60,670 | 4.42 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 34 | $93,887 | $11,887 | $23,284 | 1.32 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 31 | $80,291 | $12,320 | $19,912 | 1.36 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 28 | $70,105 | $9,459 | $17,386 | 1.03 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 27 | $67,629 | $9,388 | $16,772 | 1.06 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 24 | $94,782 | $14,578 | $23,506 | 1.79 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 23 | $54,676 | $5,733 | $13,560 | 0.69 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 22 | $66,485 | $9,377 | $16,488 | 1.14 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 22 | $139,885 | $21,474 | $34,692 | 2.27 |
| Seizures without MCCMS-DRG 101, medical | 22 | $56,354 | $7,944 | $13,976 | 0.91 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 19 | $141,698 | $22,353 | $35,141 | 2.28 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 19 | $121,384 | $12,245 | $30,103 | 1.36 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 18 | $132,464 | $17,211 | $32,851 | 1.79 |
| Extracranial procedures with CCMS-DRG 038, surgical | 16 | $116,224 | $14,729 | $28,824 | 1.60 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 15 | $72,986 | $7,175 | $18,101 | 0.80 |
| Traumatic stupor and coma <1 hour without cc/mccMS-DRG 087, medical | 15 | $66,057 | $7,746 | $16,382 | 0.89 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 14 | $82,044 | $13,501 | $20,347 | 1.47 |
| Seizures with MCCMS-DRG 100, medical | 14 | $137,300 | $17,763 | $34,050 | 1.98 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 13 | $203,658 | $34,433 | $50,507 | 3.79 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 13 | $86,019 | $21,460 | $21,333 | 2.39 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 062, medical | 13 | $102,684 | $17,499 | $25,466 | 1.87 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 12 | $77,689 | $9,635 | $19,267 | 1.03 |
| Headaches without MCCMS-DRG 103, medical | 12 | $84,603 | $7,152 | $20,982 | 0.84 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 11 | $101,789 | $17,676 | $25,244 | 1.81 |
Digestive system676 discharges in 18 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 | 112 | $49,114 | $6,624 | $12,180 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 107 | $56,923 | $8,971 | $14,117 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 60 | $107,672 | $17,567 | $26,703 | 1.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 50 | $118,770 | $21,203 | $29,455 | 2.37 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 47 | $89,143 | $12,834 | $22,107 | 1.28 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 47 | $57,640 | $8,501 | $14,295 | 0.94 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 41 | $50,260 | $6,750 | $12,465 | 0.80 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 41 | $71,816 | $15,211 | $17,810 | 1.62 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 30 | $218,102 | $44,323 | $54,089 | 4.52 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 24 | $59,322 | $9,079 | $14,712 | 1.04 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 21 | $97,319 | $13,680 | $24,135 | 1.67 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 19 | $40,385 | $4,542 | $10,016 | 0.56 |
| Digestive malignancy with MCCMS-DRG 374, medical | 18 | $111,911 | $20,973 | $27,754 | 2.10 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 14 | $88,114 | $15,260 | $21,852 | 1.75 |
| Complicated peptic ulcer with CCMS-DRG 381, medical | 12 | $65,183 | $9,607 | $16,165 | 1.07 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 11 | $178,413 | $39,705 | $44,246 | 4.28 |
| Digestive malignancy with CCMS-DRG 375, medical | 11 | $57,243 | $10,351 | $14,196 | 1.20 |
| Complicated peptic ulcer with MCCMS-DRG 380, medical | 11 | $94,731 | $18,997 | $23,493 | 1.95 |
Kidney and urinary tract520 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 144 | $50,112 | $7,212 | $12,428 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 97 | $59,787 | $10,817 | $14,827 | 1.17 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 88 | $78,349 | $15,521 | $19,430 | 1.65 |
| Renal failure with CCMS-DRG 683, medical | 74 | $52,739 | $7,482 | $13,079 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 68 | $70,152 | $13,713 | $17,398 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 36 | $50,696 | $9,342 | $12,573 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 13 | $59,682 | $11,392 | $14,801 | 1.35 |
Endocrine, nutritional and metabolic298 discharges in 10 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 | 74 | $50,983 | $6,556 | $12,644 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 70 | $74,724 | $12,852 | $18,532 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 36 | $49,370 | $7,516 | $12,244 | 0.90 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 24 | $99,519 | $16,155 | $24,681 | 1.98 |
| Diabetes with MCCMS-DRG 637, medical | 22 | $85,584 | $13,150 | $21,225 | 1.45 |
| O.r. procedures for obesity without cc/mccMS-DRG 621, surgical | 18 | $64,152 | $10,917 | $15,910 | 1.52 |
| Endocrine disorders with CCMS-DRG 644, medical | 16 | $58,928 | $9,418 | $14,614 | 1.06 |
| Endocrine disorders with MCCMS-DRG 643, medical | 14 | $111,920 | $17,681 | $27,756 | 1.65 |
| Skin grafts and wound debridement for endocrine, nutritional and metabolic disorders witMS-DRG 623, surgical | 13 | $94,144 | $17,121 | $23,348 | 1.86 |
| Other endocrine, nutritional and metabolic o.r. procedures with CCMS-DRG 629, surgical | 11 | $95,558 | $18,901 | $23,698 | 2.26 |
Liver, gallbladder and pancreas202 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of the biliary tract with CCMS-DRG 445, medical | 37 | $70,035 | $10,268 | $17,369 | 1.09 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 29 | $111,840 | $15,208 | $27,736 | 1.63 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 22 | $67,772 | $7,881 | $16,807 | 0.86 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 18 | $110,542 | $18,227 | $27,414 | 1.92 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 18 | $75,472 | $17,408 | $18,717 | 1.76 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 18 | $89,244 | $17,140 | $22,132 | 1.83 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 16 | $102,025 | $21,290 | $25,302 | 2.32 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 16 | $109,021 | $14,734 | $27,037 | 1.63 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 15 | $45,594 | $8,587 | $11,307 | 0.95 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 13 | $75,709 | $11,192 | $18,776 | 1.31 |
Skin, subcutaneous tissue and breast185 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 113 | $45,178 | $7,617 | $11,204 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 28 | $72,040 | $13,426 | $17,866 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 21 | $63,411 | $8,351 | $15,726 | 0.91 |
| Trauma to the skin, subcutaneous tissue and breast with MCCMS-DRG 604, medical | 12 | $96,516 | $14,736 | $23,936 | 1.51 |
| Other skin, subcutaneous tissue and breast procedures with CCMS-DRG 580, surgical | 11 | $109,464 | $16,861 | $27,147 | 1.75 |
Blood and immune system82 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 23 | $55,461 | $8,472 | $13,754 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 22 | $75,696 | $13,495 | $18,773 | 1.40 |
| Coagulation disordersMS-DRG 813, medical | 20 | $73,721 | $15,323 | $18,283 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 17 | $62,405 | $11,034 | $15,476 | 1.20 |
Injuries, poisonings and toxic effects of drugs47 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 29 | $85,073 | $15,263 | $21,098 | 1.60 |
| Complications of treatment with MCCMS-DRG 919, medical | 18 | $83,426 | $17,892 | $20,690 | 1.82 |
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 | 29 | $72,649 | $14,899 | $18,017 | 1.76 |
| PsychosesMS-DRG 885, medical | 11 | $66,778 | $12,559 | $16,561 | 1.37 |
Alcohol and drug use38 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Alcohol, drug abuse or dependence without rehabilitation therapy with MCCMS-DRG 896, medical | 22 | $91,788 | $17,055 | $22,764 | 1.78 |
| Alcohol, drug abuse or dependence without rehabilitation therapy without MCCMS-DRG 897, medical | 16 | $64,274 | $7,155 | $15,940 | 0.86 |
Factors influencing health status34 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 | 34 | $60,871 | $7,066 | $15,096 | 0.80 |
Multiple significant trauma30 discharges in 2 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 | 16 | $158,267 | $33,845 | $39,250 | 3.88 |
| Other multiple significant trauma with CCMS-DRG 964, medical | 14 | $115,857 | $14,255 | $28,732 | 1.50 |
Other28 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Single level spinal fusion except cervical without MCCMS-DRG 451 | 15 | $154,855 | $30,354 | $38,404 | |
| Extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 981, surgical | 13 | $210,925 | $34,626 | $52,310 | 4.74 |
Blood cancers and poorly differentiated neoplasms15 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 | 15 | $87,595 | $27,409 | $21,724 | 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 |
|---|---|---|---|---|---|
| Comprehensive Observation ServicesAPC 8011 | 1,458 | 1,350 | $32,149 | $2,771 | $2,090 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 266 | 250 | $10,096 | $1,615 | $1,196 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 265 | 260 | $21,441 | $3,229 | $2,373 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 254 | 248 | $80,421 | $14,961 | $10,772 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 250 | 219 | $9,292 | $1,629 | $1,220 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 232 | 230 | $41,249 | $7,369 | $5,339 |
| Level 1 Endovascular ProceduresAPC 5191 | 192 | 192 | $40,137 | $2,959 | $2,208 |
| Level 5 Urology and Related ServicesAPC 5375 | 180 | 163 | $30,147 | $5,233 | $3,918 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 166 | 163 | $47,175 | $5,798 | $4,358 |
| Level 4 Urology and Related ServicesAPC 5374 | 150 | 136 | $22,050 | $3,452 | $2,629 |
| Level 1 Nerve ProceduresAPC 5431 | 140 | 119 | $12,244 | $1,937 | $1,407 |
| Level 2 Upper GI ProceduresAPC 5302 | 139 | 125 | $12,809 | $1,912 | $1,445 |
| Level 3 Endovascular ProceduresAPC 5193 | 85 | 82 | $83,626 | $12,392 | $8,874 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 84 | 82 | $40,130 | $6,614 | $4,982 |
| Level 3 Urology and Related ServicesAPC 5373 | 77 | 64 | $13,660 | $2,035 | $1,516 |
| Level 4 Vascular ProceduresAPC 5184 | 76 | 63 | $54,511 | $4,633 | $3,946 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 73 | 71 | $102,112 | $21,802 | $15,763 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 66 | 65 | $72,556 | $11,494 | $8,164 |
| Level 2 Endovascular ProceduresAPC 5192 | 55 | 48 | $43,811 | $5,706 | $4,338 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 55 | 55 | $55,418 | $11,802 | $8,569 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 51 | 50 | $21,425 | $3,879 | $2,930 |
| Level 3 Vascular ProceduresAPC 5183 | 51 | 49 | $27,245 | $3,175 | $2,405 |
| Level 3 Lower GI ProceduresAPC 5313 | 51 | 49 | $17,709 | $2,818 | $2,176 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 48 | 48 | $18,368 | $2,891 | $2,141 |
| Level 6 Gynecologic ProceduresAPC 5416 | 41 | 41 | $47,470 | $8,006 | $5,836 |
| Level 2 Vascular ProceduresAPC 5182 | 40 | 40 | $8,791 | $1,589 | $1,204 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 37 | 35 | $25,528 | $3,513 | $2,636 |
| Level 4 Gynecologic ProceduresAPC 5414 | 32 | 32 | $20,211 | $3,071 | $2,389 |
| Level 4 Airway EndoscopyAPC 5154 | 29 | 28 | $28,823 | $3,811 | $2,833 |
| Level 3 Airway EndoscopyAPC 5153 | 23 | 23 | $10,540 | $1,717 | $1,264 |
| Level 5 Airway EndoscopyAPC 5155 | 23 | 23 | $40,862 | $7,106 | $5,183 |
| Level 4 Endovascular ProceduresAPC 5194 | 23 | 22 | $103,916 | $19,804 | $14,606 |
| Level 5 Gynecologic ProceduresAPC 5415 | 21 | 21 | $31,257 | $5,061 | $3,792 |
| Level 6 Urology and Related ServicesAPC 5376 | 20 | 20 | $52,675 | $10,118 | $7,291 |
| Level 3 Upper GI ProceduresAPC 5303 | 18 | 18 | $24,965 | $3,897 | $2,888 |
| Complex GI ProceduresAPC 5331 | 12 | 11 | $28,750 | $5,830 | $4,263 |
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.