Texas Health Dallas Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Texas Health Dallas, Dallas, TX in 2024, from traditional Medicare claims. Back to the Texas Health Dallas profile, with quality ratings, finances and negotiated rates.
4,882
Medicare inpatient discharges
In 142 published DRGs
2.29
Case mix index
IPPS FY 2027
33%
Surgical stays
67%
Stays with complications
In DRGs with a CC or MCC
3,459
Medicare outpatient services
In 40 service groups
Inpatient stays by major diagnostic category
Circulatory system1,332 discharges in 34 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 238 | $93,186 | $23,147 | $22,551 | 3.24 |
| Heart failure and shock with MCCMS-DRG 291, medical | 237 | $55,425 | $9,708 | $13,413 | 1.28 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 134 | $159,756 | $44,263 | $38,661 | 6.25 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 79 | $139,071 | $34,218 | $33,655 | 4.88 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 61 | $63,145 | $10,557 | $15,281 | 1.59 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 43 | $33,255 | $5,271 | $8,048 | 0.74 |
| Syncope and collapseMS-DRG 312, medical | 36 | $45,768 | $6,358 | $11,076 | 0.86 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 34 | $53,162 | $8,728 | $12,865 | 1.20 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 33 | $109,174 | $15,461 | $26,420 | 2.28 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 32 | $85,400 | $12,589 | $20,667 | 1.82 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 26 | $208,308 | $39,955 | $50,411 | 5.88 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 25 | $130,935 | $19,757 | $31,686 | 2.87 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 24 | $41,299 | $6,858 | $9,994 | 0.91 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 22 | $128,919 | $27,461 | $31,198 | 3.90 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 22 | $32,005 | $4,013 | $7,745 | 0.55 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 21 | $142,152 | $23,904 | $34,401 | 3.46 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 21 | $85,922 | $13,542 | $20,793 | 2.09 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 20 | $355,373 | $60,971 | $86,000 | 7.71 |
| Other vascular procedures with CCMS-DRG 253, surgical | 18 | $117,064 | $17,631 | $28,329 | 2.55 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 18 | $139,232 | $32,006 | $33,694 | 5.06 |
| Hypertension with MCCMS-DRG 304, medical | 17 | $41,926 | $8,243 | $10,146 | 1.15 |
| Chest painMS-DRG 313, medical | 17 | $43,625 | $5,790 | $10,557 | 0.72 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 16 | $52,487 | $7,517 | $12,702 | 1.07 |
| Hypertension without MCCMS-DRG 305, medical | 16 | $34,230 | $5,543 | $8,284 | 0.75 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 14 | $249,979 | $53,006 | $60,495 | 7.80 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 13 | $105,899 | $24,343 | $25,627 | 3.35 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 13 | $104,002 | $19,835 | $25,169 | 3.27 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 13 | $167,472 | $27,927 | $40,528 | 4.16 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 12 | $163,926 | $27,401 | $39,670 | 3.46 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 12 | $77,336 | $15,617 | $18,715 | 2.16 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 12 | $64,085 | $7,400 | $15,508 | 1.08 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 11 | $99,099 | $23,628 | $23,982 | 3.18 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 11 | $88,009 | $12,047 | $21,298 | 1.83 |
| Heart failure and shock with CCMS-DRG 292, medical | 11 | $32,015 | $5,743 | $7,748 | 0.86 |
Respiratory system586 discharges in 16 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 123 | $58,183 | $11,550 | $14,080 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 112 | $52,000 | $9,319 | $12,584 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 76 | $48,021 | $8,730 | $11,621 | 1.23 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 44 | $34,548 | $5,461 | $8,361 | 0.82 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 32 | $38,743 | $6,689 | $9,376 | 0.99 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 28 | $45,857 | $7,369 | $11,097 | 1.10 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 26 | $114,489 | $19,364 | $27,706 | 2.70 |
| Major chest trauma with CCMS-DRG 184, medical | 22 | $46,110 | $7,295 | $11,159 | 1.05 |
| Major chest procedures with CCMS-DRG 164, surgical | 21 | $109,461 | $15,471 | $26,490 | 2.55 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 19 | $51,435 | $10,417 | $12,447 | 1.40 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 19 | $44,561 | $5,864 | $10,784 | 0.82 |
| Major chest procedures with MCCMS-DRG 163, surgical | 16 | $151,816 | $30,559 | $36,739 | 4.71 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 12 | $117,738 | $24,630 | $28,493 | 4.06 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 12 | $35,104 | $6,704 | $8,495 | 0.85 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 12 | $43,830 | $7,384 | $10,607 | 0.96 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 12 | $350,964 | $65,212 | $84,933 | 6.91 |
Musculoskeletal system and connective tissue581 discharges in 19 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 | 94 | $75,248 | $14,460 | $18,210 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 67 | $40,448 | $6,855 | $9,788 | 0.97 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 62 | $87,874 | $14,945 | $21,266 | 2.11 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 52 | $71,246 | $13,215 | $17,241 | 1.88 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 37 | $139,250 | $24,007 | $33,699 | 3.49 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 33 | $91,914 | $14,915 | $22,243 | 2.40 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 28 | $89,941 | $19,529 | $21,766 | 2.95 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 27 | $35,830 | $5,619 | $8,671 | 0.79 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 25 | $56,531 | $11,373 | $13,681 | 1.59 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 25 | $111,822 | $17,344 | $27,061 | 2.48 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 21 | $111,160 | $19,047 | $26,901 | 2.67 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 18 | $125,426 | $20,304 | $30,353 | 3.00 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 16 | $114,425 | $20,288 | $27,691 | 2.99 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 15 | $64,421 | $14,488 | $15,590 | 2.04 |
| Medical back problems with MCCMS-DRG 551, medical | 14 | $57,685 | $11,082 | $13,960 | 1.70 |
| Revision of hip or knee replacement with MCCMS-DRG 466, surgical | 13 | $280,779 | $34,301 | $67,949 | 5.19 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 12 | $100,387 | $15,572 | $24,294 | 2.38 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 463, surgical | 11 | $254,348 | $45,778 | $61,552 | 5.66 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 11 | $36,799 | $6,219 | $8,905 | 0.82 |
Infectious and parasitic diseases492 discharges in 5 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 | 329 | $71,380 | $13,615 | $17,274 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 61 | $44,495 | $7,422 | $10,768 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 51 | $173,112 | $32,330 | $41,893 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 27 | $263,293 | $49,230 | $63,717 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 24 | $70,086 | $11,830 | $16,961 | 2.04 |
Nervous system472 discharges in 19 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 | 90 | $48,222 | $7,170 | $11,670 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 79 | $68,318 | $12,109 | $16,533 | 2.00 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 28 | $43,439 | $7,699 | $10,512 | 1.06 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 24 | $78,809 | $11,205 | $19,072 | 1.79 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 24 | $60,218 | $9,426 | $14,573 | 1.32 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 23 | $43,712 | $7,699 | $10,578 | 1.03 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 22 | $38,049 | $4,445 | $9,208 | 0.69 |
| Seizures without MCCMS-DRG 101, medical | 22 | $43,786 | $6,778 | $10,596 | 0.91 |
| Seizures with MCCMS-DRG 100, medical | 19 | $78,650 | $14,925 | $19,033 | 1.98 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 18 | $150,257 | $29,234 | $36,362 | 4.42 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 18 | $41,565 | $9,330 | $10,059 | 1.36 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 18 | $77,285 | $15,747 | $18,703 | 2.27 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 15 | $42,090 | $6,118 | $10,186 | 0.80 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 13 | $55,609 | $10,511 | $13,457 | 1.47 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 13 | $60,750 | $12,383 | $14,701 | 1.79 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 12 | $202,825 | $38,712 | $49,084 | 5.67 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 12 | $45,423 | $14,125 | $10,992 | 2.39 |
| Extracranial procedures with CCMS-DRG 038, surgical | 11 | $58,660 | $11,648 | $14,196 | 1.60 |
| Headaches without MCCMS-DRG 103, medical | 11 | $44,336 | $7,082 | $10,729 | 0.84 |
Digestive system448 discharges in 15 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 | 86 | $31,733 | $5,601 | $7,679 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 57 | $43,040 | $7,255 | $10,416 | 0.98 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 48 | $92,311 | $15,088 | $22,339 | 2.37 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 47 | $27,489 | $6,097 | $6,652 | 0.80 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 39 | $71,143 | $11,372 | $17,217 | 1.79 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 28 | $183,568 | $30,786 | $44,424 | 4.52 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 26 | $64,556 | $10,490 | $15,623 | 1.67 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 25 | $39,887 | $9,266 | $9,653 | 1.28 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 19 | $31,617 | $6,959 | $7,651 | 0.94 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 13 | $42,663 | $7,109 | $10,325 | 1.04 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 13 | $27,817 | $4,004 | $6,732 | 0.56 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 12 | $158,682 | $33,155 | $38,401 | 5.08 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 12 | $65,939 | $10,898 | $15,957 | 1.45 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 12 | $73,574 | $12,443 | $17,805 | 1.62 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 11 | $66,350 | $11,280 | $16,057 | 1.75 |
Kidney and urinary tract415 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 92 | $48,249 | $8,759 | $11,676 | 1.17 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 81 | $31,380 | $5,923 | $7,594 | 0.81 |
| Renal failure with MCCMS-DRG 682, medical | 75 | $48,122 | $10,482 | $11,646 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 68 | $36,021 | $6,675 | $8,717 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 53 | $61,000 | $11,468 | $14,762 | 1.65 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 28 | $33,993 | $7,235 | $8,226 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 18 | $54,772 | $9,888 | $13,255 | 1.35 |
Endocrine, nutritional and metabolic177 discharges in 5 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 | 66 | $55,408 | $9,458 | $13,409 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 58 | $34,136 | $5,691 | $8,261 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 25 | $35,011 | $6,746 | $8,473 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 16 | $66,583 | $10,867 | $16,113 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 12 | $60,479 | $11,665 | $14,636 | 1.65 |
Skin, subcutaneous tissue and breast102 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 57 | $32,189 | $6,380 | $7,790 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 20 | $51,120 | $9,412 | $12,371 | 1.49 |
| Other skin, subcutaneous tissue and breast procedures with MCCMS-DRG 579, surgical | 13 | $163,595 | $26,870 | $39,590 | 3.34 |
| Skin debridement with CCMS-DRG 571, surgical | 12 | $73,193 | $12,906 | $17,713 | 1.69 |
Liver, gallbladder and pancreas73 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of the biliary tract with CCMS-DRG 445, medical | 17 | $48,215 | $7,975 | $11,668 | 1.09 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 16 | $89,839 | $11,542 | $21,741 | 1.63 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 15 | $64,715 | $10,586 | $15,661 | 1.63 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 13 | $80,188 | $12,080 | $19,405 | 1.76 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 12 | $59,558 | $12,346 | $14,413 | 1.67 |
Blood and immune system46 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 25 | $31,234 | $7,294 | $7,559 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 21 | $43,372 | $9,184 | $10,496 | 1.40 |
Other35 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Concomitant left atrial appendage closure and cardiac ablationMS-DRG 317 | 18 | $173,867 | $44,919 | $42,076 | |
| Extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 981, surgical | 17 | $180,969 | $31,278 | $43,794 | 4.74 |
Transplants, ECMO and tracheostomy (pre-MDC)32 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 | 20 | $597,424 | $125,198 | $144,577 | 21.32 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 12 | $522,132 | $92,333 | $126,356 | 14.70 |
Injuries, poisonings and toxic effects of drugs25 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 13 | $78,419 | $12,858 | $18,978 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 12 | $34,120 | $7,907 | $8,257 | 1.03 |
Mental diseases and disorders15 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| PsychosesMS-DRG 885, medical | 15 | $23,148 | $9,582 | $5,602 | 1.37 |
Factors influencing health status15 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 | 15 | $37,113 | $5,722 | $8,981 | 0.80 |
Blood cancers and poorly differentiated neoplasms13 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy aMS-DRG 837, medical | 13 | $140,163 | $29,429 | $33,919 | 4.84 |
Multiple significant trauma12 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 | 12 | $110,037 | $24,495 | $26,629 | 3.88 |
Eye11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other disorders of the eye without MCCMS-DRG 125, medical | 11 | $30,619 | $6,284 | $7,410 | 0.80 |
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 | 870 | 794 | $22,328 | $1,947 | $2,090 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 230 | 223 | $102,601 | $19,443 | $21,117 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 213 | 205 | $54,354 | $10,196 | $10,772 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 198 | 191 | $12,787 | $1,160 | $1,220 |
| Level 1 Endovascular ProceduresAPC 5191 | 176 | 176 | $21,051 | $2,060 | $2,208 |
| Level 2 Upper GI ProceduresAPC 5302 | 156 | 140 | $12,296 | $1,366 | $1,445 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 154 | 154 | $46,297 | $4,109 | $4,358 |
| Level 3 Endovascular ProceduresAPC 5193 | 132 | 122 | $61,762 | $8,197 | $8,874 |
| Level 3 Vascular ProceduresAPC 5183 | 121 | 111 | $15,539 | $2,152 | $2,405 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 92 | 86 | $18,295 | $2,013 | $2,141 |
| Level 4 Endovascular ProceduresAPC 5194 | 89 | 82 | $83,711 | $13,799 | $14,606 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 87 | 87 | $52,046 | $7,788 | $8,569 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 75 | 68 | $19,648 | $2,732 | $2,930 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 66 | 66 | $53,047 | $7,393 | $8,164 |
| Level 5 Urology and Related ServicesAPC 5375 | 63 | 60 | $20,080 | $3,710 | $3,918 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 60 | 52 | $24,667 | $2,436 | $2,636 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 57 | 56 | $39,377 | $4,674 | $4,982 |
| Level 5 Airway EndoscopyAPC 5155 | 56 | 52 | $37,662 | $4,820 | $5,183 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 44 | 44 | $44,895 | $5,013 | $5,339 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 41 | 41 | $155,594 | $27,887 | $29,375 |
| Level 4 Urology and Related ServicesAPC 5374 | 40 | 38 | $18,437 | $2,495 | $2,629 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 39 | 39 | $88,308 | $15,103 | $15,763 |
| Level 2 Endovascular ProceduresAPC 5192 | 36 | 34 | $37,931 | $4,098 | $4,338 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 35 | 35 | $37,127 | $6,091 | $6,514 |
| Level 3 Urology and Related ServicesAPC 5373 | 32 | 28 | $14,290 | $1,460 | $1,516 |
| Level 4 Airway EndoscopyAPC 5154 | 29 | 28 | $27,207 | $2,685 | $2,833 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 29 | 29 | $98,334 | $15,864 | $17,052 |
| Level 4 Extraocular, Repair, and Plastic Eye ProceduresAPC 5504 | 25 | 22 | $18,212 | $2,550 | $2,969 |
| Level 2 Vascular ProceduresAPC 5182 | 23 | 23 | $9,236 | $1,148 | $1,204 |
| Level 4 Vascular ProceduresAPC 5184 | 23 | 22 | $42,462 | $3,769 | $3,946 |
| Level 2 Intraocular ProceduresAPC 5492 | 23 | 22 | $12,996 | $2,915 | $3,116 |
| Level 5 ENT ProceduresAPC 5165 | 21 | 20 | $24,983 | $4,199 | $4,436 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 20 | 19 | $13,842 | $1,143 | $1,196 |
| Level 3 Upper GI ProceduresAPC 5303 | 20 | 20 | $29,762 | $2,746 | $2,888 |
| Complex GI ProceduresAPC 5331 | 19 | 19 | $34,290 | $3,871 | $4,263 |
| Level 1 Intraocular ProceduresAPC 5491 | 17 | 14 | $10,133 | $1,671 | $1,752 |
| Level 1 Nerve ProceduresAPC 5431 | 14 | 13 | $23,640 | $1,285 | $1,407 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 12 | 12 | $19,586 | $2,321 | $2,373 |
| Level 4 Breast/Lymphatic Surgery and Related ProceduresAPC 5094 | 11 | 11 | $72,170 | $14,194 | $15,549 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 11 | 11 | $18,047 | $1,658 | $1,780 |
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.