Texas Health Fort Worth Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Texas Health Fort Worth, Fort Worth, TX in 2024, from traditional Medicare claims. Back to the Texas Health Fort Worth profile, with quality ratings, finances and negotiated rates.
7,171
Medicare inpatient discharges
In 182 published DRGs
2.17
Case mix index
IPPS FY 2027
29%
Surgical stays
73%
Stays with complications
In DRGs with a CC or MCC
2,919
Medicare outpatient services
In 42 service groups
Inpatient stays by major diagnostic category
Circulatory system1,506 discharges in 37 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 265 | $57,561 | $9,402 | $13,181 | 1.28 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 126 | $142,077 | $34,191 | $32,536 | 4.88 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 93 | $63,933 | $11,292 | $14,641 | 1.59 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 79 | $32,955 | $5,356 | $7,547 | 0.74 |
| Syncope and collapseMS-DRG 312, medical | 78 | $42,836 | $6,421 | $9,809 | 0.86 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 61 | $91,511 | $23,542 | $20,956 | 3.24 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 52 | $58,577 | $8,949 | $13,414 | 1.20 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 46 | $148,462 | $23,976 | $33,998 | 3.35 |
| Hypertension without MCCMS-DRG 305, medical | 44 | $33,588 | $5,317 | $7,692 | 0.75 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 42 | $234,240 | $44,864 | $53,641 | 6.25 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 42 | $42,623 | $6,587 | $9,761 | 0.91 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 41 | $131,064 | $20,383 | $30,014 | 2.87 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 41 | $87,140 | $10,096 | $19,955 | 1.82 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 34 | $40,950 | $8,313 | $9,378 | 1.07 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 28 | $185,314 | $31,475 | $42,437 | 5.06 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 28 | $68,770 | $13,968 | $15,748 | 2.09 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 27 | $166,625 | $24,385 | $38,157 | 4.04 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 27 | $117,246 | $19,128 | $26,849 | 3.46 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 27 | $23,701 | $3,704 | $5,427 | 0.55 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 26 | $199,456 | $40,115 | $45,675 | 5.88 |
| Other vascular procedures with CCMS-DRG 253, surgical | 26 | $102,737 | $16,995 | $23,527 | 2.55 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 25 | $88,861 | $15,658 | $20,349 | 2.28 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 24 | $155,854 | $36,657 | $35,691 | 5.04 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 21 | $50,979 | $10,969 | $11,674 | 1.58 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 20 | $279,175 | $45,095 | $63,931 | 7.80 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 18 | $122,460 | $23,952 | $28,043 | 3.18 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 18 | $86,633 | $14,754 | $19,839 | 2.16 |
| Hypertension with MCCMS-DRG 304, medical | 18 | $48,111 | $8,144 | $11,017 | 1.15 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 17 | $144,595 | $27,766 | $33,112 | 4.16 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 16 | $148,468 | $19,461 | $33,999 | 3.27 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 16 | $41,106 | $7,484 | $9,413 | 0.97 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 15 | $165,766 | $19,869 | $37,961 | 3.46 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 15 | $42,939 | $6,109 | $9,833 | 1.08 |
| Chest painMS-DRG 313, medical | 14 | $29,069 | $5,156 | $6,657 | 0.72 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 13 | $311,776 | $53,029 | $71,397 | 7.71 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 12 | $102,938 | $25,878 | $23,573 | 3.90 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 11 | $212,978 | $27,716 | $48,772 | 4.81 |
Nervous system1,013 discharges in 29 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 162 | $78,185 | $12,728 | $17,904 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 118 | $56,238 | $7,106 | $12,878 | 1.02 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 70 | $168,264 | $31,258 | $38,532 | 4.42 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 59 | $56,241 | $9,166 | $12,879 | 1.32 |
| Seizures without MCCMS-DRG 101, medical | 53 | $40,787 | $6,882 | $9,340 | 0.91 |
| Seizures with MCCMS-DRG 100, medical | 45 | $91,874 | $12,226 | $21,039 | 1.98 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 37 | $85,477 | $14,340 | $19,574 | 2.27 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 36 | $198,654 | $36,144 | $45,492 | 5.67 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 34 | $44,843 | $5,772 | $10,269 | 0.80 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 30 | $51,452 | $9,141 | $11,783 | 1.36 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 29 | $46,922 | $7,933 | $10,745 | 1.14 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 29 | $52,128 | $6,585 | $11,937 | 1.03 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 28 | $45,826 | $5,045 | $10,494 | 0.69 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 27 | $122,553 | $17,372 | $28,065 | 2.43 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 27 | $65,622 | $9,897 | $15,027 | 1.36 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 24 | $45,837 | $7,627 | $10,497 | 1.06 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 23 | $133,609 | $19,209 | $30,597 | 2.95 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 23 | $89,595 | $15,478 | $20,517 | 2.28 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 22 | $128,676 | $24,765 | $29,467 | 3.79 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 20 | $74,399 | $11,325 | $17,037 | 1.79 |
| Extracranial procedures with CCMS-DRG 038, surgical | 19 | $65,273 | $10,890 | $14,948 | 1.60 |
| Hypertensive encephalopathy with CCMS-DRG 078, medical | 17 | $55,995 | $7,048 | $12,823 | 1.02 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 13 | $70,388 | $9,206 | $16,119 | 1.47 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 12 | $80,779 | $17,319 | $18,498 | 2.39 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 062, medical | 12 | $95,119 | $10,841 | $21,782 | 1.87 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 11 | $101,591 | $16,761 | $23,264 | 2.30 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 11 | $76,989 | $12,447 | $17,630 | 1.81 |
| Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurMS-DRG 041, surgical | 11 | $87,689 | $14,694 | $20,081 | 2.23 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 11 | $36,269 | $7,214 | $8,306 | 1.03 |
Infectious and parasitic diseases918 discharges in 8 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 | 574 | $76,528 | $13,300 | $17,525 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 117 | $45,598 | $7,568 | $10,442 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 114 | $173,985 | $30,614 | $39,843 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 49 | $223,954 | $44,810 | $51,286 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 19 | $87,177 | $14,532 | $19,964 | 2.04 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 17 | $135,411 | $27,563 | $31,009 | 4.43 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 16 | $106,948 | $15,514 | $24,491 | 2.14 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 12 | $114,055 | $21,300 | $26,119 | 1.84 |
Respiratory system824 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 182 | $57,811 | $11,048 | $13,239 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 159 | $51,735 | $9,381 | $11,847 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 90 | $50,111 | $8,752 | $11,476 | 1.23 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 46 | $34,276 | $5,960 | $7,849 | 0.82 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 39 | $108,014 | $18,280 | $24,735 | 2.70 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 36 | $47,062 | $7,655 | $10,777 | 1.10 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 35 | $55,815 | $9,576 | $12,782 | 1.40 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 34 | $48,126 | $7,159 | $11,021 | 0.99 |
| Major chest procedures with MCCMS-DRG 163, surgical | 32 | $152,295 | $29,307 | $34,875 | 4.71 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 28 | $200,050 | $40,149 | $45,812 | 6.91 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 23 | $40,948 | $5,963 | $9,377 | 0.82 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 22 | $107,282 | $23,841 | $24,568 | 4.06 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 17 | $33,145 | $6,926 | $7,590 | 0.85 |
| Major chest procedures with CCMS-DRG 164, surgical | 15 | $122,042 | $15,624 | $27,948 | 2.55 |
| Major chest trauma with MCCMS-DRG 183, medical | 14 | $69,383 | $11,099 | $15,889 | 1.57 |
| Major chest trauma with CCMS-DRG 184, medical | 14 | $60,621 | $7,214 | $13,882 | 1.05 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 13 | $73,209 | $13,012 | $16,765 | 1.74 |
| Pneumothorax with CCMS-DRG 200, medical | 13 | $47,501 | $7,322 | $10,878 | 1.08 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 12 | $46,829 | $11,576 | $10,724 | 1.81 |
Musculoskeletal system and connective tissue711 discharges in 22 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 | 126 | $80,062 | $14,272 | $18,334 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 91 | $41,165 | $7,023 | $9,427 | 0.97 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 60 | $90,800 | $14,630 | $20,793 | 2.11 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 46 | $86,620 | $16,094 | $19,836 | 2.40 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 41 | $107,284 | $19,293 | $24,568 | 2.95 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 40 | $142,232 | $22,766 | $32,571 | 3.66 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 38 | $230,740 | $45,460 | $52,839 | 6.12 |
| Medical back problems with MCCMS-DRG 551, medical | 30 | $64,831 | $10,977 | $14,846 | 1.70 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 30 | $32,639 | $6,442 | $7,474 | 0.90 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 26 | $89,901 | $20,220 | $20,587 | 2.96 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 21 | $82,884 | $14,141 | $18,980 | 2.04 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 18 | $145,319 | $23,288 | $33,278 | 3.46 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 17 | $67,725 | $10,820 | $15,509 | 1.59 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 17 | $60,870 | $12,390 | $13,939 | 1.87 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 17 | $40,705 | $5,958 | $9,321 | 0.79 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 17 | $34,458 | $7,492 | $7,891 | 1.09 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 15 | $142,249 | $22,603 | $32,575 | 2.99 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 13 | $185,628 | $24,475 | $42,509 | 3.49 |
| Cervical spinal fusion with MCCMS-DRG 471, surgical | 13 | $166,661 | $32,373 | $38,165 | 4.92 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 12 | $100,054 | $19,160 | $22,912 | 3.00 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 12 | $33,472 | $6,307 | $7,665 | 0.82 |
| Other musculoskeletal system and connective tissue o.r. procedures with MCCMS-DRG 515, surgical | 11 | $99,750 | $20,632 | $22,843 | 3.16 |
Digestive system702 discharges in 20 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 | 97 | $34,228 | $5,683 | $7,838 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 78 | $43,045 | $6,982 | $9,857 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 75 | $70,969 | $12,423 | $16,252 | 1.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 66 | $99,320 | $15,425 | $22,744 | 2.37 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 44 | $35,794 | $5,849 | $8,197 | 0.80 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 43 | $179,876 | $31,042 | $41,191 | 4.52 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 42 | $75,815 | $11,386 | $17,362 | 1.67 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 37 | $53,808 | $9,571 | $12,322 | 1.28 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 29 | $57,403 | $10,843 | $13,145 | 1.62 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 27 | $53,634 | $10,340 | $12,282 | 1.45 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 26 | $37,370 | $6,091 | $8,558 | 0.94 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 20 | $23,994 | $3,852 | $5,495 | 0.56 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 18 | $202,356 | $32,271 | $46,339 | 4.28 |
| Digestive malignancy with MCCMS-DRG 374, medical | 17 | $73,718 | $13,692 | $16,881 | 2.10 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 16 | $76,216 | $11,596 | $17,453 | 1.75 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 16 | $37,262 | $8,021 | $8,533 | 1.04 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 13 | $255,252 | $34,468 | $58,453 | 5.08 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 13 | $96,806 | $16,401 | $22,169 | 2.50 |
| Digestive malignancy with CCMS-DRG 375, medical | 13 | $60,858 | $7,555 | $13,936 | 1.20 |
| Gastrointestinal hemorrhage without cc/mccMS-DRG 379, medical | 12 | $28,540 | $4,430 | $6,536 | 0.63 |
Kidney and urinary tract603 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 113 | $45,135 | $8,468 | $10,336 | 1.17 |
| Renal failure with MCCMS-DRG 682, medical | 108 | $64,142 | $10,430 | $14,688 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 105 | $40,563 | $6,536 | $9,289 | 0.90 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 97 | $35,729 | $5,967 | $8,182 | 0.81 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 80 | $58,836 | $11,186 | $13,473 | 1.65 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 30 | $39,643 | $7,731 | $9,078 | 1.02 |
| Kidney transplantMS-DRG 652, surgical | 23 | $316,310 | $15,582 | $72,435 | 3.00 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 20 | $102,616 | $24,198 | $23,499 | 3.70 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 14 | $93,338 | $16,378 | $21,374 | 2.38 |
| Renal failure without cc/mccMS-DRG 684, medical | 13 | $31,990 | $4,319 | $7,326 | 0.61 |
Endocrine, nutritional and metabolic293 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 with MCCMS-DRG 640, medical | 101 | $50,842 | $9,702 | $11,643 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 65 | $39,064 | $5,663 | $8,946 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 44 | $56,375 | $9,749 | $12,910 | 1.45 |
| Diabetes with CCMS-DRG 638, medical | 34 | $31,884 | $6,339 | $7,301 | 0.90 |
| Endocrine disorders with MCCMS-DRG 643, medical | 23 | $74,602 | $9,909 | $17,084 | 1.65 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 14 | $81,301 | $9,788 | $18,618 | 1.98 |
| Endocrine disorders with CCMS-DRG 644, medical | 12 | $36,623 | $7,083 | $8,387 | 1.06 |
Liver, gallbladder and pancreas185 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 | 32 | $49,204 | $7,547 | $11,268 | 1.09 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 26 | $86,239 | $10,744 | $19,749 | 1.63 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 23 | $116,089 | $18,193 | $26,584 | 2.32 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 21 | $67,608 | $13,547 | $15,482 | 1.92 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 20 | $40,621 | $5,661 | $9,302 | 0.86 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 14 | $94,429 | $13,087 | $21,624 | 1.76 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 13 | $82,132 | $11,922 | $18,808 | 1.67 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 13 | $37,866 | $7,532 | $8,671 | 0.95 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 12 | $59,064 | $13,568 | $13,526 | 1.83 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 11 | $82,958 | $11,699 | $18,997 | 1.63 |
Skin, subcutaneous tissue and breast100 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 62 | $34,816 | $6,550 | $7,973 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 24 | $49,941 | $10,231 | $11,436 | 1.49 |
| Skin debridement with CCMS-DRG 571, surgical | 14 | $57,873 | $11,370 | $13,253 | 1.69 |
Blood and immune system72 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 | 45 | $31,304 | $7,197 | $7,169 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 27 | $52,737 | $9,849 | $12,077 | 1.40 |
Injuries, poisonings and toxic effects of drugs68 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 18 | $72,083 | $14,857 | $16,507 | 2.00 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 18 | $70,870 | $10,880 | $16,229 | 1.60 |
| Complications of treatment with MCCMS-DRG 919, medical | 17 | $83,082 | $13,185 | $19,026 | 1.82 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 15 | $114,692 | $22,423 | $26,264 | 3.72 |
Other46 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 | 35 | $140,643 | $27,622 | $32,207 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 11 | $85,700 | $17,927 | $19,625 | 2.49 |
Blood cancers and poorly differentiated neoplasms39 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Chemotherapy without acute leukemia as secondary diagnosis with CCMS-DRG 847, medical | 15 | $72,786 | $9,341 | $16,668 | 1.21 |
| Acute leukemia with MCCMS-DRG 834, medical | 12 | $234,664 | $32,898 | $53,738 | 5.60 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 12 | $93,062 | $21,140 | $21,311 | 3.13 |
Factors influencing health status19 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 | 19 | $35,087 | $6,079 | $8,035 | 0.80 |
Mental diseases and disorders18 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 18 | $49,322 | $10,936 | $11,295 | 1.76 |
Multiple significant trauma18 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 | 18 | $140,358 | $24,649 | $32,142 | 3.88 |
Transplants, ECMO and tracheostomy (pre-MDC)13 discharges in 1 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 | 13 | $489,814 | $115,247 | $112,167 | 21.32 |
Ear, nose, mouth and throat12 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 12 | $42,878 | $5,168 | $9,819 | 0.74 |
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 | $29,775 | $6,032 | $6,818 | 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 | 554 | 530 | $21,983 | $1,917 | $2,090 |
| Level 3 Vascular ProceduresAPC 5183 | 238 | 207 | $15,642 | $2,035 | $2,405 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 223 | 213 | $10,893 | $1,149 | $1,220 |
| Level 2 Upper GI ProceduresAPC 5302 | 190 | 159 | $9,960 | $1,348 | $1,445 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 124 | 124 | $40,537 | $4,036 | $4,358 |
| Level 1 Endovascular ProceduresAPC 5191 | 116 | 116 | $20,500 | $2,072 | $2,208 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 112 | 111 | $64,360 | $7,354 | $8,164 |
| Level 4 Vascular ProceduresAPC 5184 | 109 | 101 | $39,752 | $3,901 | $3,946 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 101 | 96 | $105,072 | $19,492 | $21,117 |
| Level 5 Airway EndoscopyAPC 5155 | 99 | 95 | $40,096 | $4,858 | $5,183 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 76 | 75 | $38,079 | $4,995 | $5,339 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 70 | 70 | $48,713 | $7,857 | $8,569 |
| Level 3 Endovascular ProceduresAPC 5193 | 69 | 67 | $60,922 | $8,260 | $8,874 |
| Level 4 Airway EndoscopyAPC 5154 | 59 | 51 | $23,852 | $2,685 | $2,833 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 54 | 53 | $58,217 | $10,007 | $10,772 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 53 | 52 | $15,648 | $2,036 | $2,141 |
| Level 2 Endovascular ProceduresAPC 5192 | 51 | 42 | $42,564 | $4,018 | $4,338 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 46 | 44 | $67,499 | $14,781 | $15,763 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 43 | 42 | $20,101 | $2,669 | $2,930 |
| Level 2 Vascular ProceduresAPC 5182 | 36 | 35 | $7,748 | $1,148 | $1,204 |
| Level 3 Airway EndoscopyAPC 5153 | 34 | 31 | $13,911 | $1,217 | $1,264 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 33 | 33 | $39,206 | $2,481 | $2,636 |
| Level 4 Endovascular ProceduresAPC 5194 | 31 | 28 | $95,837 | $14,117 | $14,606 |
| Level 5 Urology and Related ServicesAPC 5375 | 30 | 28 | $20,781 | $3,710 | $3,918 |
| Level 4 Urology and Related ServicesAPC 5374 | 29 | 27 | $17,177 | $2,500 | $2,629 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 28 | 28 | $36,338 | $4,342 | $4,982 |
| Level 3 Upper GI ProceduresAPC 5303 | 28 | 28 | $24,938 | $2,746 | $2,888 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 27 | 27 | $15,249 | $1,152 | $1,196 |
| Level 3 Lower GI ProceduresAPC 5313 | 26 | 26 | $13,697 | $2,033 | $2,176 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 24 | 24 | $24,662 | $2,321 | $2,373 |
| Level 3 Urology and Related ServicesAPC 5373 | 22 | 12 | $11,713 | $1,460 | $1,516 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 21 | 20 | $90,058 | $15,864 | $17,052 |
| Level 1 Nerve ProceduresAPC 5431 | 20 | 18 | $16,703 | $1,315 | $1,407 |
| Level 5 Gynecologic ProceduresAPC 5415 | 19 | 18 | $22,020 | $3,379 | $3,792 |
| Level 5 ENT ProceduresAPC 5165 | 18 | 17 | $35,376 | $4,199 | $4,436 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 17 | 17 | $150,257 | $27,887 | $29,375 |
| Level 2 Intraocular ProceduresAPC 5492 | 17 | 16 | $14,709 | $2,572 | $3,116 |
| Complex GI ProceduresAPC 5331 | 16 | 15 | $34,778 | $4,086 | $4,263 |
| Level 4 Gynecologic ProceduresAPC 5414 | 16 | 16 | $15,933 | $2,230 | $2,389 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 15 | 15 | $39,380 | $6,084 | $6,514 |
| Level 6 Gynecologic ProceduresAPC 5416 | 13 | 13 | $32,824 | $5,418 | $5,836 |
| Level 3 Breast/Lymphatic Surgery and Related ProceduresAPC 5093 | 12 | $42,740 | $6,279 | $7,546 |
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.