Texas Health Plano Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Texas Health Plano, Plano, TX in 2024, from traditional Medicare claims. Back to the Texas Health Plano profile, with quality ratings, finances and negotiated rates.
3,045
Medicare inpatient discharges
In 93 published DRGs
2.02
Case mix index
IPPS FY 2027
23%
Surgical stays
73%
Stays with complications
In DRGs with a CC or MCC
1,920
Medicare outpatient services
In 28 service groups
Inpatient stays by major diagnostic category
Infectious and parasitic diseases543 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 | 396 | $68,983 | $12,773 | $15,935 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 70 | $43,094 | $6,728 | $9,955 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 45 | $143,530 | $29,664 | $33,155 | 5.00 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 20 | $110,211 | $13,123 | $25,459 | 2.04 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 12 | $269,620 | $51,098 | $62,282 | 6.96 |
Circulatory system452 discharges in 17 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 144 | $52,049 | $8,896 | $12,023 | 1.28 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 32 | $55,044 | $7,851 | $12,715 | 1.20 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 30 | $88,030 | $21,259 | $20,335 | 3.24 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 28 | $93,874 | $10,104 | $21,685 | 1.82 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 25 | $142,071 | $33,358 | $32,818 | 4.88 |
| Hypertension without MCCMS-DRG 305, medical | 25 | $45,422 | $5,396 | $10,493 | 0.75 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 21 | $58,519 | $9,685 | $13,518 | 1.59 |
| Syncope and collapseMS-DRG 312, medical | 21 | $45,684 | $5,580 | $10,553 | 0.86 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 20 | $34,753 | $4,680 | $8,028 | 0.74 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 18 | $31,000 | $3,513 | $7,161 | 0.55 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 16 | $59,406 | $13,718 | $13,723 | 2.09 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 15 | $191,275 | $35,492 | $44,185 | 5.88 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 12 | $86,405 | $15,239 | $19,960 | 2.28 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 12 | $134,684 | $18,035 | $31,112 | 2.87 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 11 | $149,058 | $41,883 | $34,432 | 6.25 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 11 | $41,126 | $6,749 | $9,500 | 0.91 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 11 | $74,818 | $10,877 | $17,283 | 2.16 |
Musculoskeletal system and connective tissue383 discharges in 16 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 | 74 | $79,799 | $13,319 | $18,434 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 36 | $39,187 | $6,290 | $9,052 | 0.97 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 35 | $87,746 | $13,353 | $20,269 | 2.11 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 29 | $133,974 | $23,063 | $30,948 | 3.49 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 28 | $84,633 | $15,473 | $19,550 | 2.40 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 25 | $114,215 | $15,793 | $26,384 | 2.48 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 24 | $87,496 | $12,875 | $20,212 | 1.88 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 22 | $91,462 | $17,777 | $21,128 | 2.67 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 20 | $122,989 | $19,446 | $28,410 | 2.95 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 14 | $48,450 | $8,644 | $11,192 | 1.49 |
| Medical back problems with MCCMS-DRG 551, medical | 14 | $60,630 | $11,565 | $14,006 | 1.70 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 13 | $86,348 | $16,697 | $19,946 | 2.96 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 13 | $119,878 | $20,592 | $27,692 | 2.99 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 13 | $39,010 | $5,438 | $9,011 | 0.90 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 12 | $52,863 | $10,481 | $12,211 | 1.59 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 11 | $98,364 | $15,915 | $22,722 | 2.38 |
Respiratory system350 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 116 | $64,314 | $11,564 | $14,856 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 64 | $49,804 | $8,760 | $11,505 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 36 | $47,499 | $8,450 | $10,972 | 1.23 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 29 | $38,088 | $6,856 | $8,798 | 0.99 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 28 | $40,132 | $5,183 | $9,270 | 0.82 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 18 | $55,025 | $9,075 | $12,711 | 1.40 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 18 | $89,748 | $16,962 | $20,732 | 2.70 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 17 | $50,902 | $7,660 | $11,758 | 1.10 |
| Major chest procedures with CCMS-DRG 164, surgical | 12 | $124,840 | $17,064 | $28,838 | 2.55 |
| Major chest trauma with CCMS-DRG 184, medical | 12 | $52,346 | $5,323 | $12,092 | 1.05 |
Nervous system325 discharges in 13 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 67 | $82,555 | $13,007 | $19,070 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 56 | $51,449 | $6,630 | $11,885 | 1.02 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 28 | $147,690 | $28,406 | $34,116 | 4.42 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 28 | $79,410 | $15,008 | $18,344 | 2.27 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 23 | $47,785 | $8,414 | $11,038 | 1.32 |
| Seizures with MCCMS-DRG 100, medical | 23 | $56,713 | $12,060 | $13,101 | 1.98 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 17 | $40,463 | $4,185 | $9,347 | 0.69 |
| Traumatic stupor and coma <1 hour without cc/mccMS-DRG 087, medical | 17 | $40,356 | $6,148 | $9,322 | 0.89 |
| Seizures without MCCMS-DRG 101, medical | 16 | $47,419 | $5,905 | $10,954 | 0.91 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 15 | $190,922 | $37,296 | $44,103 | 5.67 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 13 | $48,787 | $9,519 | $11,270 | 1.36 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 11 | $73,084 | $9,368 | $16,882 | 1.36 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 11 | $52,431 | $7,356 | $12,112 | 1.06 |
Kidney and urinary tract323 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 72 | $66,109 | $11,443 | $15,271 | 1.65 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 66 | $46,472 | $7,927 | $10,735 | 1.17 |
| Renal failure with MCCMS-DRG 682, medical | 64 | $53,058 | $9,751 | $12,256 | 1.50 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 54 | $33,795 | $5,436 | $7,807 | 0.81 |
| Renal failure with CCMS-DRG 683, medical | 51 | $35,539 | $5,811 | $8,209 | 0.90 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 16 | $37,121 | $6,219 | $8,575 | 1.02 |
Digestive system321 discharges in 11 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 | 67 | $36,336 | $5,360 | $8,394 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 38 | $43,408 | $6,670 | $10,027 | 0.98 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 36 | $85,836 | $15,010 | $19,828 | 2.37 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 34 | $75,198 | $11,238 | $17,371 | 1.79 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 31 | $37,719 | $5,222 | $8,713 | 0.80 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 26 | $60,805 | $8,914 | $14,046 | 1.28 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 25 | $74,382 | $10,064 | $17,182 | 1.67 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 19 | $181,990 | $28,130 | $42,040 | 4.52 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 18 | $39,691 | $6,474 | $9,169 | 1.04 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 15 | $39,703 | $6,719 | $9,171 | 0.94 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 12 | $26,025 | $3,597 | $6,012 | 0.56 |
Endocrine, nutritional and metabolic146 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 | 63 | $53,218 | $8,897 | $12,293 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 38 | $34,630 | $5,290 | $7,999 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 21 | $57,614 | $9,748 | $13,309 | 1.45 |
| Diabetes with CCMS-DRG 638, medical | 12 | $31,718 | $5,667 | $7,327 | 0.90 |
| Endocrine disorders with MCCMS-DRG 643, medical | 12 | $65,650 | $11,721 | $15,165 | 1.65 |
Skin, subcutaneous tissue and breast80 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 53 | $33,620 | $5,532 | $7,766 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 14 | $46,895 | $9,772 | $10,833 | 1.49 |
| Other skin, subcutaneous tissue and breast procedures with CCMS-DRG 580, surgical | 13 | $73,930 | $11,317 | $17,078 | 1.75 |
Liver, gallbladder and pancreas54 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 19 | $116,313 | $16,551 | $26,868 | 2.32 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 19 | $79,878 | $9,873 | $18,452 | 1.63 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 16 | $66,412 | $10,190 | $15,341 | 1.83 |
Blood and immune system43 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 | 24 | $48,116 | $6,307 | $11,115 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 19 | $57,680 | $9,921 | $13,324 | 1.40 |
Factors influencing health status14 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 | 14 | $35,969 | $4,667 | $8,309 | 0.80 |
Injuries, poisonings and toxic effects of drugs11 discharges in 1 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 | 11 | $41,852 | $8,859 | $9,668 | 1.60 |
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 | 488 | 467 | $23,668 | $1,942 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 295 | 279 | $65,541 | $10,127 | $10,772 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 155 | 154 | $34,227 | $4,077 | $4,358 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 116 | 109 | $9,470 | $1,145 | $1,220 |
| Level 2 Upper GI ProceduresAPC 5302 | 115 | 105 | $11,752 | $1,358 | $1,445 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 95 | 95 | $93,733 | $19,687 | $21,117 |
| Level 1 Endovascular ProceduresAPC 5191 | 71 | 71 | $21,803 | $2,106 | $2,208 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 51 | 50 | $23,422 | $1,997 | $2,141 |
| Level 5 Urology and Related ServicesAPC 5375 | 48 | 46 | $18,512 | $3,704 | $3,918 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 44 | 44 | $40,364 | $5,130 | $5,339 |
| Level 3 Endovascular ProceduresAPC 5193 | 43 | 40 | $64,044 | $8,255 | $8,874 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 39 | 39 | $57,651 | $7,617 | $8,164 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 38 | 38 | $68,815 | $15,103 | $15,763 |
| Level 4 Urology and Related ServicesAPC 5374 | 36 | 34 | $15,812 | $2,500 | $2,629 |
| Level 3 Vascular ProceduresAPC 5183 | 35 | 34 | $13,491 | $2,220 | $2,405 |
| Level 5 Airway EndoscopyAPC 5155 | 33 | 33 | $41,939 | $4,604 | $5,183 |
| Level 2 Vascular ProceduresAPC 5182 | 32 | 31 | $5,965 | $1,148 | $1,204 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 28 | 28 | $52,366 | $7,971 | $8,569 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 25 | 25 | $25,017 | $2,481 | $2,636 |
| Level 3 Urology and Related ServicesAPC 5373 | 22 | 20 | $11,302 | $1,460 | $1,516 |
| Level 4 Airway EndoscopyAPC 5154 | 16 | 16 | $23,244 | $2,685 | $2,833 |
| Level 4 Endovascular ProceduresAPC 5194 | 16 | 15 | $80,518 | $14,117 | $14,606 |
| Level 3 Airway EndoscopyAPC 5153 | 15 | 14 | $13,227 | $1,217 | $1,264 |
| Level 4 Vascular ProceduresAPC 5184 | 15 | 14 | $32,489 | $3,923 | $3,946 |
| Level 5 Gynecologic ProceduresAPC 5415 | 13 | 13 | $23,290 | $3,292 | $3,792 |
| Level 6 Gynecologic ProceduresAPC 5416 | 13 | 13 | $35,322 | $5,418 | $5,836 |
| Level 3 Upper GI ProceduresAPC 5303 | 12 | 12 | $19,772 | $2,746 | $2,888 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 11 | 11 | $28,627 | $2,321 | $2,373 |
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.