The Methodist Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for The Methodist Hospital, Houston, TX in 2024, from traditional Medicare claims. Back to the The Methodist Hospital profile, with quality ratings, finances and negotiated rates.
10,386
Medicare inpatient discharges
In 227 published DRGs
2.61
Case mix index
IPPS FY 2027
32%
Surgical stays
74%
Stays with complications
In DRGs with a CC or MCC
11,682
Medicare outpatient services
In 62 service groups
Inpatient stays by major diagnostic category
Circulatory system2,533 discharges in 40 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 513 | $91,730 | $10,537 | $14,585 | 1.28 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 149 | $186,157 | $19,494 | $29,599 | 2.16 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 135 | $342,533 | $37,413 | $54,463 | 4.88 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 107 | $604,691 | $73,987 | $96,146 | 7.71 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 106 | $267,500 | $26,080 | $42,532 | 3.24 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 104 | $158,926 | $18,237 | $25,269 | 2.09 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 103 | $379,640 | $45,732 | $60,363 | 5.88 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 99 | $448,149 | $52,540 | $71,256 | 6.25 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 88 | $52,832 | $5,392 | $8,400 | 0.74 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 85 | $212,858 | $27,031 | $33,844 | 3.35 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 74 | $87,862 | $8,485 | $13,970 | 1.20 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 67 | $140,065 | $13,861 | $22,270 | 1.59 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 59 | $58,372 | $7,465 | $9,281 | 1.07 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 55 | $443,947 | $47,080 | $70,588 | 5.06 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 51 | $251,105 | $24,280 | $39,926 | 3.18 |
| Syncope and collapseMS-DRG 312, medical | 50 | $58,500 | $6,976 | $9,301 | 0.86 |
| Hypertension without MCCMS-DRG 305, medical | 49 | $41,507 | $5,107 | $6,600 | 0.75 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 49 | $118,300 | $12,853 | $18,810 | 1.82 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 48 | $212,282 | $20,741 | $33,753 | 2.87 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 44 | $69,551 | $6,696 | $11,059 | 0.97 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 41 | $78,521 | $8,395 | $12,485 | 1.08 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 38 | $123,003 | $12,801 | $19,557 | 1.58 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 37 | $152,787 | $15,742 | $24,293 | 2.28 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 34 | $391,144 | $51,385 | $62,192 | 5.04 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 31 | $265,888 | $30,297 | $42,276 | 3.90 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 30 | $24,912 | $3,075 | $3,961 | 0.55 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 29 | $462,642 | $60,253 | $73,560 | 7.80 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 27 | $254,478 | $26,814 | $40,462 | 3.27 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 26 | $285,717 | $30,555 | $45,429 | 3.46 |
| Other vascular procedures with CCMS-DRG 253, surgical | 26 | $185,190 | $20,588 | $29,445 | 2.55 |
| Hypertension with MCCMS-DRG 304, medical | 26 | $64,546 | $8,812 | $10,263 | 1.15 |
| Chest painMS-DRG 313, medical | 23 | $45,696 | $5,193 | $7,266 | 0.72 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 18 | $773,309 | $97,592 | $122,956 | 9.71 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 18 | $440,820 | $42,478 | $70,090 | 4.81 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 18 | $332,258 | $34,046 | $52,829 | 4.16 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 18 | $279,833 | $30,147 | $44,493 | 3.46 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 17 | $57,145 | $6,764 | $9,086 | 0.91 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 15 | $445,675 | $45,022 | $70,862 | 5.24 |
| Cardiac defibrillator implant with MCC or carotid sinus neurostimulatorMS-DRG 276, surgical | 14 | $595,887 | $65,323 | $94,746 | 6.21 |
| Cardiac congenital and valvular disorders with MCCMS-DRG 306, medical | 12 | $159,244 | $20,665 | $25,320 | 1.54 |
Infectious and parasitic diseases1,291 discharges in 11 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 | 808 | $156,750 | $16,752 | $24,923 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 182 | $61,623 | $7,348 | $9,798 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 118 | $488,974 | $57,252 | $77,747 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 39 | $794,323 | $84,525 | $126,297 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 35 | $139,047 | $14,592 | $22,108 | 2.04 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 26 | $565,834 | $65,284 | $89,968 | 4.43 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 24 | $106,089 | $13,996 | $16,868 | 1.84 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 22 | $130,773 | $16,058 | $20,793 | 2.14 |
| Fever and inflammatory conditionsMS-DRG 864, medical | 14 | $80,368 | $7,400 | $12,779 | 0.88 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 12 | $46,511 | $7,730 | $7,395 | 1.01 |
| Viral illness with MCCMS-DRG 865, medical | 11 | $173,655 | $11,015 | $27,611 | 1.64 |
Digestive system1,044 discharges in 22 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 125 | $122,322 | $14,562 | $19,449 | 1.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 117 | $58,696 | $7,257 | $9,333 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 114 | $43,604 | $5,608 | $6,933 | 0.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 76 | $174,163 | $17,089 | $27,692 | 2.37 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 71 | $48,897 | $5,332 | $7,775 | 0.80 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 69 | $88,561 | $10,508 | $14,081 | 1.28 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 63 | $298,124 | $38,228 | $47,402 | 4.52 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 59 | $129,107 | $12,797 | $20,528 | 1.62 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 56 | $60,266 | $6,813 | $9,582 | 0.94 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 38 | $202,165 | $19,362 | $32,144 | 1.45 |
| Digestive malignancy with MCCMS-DRG 374, medical | 34 | $181,648 | $19,759 | $28,882 | 2.10 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 33 | $120,868 | $14,521 | $19,218 | 1.75 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 22 | $391,719 | $52,287 | $62,283 | 5.08 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 21 | $128,944 | $12,733 | $20,502 | 1.67 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 21 | $59,280 | $7,863 | $9,426 | 1.04 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 20 | $168,867 | $17,613 | $26,850 | 2.50 |
| Hernia procedures except inguinal and femoral with CCMS-DRG 354, surgical | 20 | $158,027 | $12,678 | $25,126 | 1.72 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 19 | $160,774 | $14,809 | $25,563 | 2.11 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 19 | $30,693 | $3,357 | $4,880 | 0.56 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 16 | $330,013 | $38,977 | $52,472 | 4.28 |
| Digestive malignancy with CCMS-DRG 375, medical | 16 | $88,048 | $8,239 | $14,000 | 1.20 |
| Inflammatory bowel disease with CCMS-DRG 386, medical | 15 | $53,287 | $7,154 | $8,473 | 0.97 |
Respiratory system1,006 discharges in 22 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 215 | $118,884 | $13,279 | $18,903 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 125 | $108,148 | $9,587 | $17,196 | 1.23 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 123 | $104,234 | $9,851 | $16,573 | 1.33 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 59 | $137,069 | $14,956 | $21,794 | 1.81 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 44 | $54,160 | $7,000 | $8,611 | 0.99 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 41 | $365,364 | $41,129 | $58,093 | 4.06 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 40 | $157,846 | $16,416 | $25,097 | 1.90 |
| Major chest procedures with CCMS-DRG 164, surgical | 38 | $147,623 | $19,180 | $23,472 | 2.55 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 35 | $132,243 | $13,918 | $21,027 | 1.74 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 33 | $286,001 | $23,202 | $45,474 | 2.70 |
| Major chest procedures with MCCMS-DRG 163, surgical | 32 | $311,942 | $39,477 | $49,599 | 4.71 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 30 | $52,011 | $5,494 | $8,270 | 0.82 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 27 | $98,455 | $8,093 | $15,654 | 1.10 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 27 | $667,558 | $70,081 | $106,142 | 6.91 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 25 | $86,562 | $7,981 | $13,763 | 0.96 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 24 | $94,422 | $9,397 | $15,013 | 1.40 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 18 | $212,778 | $17,413 | $33,832 | 0.91 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 17 | $98,776 | $14,039 | $15,705 | 1.88 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 17 | $72,531 | $5,227 | $11,532 | 0.82 |
| Other respiratory system o.r. procedures with CCMS-DRG 167, surgical | 14 | $212,999 | $18,657 | $33,867 | 1.82 |
| Pleural effusion with MCCMS-DRG 186, medical | 11 | $121,835 | $11,625 | $19,372 | 1.55 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 11 | $77,549 | $5,613 | $12,330 | 0.85 |
Nervous system983 discharges in 31 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 103 | $156,693 | $16,119 | $24,914 | 2.00 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 73 | $298,866 | $36,167 | $47,520 | 4.42 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 73 | $62,784 | $7,096 | $9,983 | 1.02 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 63 | $69,324 | $8,109 | $11,022 | 1.03 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 60 | $97,875 | $15,014 | $15,562 | 1.79 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 51 | $256,907 | $30,588 | $40,848 | 2.39 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 46 | $168,918 | $17,622 | $26,858 | 2.43 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 45 | $98,254 | $12,433 | $15,622 | 1.36 |
| Seizures with MCCMS-DRG 100, medical | 44 | $123,951 | $15,862 | $19,708 | 1.98 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 34 | $130,201 | $9,968 | $20,702 | 1.03 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 32 | $68,096 | $10,895 | $10,827 | 1.47 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 32 | $88,466 | $13,357 | $14,066 | 1.79 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 28 | $347,594 | $43,543 | $55,267 | 5.67 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 27 | $241,453 | $27,156 | $38,391 | 2.95 |
| Seizures without MCCMS-DRG 101, medical | 24 | $42,564 | $5,785 | $6,768 | 0.91 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 22 | $44,582 | $5,639 | $7,089 | 0.80 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 22 | $57,546 | $7,781 | $9,150 | 1.06 |
| Ventricular shunt procedures with CCMS-DRG 032, surgical | 21 | $118,957 | $15,831 | $18,914 | 2.15 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 19 | $107,148 | $16,420 | $17,037 | 2.27 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 18 | $155,254 | $16,385 | $24,685 | 2.30 |
| Ventricular shunt procedures without cc/mccMS-DRG 033, surgical | 16 | $98,518 | $12,264 | $15,664 | 1.62 |
| Cranial and peripheral nerve disorders with MCCMS-DRG 073, medical | 16 | $138,047 | $14,296 | $21,949 | 1.51 |
| Headaches without MCCMS-DRG 103, medical | 16 | $52,985 | $5,137 | $8,425 | 0.84 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 15 | $89,314 | $17,646 | $14,201 | 2.28 |
| Spinal procedures with CC or spinal neurostimulatorsMS-DRG 029, surgical | 14 | $238,821 | $26,548 | $37,973 | 3.43 |
| Extracranial procedures with CCMS-DRG 038, surgical | 13 | $126,688 | $12,014 | $20,143 | 1.60 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 062, medical | 12 | $125,024 | $12,933 | $19,879 | 1.87 |
| Spinal procedures with MCCMS-DRG 028, surgical | 11 | $215,028 | $42,273 | $34,189 | 6.03 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 11 | $143,853 | $12,287 | $22,873 | 1.81 |
| Peripheral, cranial nerve and other nervous system procedures with MCCMS-DRG 040, surgical | 11 | $436,841 | $45,706 | $69,458 | 3.85 |
| Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurMS-DRG 041, surgical | 11 | $156,263 | $15,650 | $24,846 | 2.23 |
Musculoskeletal system and connective tissue930 discharges in 33 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 80 | $141,208 | $14,020 | $22,452 | 1.88 |
| Medical back problems without MCCMS-DRG 552, medical | 80 | $46,076 | $6,585 | $7,326 | 0.97 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 79 | $218,698 | $24,587 | $34,773 | 3.49 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 70 | $621,177 | $62,725 | $98,767 | 6.12 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 55 | $407,245 | $34,636 | $64,752 | 3.66 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 51 | $239,812 | $20,869 | $38,130 | 2.96 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 37 | $510,198 | $53,345 | $81,121 | 4.61 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 34 | $116,123 | $14,561 | $18,464 | 2.04 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 31 | $118,787 | $15,048 | $18,887 | 2.07 |
| Medical back problems with MCCMS-DRG 551, medical | 29 | $75,280 | $12,165 | $11,969 | 1.70 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 28 | $139,093 | $14,450 | $22,116 | 1.97 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 28 | $165,303 | $14,490 | $26,283 | 2.11 |
| Other musculoskeletal system and connective tissue o.r. procedures with MCCMS-DRG 515, surgical | 25 | $213,541 | $23,363 | $33,953 | 3.16 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 22 | $219,773 | $20,394 | $34,944 | 2.67 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 20 | $206,277 | $24,324 | $32,798 | 2.95 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 20 | $162,373 | $16,894 | $25,817 | 2.40 |
| Cervical spinal fusion without cc/mccMS-DRG 473, surgical | 19 | $210,902 | $17,376 | $33,533 | 2.46 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 19 | $36,105 | $6,302 | $5,741 | 0.90 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 17 | $178,311 | $20,524 | $28,352 | 3.00 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 17 | $64,076 | $7,674 | $10,188 | 1.09 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 16 | $265,556 | $20,606 | $42,223 | 2.48 |
| Connective tissue disorders with CCMS-DRG 546, medical | 16 | $80,912 | $9,118 | $12,865 | 1.20 |
| Connective tissue disorders with MCCMS-DRG 545, medical | 15 | $166,172 | $19,764 | $26,421 | 2.49 |
| Combined anterior and posterior spinal fusion with MCCMS-DRG 453, surgical | 14 | $744,400 | $96,147 | $118,360 | 8.86 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 14 | $270,203 | $30,120 | $42,962 | 2.99 |
| Cervical spinal fusion with MCCMS-DRG 471, surgical | 13 | $534,601 | $44,005 | $85,001 | 4.92 |
| Revision of hip or knee replacement with MCCMS-DRG 466, surgical | 12 | $354,721 | $44,230 | $56,401 | 5.19 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 12 | $126,495 | $16,347 | $20,113 | 2.38 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 12 | $82,418 | $11,020 | $13,105 | 1.49 |
| Osteomyelitis with MCCMS-DRG 539, medical | 12 | $94,531 | $15,028 | $15,030 | 1.98 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 457, surgical | 11 | $672,455 | $66,178 | $106,920 | 6.08 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 463, surgical | 11 | $379,886 | $46,068 | $60,402 | 5.66 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 11 | $225,453 | $23,693 | $35,847 | 1.82 |
Kidney and urinary tract920 discharges in 12 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 | 165 | $86,774 | $12,639 | $13,797 | 1.65 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 130 | $100,830 | $10,505 | $16,032 | 1.02 |
| Renal failure with MCCMS-DRG 682, medical | 121 | $79,788 | $10,830 | $12,686 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 110 | $53,416 | $6,524 | $8,493 | 0.90 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 110 | $43,895 | $5,896 | $6,979 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 99 | $68,841 | $8,751 | $10,946 | 1.17 |
| Kidney transplantMS-DRG 652, surgical | 61 | $514,664 | $25,216 | $81,832 | 3.00 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 36 | $239,287 | $36,165 | $38,047 | 3.70 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 28 | $104,852 | $9,820 | $16,671 | 1.35 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 23 | $127,408 | $16,923 | $20,258 | 2.38 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 19 | $128,783 | $19,150 | $20,477 | 2.59 |
| Kidney transplant with hemodialysis with MCCMS-DRG 650, surgical | 18 | $622,055 | $42,165 | $98,907 | 4.50 |
Liver, gallbladder and pancreas465 discharges in 13 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 117 | $229,051 | $23,566 | $36,419 | 1.92 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 56 | $255,150 | $26,701 | $40,569 | 1.83 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 40 | $67,990 | $7,326 | $10,810 | 1.09 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 36 | $86,508 | $7,897 | $13,755 | 1.03 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 33 | $151,976 | $15,667 | $24,164 | 1.76 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 32 | $127,077 | $11,783 | $20,205 | 1.63 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 30 | $451,285 | $56,410 | $71,754 | 5.51 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 26 | $88,218 | $11,634 | $14,027 | 1.63 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 25 | $91,211 | $7,125 | $14,503 | 0.95 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 24 | $113,694 | $11,615 | $18,077 | 1.67 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 24 | $60,596 | $5,449 | $9,635 | 0.86 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 11 | $243,302 | $23,484 | $38,685 | 2.89 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 11 | $118,484 | $17,654 | $18,839 | 2.32 |
Endocrine, nutritional and metabolic317 discharges in 8 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 | 117 | $80,119 | $9,778 | $12,739 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 47 | $44,289 | $5,276 | $7,042 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 37 | $52,835 | $6,146 | $8,401 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 36 | $107,335 | $9,258 | $17,066 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 35 | $138,306 | $14,320 | $21,991 | 1.65 |
| Adrenal and pituitary procedures with cc/mccMS-DRG 614, surgical | 19 | $158,605 | $16,913 | $25,218 | 2.25 |
| Endocrine disorders with CCMS-DRG 644, medical | 15 | $36,938 | $7,571 | $5,873 | 1.06 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 11 | $93,963 | $11,784 | $14,940 | 1.98 |
Transplants, ECMO and tracheostomy (pre-MDC)176 discharges in 6 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 | 47 | $2,674,439 | $320,179 | $425,236 | 21.32 |
| Liver transplant with MCC or intestinal transplantMS-DRG 005, surgical | 36 | $1,309,160 | $128,626 | $208,156 | 10.35 |
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 29 | $2,373,680 | $306,751 | $377,415 | 27.10 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 25 | $1,271,769 | $155,928 | $202,211 | 14.70 |
| Lung transplantMS-DRG 007, surgical | 21 | $1,575,885 | $154,846 | $250,566 | 12.27 |
| Autologous bone marrow transplant with cc/mccMS-DRG 016, medical | 18 | $244,845 | $42,773 | $38,930 | 6.18 |
Other170 discharges in 8 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 | 51 | $316,161 | $41,040 | $50,270 | 4.74 |
| Concomitant left atrial appendage closure and cardiac ablationMS-DRG 317 | 26 | $250,876 | $46,849 | $39,889 | |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 22 | $170,997 | $17,861 | $27,189 | 2.49 |
| Multiple level combined anterior and posterior spinal fusion except cervical with CCMS-DRG 427 | 16 | $862,542 | $95,427 | $137,144 | |
| Single level combined anterior and posterior spinal fusion except cervicalMS-DRG 402 | 14 | $346,772 | $28,839 | $55,137 | |
| Single level spinal fusion except cervical without MCCMS-DRG 451 | 14 | $275,973 | $23,890 | $43,880 | |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 14 | $423,589 | $45,730 | $67,351 | 3.38 |
| Multiple level spinal fusion except cervical without MCCMS-DRG 448 | 13 | $362,392 | $34,818 | $57,620 |
Blood and immune system158 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 49 | $51,277 | $7,026 | $8,153 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 44 | $83,637 | $10,376 | $13,298 | 1.40 |
| Coagulation disordersMS-DRG 813, medical | 35 | $159,844 | $21,009 | $25,415 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 17 | $271,820 | $31,033 | $43,219 | 2.19 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 13 | $62,767 | $9,377 | $9,980 | 1.20 |
Skin, subcutaneous tissue and breast128 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 93 | $46,844 | $6,330 | $7,448 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 22 | $59,678 | $11,317 | $9,489 | 1.49 |
| Skin ulcers with MCCMS-DRG 592, medical | 13 | $89,003 | $13,204 | $14,151 | 2.09 |
Blood cancers and poorly differentiated neoplasms112 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 29 | $286,197 | $29,666 | $45,505 | 3.13 |
| Chemotherapy without acute leukemia as secondary diagnosis with CCMS-DRG 847, medical | 28 | $128,118 | $10,348 | $20,371 | 1.21 |
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 23 | $136,043 | $19,309 | $21,631 | 2.44 |
| Acute leukemia with MCCMS-DRG 834, medical | 20 | $303,454 | $47,820 | $48,249 | 5.60 |
| Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy aMS-DRG 837, medical | 12 | $286,829 | $40,683 | $45,606 | 4.84 |
Injuries, poisonings and toxic effects of drugs82 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 26 | $86,883 | $13,604 | $13,814 | 1.82 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 22 | $265,672 | $38,502 | $42,242 | 3.72 |
| Complications of treatment with CCMS-DRG 920, medical | 20 | $69,626 | $7,689 | $11,071 | 1.03 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 14 | $129,512 | $13,585 | $20,592 | 1.60 |
Eye36 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Neurological eye disordersMS-DRG 123, medical | 21 | $46,677 | $5,854 | $7,422 | 0.80 |
| Other disorders of the eye without MCCMS-DRG 125, medical | 15 | $77,780 | $7,665 | $12,367 | 0.80 |
Mental diseases and disorders19 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 | 19 | $64,444 | $11,971 | $10,247 | 1.76 |
Ear, nose, mouth and throat16 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 16 | $45,794 | $5,212 | $7,281 | 0.74 |
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 | 1,771 | 1,580 | $26,464 | $1,987 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 696 | 657 | $111,235 | $10,418 | $10,772 |
| Level 1 Endovascular ProceduresAPC 5191 | 596 | 589 | $16,690 | $2,133 | $2,208 |
| Level 1 Intraocular ProceduresAPC 5491 | 571 | 385 | $27,418 | $1,694 | $1,752 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 551 | 501 | $22,331 | $1,156 | $1,220 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 507 | 491 | $66,993 | $5,191 | $5,339 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 446 | 427 | $138,621 | $20,021 | $21,117 |
| Level 3 Vascular ProceduresAPC 5183 | 444 | 321 | $31,594 | $2,311 | $2,405 |
| Level 3 Endovascular ProceduresAPC 5193 | 389 | 348 | $82,347 | $8,439 | $8,874 |
| Level 2 Upper GI ProceduresAPC 5302 | 342 | 300 | $15,328 | $1,377 | $1,445 |
| Level 5 Urology and Related ServicesAPC 5375 | 325 | 306 | $48,169 | $3,798 | $3,918 |
| Level 4 Vascular ProceduresAPC 5184 | 303 | 284 | $54,774 | $3,820 | $3,946 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 279 | 278 | $67,415 | $4,171 | $4,358 |
| Level 4 Urology and Related ServicesAPC 5374 | 271 | 248 | $47,087 | $2,523 | $2,629 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 258 | 257 | $101,319 | $7,756 | $8,164 |
| Level 4 Airway EndoscopyAPC 5154 | 242 | 171 | $34,995 | $2,754 | $2,833 |
| Level 1 Nerve ProceduresAPC 5431 | 200 | 169 | $26,948 | $1,383 | $1,407 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 179 | 166 | $37,969 | $2,005 | $2,141 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 179 | 158 | $47,650 | $2,483 | $2,636 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 176 | 171 | $41,743 | $2,364 | $2,373 |
| Level 3 Airway EndoscopyAPC 5153 | 176 | 142 | $21,597 | $1,225 | $1,264 |
| Level 5 ENT ProceduresAPC 5165 | 164 | 158 | $56,162 | $4,247 | $4,436 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 153 | 147 | $18,900 | $1,171 | $1,196 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 149 | 146 | $178,847 | $15,296 | $15,763 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 142 | 141 | $99,239 | $8,086 | $8,569 |
| Level 2 Intraocular ProceduresAPC 5492 | 141 | 131 | $35,365 | $2,982 | $3,116 |
| Level 5 Airway EndoscopyAPC 5155 | 136 | 133 | $57,328 | $4,981 | $5,183 |
| Level 6 Urology and Related ServicesAPC 5376 | 135 | 134 | $66,854 | $6,752 | $7,291 |
| Level 2 Endovascular ProceduresAPC 5192 | 127 | 115 | $42,904 | $4,220 | $4,338 |
| Level 4 Endovascular ProceduresAPC 5194 | 119 | 113 | $137,367 | $14,594 | $14,606 |
| Level 3 Urology and Related ServicesAPC 5373 | 107 | 87 | $29,787 | $1,448 | $1,516 |
| Complex GI ProceduresAPC 5331 | 95 | 58 | $37,902 | $3,856 | $4,263 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 88 | 88 | $65,729 | $6,275 | $6,514 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 87 | 85 | $247,666 | $26,766 | $26,719 |
| Level 3 Lower GI ProceduresAPC 5313 | 81 | 73 | $22,934 | $2,094 | $2,176 |
| Level 3 Upper GI ProceduresAPC 5303 | 80 | 79 | $25,034 | $2,798 | $2,888 |
| Level 2 Vascular ProceduresAPC 5182 | 77 | 74 | $24,234 | $1,166 | $1,204 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 66 | 64 | $38,859 | $2,726 | $2,930 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 62 | 61 | $57,107 | $4,818 | $4,982 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 61 | 61 | $272,549 | $28,782 | $29,375 |
| Level 4 Gynecologic ProceduresAPC 5414 | 61 | 60 | $29,972 | $2,272 | $2,389 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 59 | 55 | $179,398 | $17,972 | $18,465 |
| Level 7 Radiation TherapyAPC 5627 | 59 | 52 | $253,746 | $5,558 | $6,121 |
| Level 5 Gynecologic ProceduresAPC 5415 | 57 | 46 | $52,585 | $3,671 | $3,792 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 57 | 56 | $33,501 | $1,722 | $1,780 |
| Level 3 Intraocular ProceduresAPC 5493 | 53 | 42 | $45,858 | $3,858 | $4,004 |
| Level 2 Nerve ProceduresAPC 5432 | 48 | 34 | $49,718 | $3,381 | $4,674 |
| Level 4 Extraocular, Repair, and Plastic Eye ProceduresAPC 5504 | 43 | 43 | $45,232 | $2,854 | $2,969 |
| Level 8 Urology and Related ServicesAPC 5378 | 40 | 36 | $208,662 | $17,029 | $17,428 |
| Implantation of Drug Infusion DeviceAPC 5471 | 26 | 25 | $144,737 | $14,870 | $14,829 |
| Level 4 ENT ProceduresAPC 5164 | 25 | 25 | $36,667 | $2,283 | $2,217 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 23 | 21 | $66,425 | $4,613 | $4,524 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 22 | 22 | $143,841 | $16,395 | $17,052 |
| Cochlear Implant ProcedureAPC 5166 | 21 | 20 | $254,052 | $29,369 | $29,489 |
| Level 7 Urology and Related ServicesAPC 5377 | 19 | 19 | $131,590 | $10,255 | $10,388 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 18 | 18 | $78,917 | $5,211 | $5,682 |
| Level 6 Gynecologic ProceduresAPC 5416 | 18 | 17 | $68,280 | $5,576 | $5,836 |
| Level 2 Urology and Related ServicesAPC 5372 | 15 | 14 | $17,791 | $458 | $502 |
| Level 3 Breast/Lymphatic Surgery and Related ProceduresAPC 5093 | 14 | 14 | $118,899 | $7,106 | $7,546 |
| Implantation Wireless PA Pressure MonitorAPC 5200 | 11 | 11 | $201,324 | $25,241 | $26,955 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 11 | 11 | $220,458 | $20,168 | $21,011 |
| Level 1 Neurostimulator and Related ProceduresAPC 5461 | 11 | 11 | $46,037 | $2,514 | $2,547 |
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.