The Queens Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for The Queens Medical Center, Honolulu, HI in 2024, from traditional Medicare claims. Back to the The Queens Medical Center profile, with quality ratings, finances and negotiated rates.
5,399
Medicare inpatient discharges
In 158 published DRGs
2.10
Case mix index
IPPS FY 2027
28%
Surgical stays
74%
Stays with complications
In DRGs with a CC or MCC
4,044
Medicare outpatient services
In 47 service groups
Inpatient stays by major diagnostic category
Circulatory system1,127 discharges in 33 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 243 | $63,446 | $11,182 | $13,831 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 139 | $85,137 | $14,042 | $18,560 | 1.59 |
| Syncope and collapseMS-DRG 312, medical | 64 | $47,424 | $7,839 | $10,338 | 0.86 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 53 | $103,357 | $13,297 | $22,532 | 1.82 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 51 | $51,066 | $7,863 | $11,132 | 0.91 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 45 | $190,896 | $41,015 | $41,615 | 4.88 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 42 | $138,848 | $31,625 | $30,269 | 3.35 |
| Other vascular procedures with CCMS-DRG 253, surgical | 29 | $123,949 | $22,912 | $27,021 | 2.55 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 29 | $54,849 | $6,213 | $11,957 | 0.74 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 26 | $72,026 | $11,678 | $15,702 | 1.20 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 26 | $183,689 | $27,058 | $40,044 | 2.87 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 24 | $197,036 | $35,669 | $42,954 | 4.04 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 23 | $57,858 | $7,903 | $12,613 | 1.08 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 23 | $48,545 | $9,041 | $10,583 | 1.07 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 22 | $234,899 | $45,545 | $51,208 | 5.88 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 22 | $94,083 | $19,248 | $20,510 | 2.28 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 21 | $89,506 | $26,237 | $19,512 | 3.27 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 21 | $243,026 | $39,223 | $52,980 | 5.06 |
| Chest painMS-DRG 313, medical | 20 | $34,514 | $6,637 | $7,524 | 0.72 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 19 | $98,428 | $14,680 | $21,457 | 2.16 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 18 | $137,678 | $32,306 | $30,014 | 3.24 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 18 | $85,097 | $17,199 | $18,551 | 1.97 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 17 | $39,929 | $5,014 | $8,705 | 0.72 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 17 | $130,471 | $20,247 | $28,443 | 2.09 |
| Hypertension without MCCMS-DRG 305, medical | 15 | $29,689 | $5,247 | $6,472 | 0.75 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 14 | $369,385 | $75,331 | $80,526 | 7.71 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 13 | $211,266 | $44,946 | $46,056 | 5.24 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 13 | $254,806 | $44,876 | $55,548 | 4.81 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 13 | $170,323 | $35,075 | $37,131 | 3.46 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 13 | $261,961 | $67,145 | $57,108 | 6.25 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 12 | $90,889 | $11,817 | $19,814 | 1.58 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 11 | $181,628 | $41,726 | $39,595 | 4.16 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 11 | $29,564 | $3,557 | $6,445 | 0.55 |
Infectious and parasitic diseases886 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical | 553 | $86,064 | $17,441 | $18,762 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 142 | $53,445 | $8,070 | $11,651 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 128 | $242,827 | $50,443 | $52,936 | 5.00 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 32 | $92,497 | $15,073 | $20,164 | 2.04 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 20 | $337,910 | $70,516 | $73,664 | 6.96 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 11 | $159,486 | $21,971 | $34,768 | 1.84 |
Nervous system678 discharges in 24 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 134 | $134,317 | $18,989 | $29,281 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 90 | $67,760 | $8,453 | $14,772 | 1.02 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 59 | $218,361 | $38,978 | $47,603 | 4.42 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 57 | $274,388 | $55,272 | $59,817 | 5.67 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 27 | $164,454 | $32,803 | $35,851 | 3.79 |
| Seizures with MCCMS-DRG 100, medical | 27 | $128,855 | $18,271 | $28,090 | 1.98 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 24 | $169,362 | $16,933 | $36,921 | 2.43 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 24 | $135,056 | $22,413 | $29,442 | 2.27 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 23 | $85,028 | $12,745 | $18,536 | 1.32 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 17 | $152,720 | $24,847 | $33,293 | 2.39 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 062, medical | 17 | $96,428 | $13,733 | $21,021 | 1.87 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 17 | $39,212 | $6,515 | $8,548 | 0.80 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 16 | $115,965 | $25,420 | $25,280 | 2.95 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 16 | $71,719 | $4,571 | $15,635 | 0.69 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 15 | $47,448 | $10,922 | $10,344 | 1.36 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 061, medical | 14 | $132,977 | $28,263 | $28,989 | 2.80 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 14 | $112,909 | $21,393 | $24,614 | 2.28 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 14 | $74,236 | $8,250 | $16,184 | 1.03 |
| Seizures without MCCMS-DRG 101, medical | 14 | $59,641 | $7,294 | $13,002 | 0.91 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 13 | $77,274 | $13,891 | $16,846 | 1.79 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 13 | $49,707 | $6,970 | $10,836 | 1.06 |
| Intracranial vascular procedures with principal diagnosis hemorrhage with MCCMS-DRG 020, surgical | 11 | $351,169 | $87,814 | $76,555 | 8.45 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 11 | $86,143 | $11,893 | $18,779 | 1.36 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 11 | $189,432 | $22,518 | $41,296 | 1.79 |
Respiratory system632 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 | 161 | $79,045 | $15,014 | $17,232 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 94 | $61,644 | $12,050 | $13,438 | 1.33 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 51 | $51,553 | $6,516 | $11,238 | 0.82 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 47 | $54,072 | $7,945 | $11,788 | 1.10 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 46 | $61,565 | $10,475 | $13,421 | 1.23 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 34 | $49,069 | $8,663 | $10,697 | 0.99 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 33 | $80,282 | $15,318 | $17,502 | 1.74 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 28 | $113,865 | $21,183 | $24,823 | 2.70 |
| Major chest procedures with CCMS-DRG 164, surgical | 23 | $116,923 | $20,709 | $25,489 | 2.55 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 21 | $95,844 | $11,421 | $20,894 | 1.88 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 18 | $57,474 | $12,408 | $12,529 | 1.40 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 17 | $33,896 | $8,552 | $7,389 | 0.96 |
| Major chest procedures with MCCMS-DRG 163, surgical | 15 | $139,364 | $35,738 | $30,381 | 4.71 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 15 | $122,379 | $27,500 | $26,679 | 4.06 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 15 | $317,954 | $64,180 | $69,314 | 6.91 |
| Pleural effusion with MCCMS-DRG 186, medical | 14 | $96,106 | $12,074 | $20,951 | 1.55 |
Digestive system531 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 107 | $48,379 | $8,133 | $10,547 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 52 | $76,777 | $16,876 | $16,737 | 1.79 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 43 | $291,958 | $46,446 | $63,647 | 4.52 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 37 | $53,641 | $5,076 | $11,694 | 0.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 35 | $100,634 | $20,096 | $21,938 | 2.37 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 31 | $77,453 | $11,551 | $16,885 | 1.28 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 28 | $43,334 | $7,947 | $9,447 | 0.94 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 27 | $29,750 | $3,981 | $6,485 | 0.56 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 23 | $31,781 | $5,908 | $6,928 | 0.80 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 23 | $76,939 | $14,855 | $16,773 | 1.62 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 16 | $296,813 | $44,129 | $64,705 | 5.08 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 16 | $180,456 | $21,139 | $39,339 | 2.50 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 16 | $73,394 | $12,364 | $16,000 | 1.67 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 16 | $71,490 | $10,464 | $15,585 | 1.45 |
| Digestive malignancy with MCCMS-DRG 374, medical | 14 | $135,378 | $16,186 | $29,512 | 2.10 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 12 | $165,993 | $33,699 | $36,187 | 4.28 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 12 | $107,933 | $15,430 | $23,529 | 1.75 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 12 | $42,139 | $9,854 | $9,186 | 1.04 |
| Digestive malignancy with CCMS-DRG 375, medical | 11 | $58,234 | $10,635 | $12,695 | 1.20 |
Kidney and urinary tract391 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with MCCMS-DRG 682, medical | 62 | $80,308 | $12,402 | $17,507 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 59 | $37,957 | $7,155 | $8,275 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 59 | $81,973 | $15,215 | $17,870 | 1.65 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 52 | $38,069 | $6,582 | $8,299 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 39 | $71,803 | $11,168 | $15,653 | 1.17 |
| Kidney transplantMS-DRG 652, surgical | 30 | $482,433 | $27,873 | $105,170 | 3.00 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 28 | $39,688 | $9,191 | $8,652 | 1.02 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 21 | $192,017 | $37,144 | $41,860 | 3.70 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 17 | $61,783 | $7,562 | $13,469 | 1.35 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 13 | $41,665 | $9,830 | $9,083 | 1.05 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 11 | $94,031 | $17,217 | $20,499 | 2.38 |
Musculoskeletal system and connective tissue369 discharges in 14 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 | 63 | $92,920 | $14,556 | $20,257 | 1.88 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 49 | $87,523 | $19,403 | $19,080 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 39 | $38,252 | $7,349 | $8,339 | 0.97 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 30 | $142,051 | $29,063 | $30,967 | 2.95 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 29 | $113,804 | $30,669 | $24,809 | 3.66 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 27 | $156,845 | $20,444 | $34,192 | 2.96 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 26 | $95,802 | $16,589 | $20,885 | 2.11 |
| Medical back problems with MCCMS-DRG 551, medical | 26 | $67,159 | $13,580 | $14,641 | 1.70 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 15 | $43,537 | $5,675 | $9,491 | 0.79 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 14 | $140,095 | $26,061 | $30,541 | 2.99 |
| Cervical spinal fusion with MCCMS-DRG 471, surgical | 13 | $217,012 | $50,282 | $47,309 | 4.92 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 13 | $130,651 | $19,656 | $28,482 | 2.40 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 13 | $35,269 | $6,266 | $7,689 | 0.82 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 12 | $149,485 | $34,730 | $32,588 | 3.49 |
Endocrine, nutritional and metabolic248 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 | 84 | $83,680 | $11,970 | $18,242 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 63 | $40,216 | $6,431 | $8,767 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 27 | $36,825 | $7,743 | $8,028 | 0.90 |
| Endocrine disorders with MCCMS-DRG 643, medical | 26 | $55,230 | $15,119 | $12,040 | 1.65 |
| Diabetes with MCCMS-DRG 637, medical | 18 | $72,388 | $13,039 | $15,781 | 1.45 |
| Skin grafts and wound debridement for endocrine, nutritional and metabolic disorders witMS-DRG 623, surgical | 16 | $76,975 | $17,853 | $16,780 | 1.86 |
| Endocrine disorders with CCMS-DRG 644, medical | 14 | $46,068 | $6,946 | $10,043 | 1.06 |
Skin, subcutaneous tissue and breast140 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 75 | $41,426 | $7,040 | $9,031 | 0.88 |
| Skin debridement with CCMS-DRG 571, surgical | 25 | $58,185 | $14,405 | $12,684 | 1.69 |
| Cellulitis with MCCMS-DRG 602, medical | 22 | $84,661 | $14,785 | $18,456 | 1.49 |
| Skin debridement with MCCMS-DRG 570, surgical | 18 | $159,592 | $28,912 | $34,791 | 2.92 |
Liver, gallbladder and pancreas131 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 19 | $68,448 | $11,641 | $14,922 | 1.83 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 18 | $97,141 | $10,856 | $21,177 | 1.76 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 16 | $48,303 | $10,218 | $10,530 | 1.09 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 15 | $105,138 | $20,162 | $22,920 | 2.32 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 15 | $75,832 | $9,471 | $16,531 | 1.63 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 14 | $92,330 | $17,010 | $20,128 | 1.92 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 12 | $66,182 | $8,258 | $14,428 | 0.95 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 11 | $56,820 | $9,025 | $12,387 | 1.31 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 11 | $59,568 | $14,448 | $12,986 | 1.63 |
Other53 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 | 38 | $226,723 | $42,894 | $49,426 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 15 | $105,216 | $22,405 | $22,937 | 2.49 |
Injuries, poisonings and toxic effects of drugs52 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 22 | $68,312 | $14,997 | $14,892 | 1.82 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 15 | $145,282 | $37,850 | $31,671 | 3.72 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 15 | $64,591 | $12,030 | $14,081 | 1.60 |
Mental diseases and disorders47 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| PsychosesMS-DRG 885, medical | 47 | $87,544 | $12,573 | $19,085 | 1.37 |
Factors influencing health status27 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other factors influencing health statusMS-DRG 951, medical | 16 | $30,634 | $5,479 | $6,678 | 0.59 |
| Signs and symptoms without MCCMS-DRG 948, medical | 11 | $55,225 | $6,699 | $12,039 | 0.80 |
Blood and immune system23 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Coagulation disordersMS-DRG 813, medical | 12 | $94,150 | $11,952 | $20,525 | 1.56 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 11 | $50,297 | $8,431 | $10,965 | 0.90 |
Blood cancers and poorly differentiated neoplasms19 discharges in 1 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 | 19 | $55,828 | $7,428 | $12,170 | 1.21 |
Alcohol and drug use12 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Alcohol, drug abuse or dependence without rehabilitation therapy without MCCMS-DRG 897, medical | 12 | $88,537 | $12,283 | $19,301 | 0.86 |
Transplants, ECMO and tracheostomy (pre-MDC)11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 11 | $722,593 | $126,896 | $157,525 | 14.70 |
Ear, nose, mouth and throat11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Otitis media and uri without MCCMS-DRG 153, medical | 11 | $47,698 | $6,056 | $10,398 | 0.73 |
Multiple significant trauma11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other o.r. procedures for multiple significant trauma with MCCMS-DRG 957, surgical | 11 | $402,526 | $70,013 | $87,751 | 7.23 |
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 | 414 | 377 | $17,072 | $2,417 | $2,090 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 316 | 287 | $9,876 | $1,386 | $1,220 |
| Level 3 Vascular ProceduresAPC 5183 | 220 | 202 | $19,368 | $2,840 | $2,405 |
| Level 2 Upper GI ProceduresAPC 5302 | 207 | 177 | $13,267 | $1,708 | $1,445 |
| Level 4 Vascular ProceduresAPC 5184 | 197 | 173 | $50,951 | $4,921 | $3,946 |
| Level 2 Endovascular ProceduresAPC 5192 | 192 | 157 | $24,271 | $5,183 | $4,338 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 185 | 182 | $67,099 | $12,738 | $10,772 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 172 | 171 | $31,601 | $5,076 | $4,358 |
| Level 1 Endovascular ProceduresAPC 5191 | 171 | 168 | $17,560 | $2,599 | $2,208 |
| Level 3 Endovascular ProceduresAPC 5193 | 120 | 112 | $49,120 | $10,728 | $8,874 |
| Level 2 Urology and Related ServicesAPC 5372 | 115 | 38 | $2,620 | $534 | $502 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 107 | 103 | $46,633 | $6,358 | $5,339 |
| Level 3 Urology and Related ServicesAPC 5373 | 105 | 81 | $12,194 | $1,796 | $1,516 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 103 | 98 | $18,653 | $2,496 | $2,141 |
| Level 4 Urology and Related ServicesAPC 5374 | 89 | 72 | $18,680 | $3,047 | $2,629 |
| Level 1 Intraocular ProceduresAPC 5491 | 83 | 68 | $10,305 | $2,005 | $1,752 |
| Level 4 Airway EndoscopyAPC 5154 | 77 | 73 | $22,642 | $3,396 | $2,833 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 74 | 59 | $17,197 | $3,016 | $2,636 |
| Level 1 Nerve ProceduresAPC 5431 | 74 | 63 | $6,885 | $1,757 | $1,407 |
| Level 2 Vascular ProceduresAPC 5182 | 73 | 72 | $6,814 | $1,379 | $1,204 |
| Level 5 Urology and Related ServicesAPC 5375 | 69 | 60 | $28,542 | $4,604 | $3,918 |
| Level 2 Intraocular ProceduresAPC 5492 | 69 | 60 | $14,926 | $3,510 | $3,116 |
| Level 5 ENT ProceduresAPC 5165 | 62 | 60 | $29,933 | $5,106 | $4,436 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 55 | 55 | $21,229 | $2,747 | $2,373 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 48 | 48 | $35,242 | $10,632 | $8,569 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 47 | 47 | $94,765 | $25,100 | $21,117 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 45 | 45 | $45,618 | $5,976 | $4,982 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 44 | 44 | $45,544 | $9,969 | $8,164 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 43 | 42 | $28,258 | $3,412 | $2,930 |
| Level 5 Airway EndoscopyAPC 5155 | 43 | 42 | $33,308 | $5,893 | $5,183 |
| Level 4 Gynecologic ProceduresAPC 5414 | 43 | 42 | $13,761 | $2,659 | $2,389 |
| Level 3 Upper GI ProceduresAPC 5303 | 39 | 35 | $18,219 | $3,509 | $2,888 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 38 | 38 | $74,288 | $18,786 | $15,763 |
| Level 4 Endovascular ProceduresAPC 5194 | 36 | 33 | $88,815 | $17,475 | $14,606 |
| Complex GI ProceduresAPC 5331 | 35 | 24 | $27,216 | $5,097 | $4,263 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 34 | 34 | $11,723 | $1,428 | $1,196 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 28 | 28 | $25,513 | $8,127 | $6,514 |
| Level 3 Lower GI ProceduresAPC 5313 | 28 | 26 | $16,533 | $2,510 | $2,176 |
| Level 3 Airway EndoscopyAPC 5153 | 22 | 22 | $14,090 | $1,551 | $1,264 |
| Level 5 Gynecologic ProceduresAPC 5415 | 22 | 18 | $28,332 | $4,144 | $3,792 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 18 | 18 | $105,702 | $33,969 | $26,719 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 18 | 18 | $18,276 | $2,022 | $1,780 |
| Level 4 ENT ProceduresAPC 5164 | 14 | 13 | $14,422 | $2,529 | $2,217 |
| Level 6 Gynecologic ProceduresAPC 5416 | 14 | 14 | $31,729 | $6,552 | $5,836 |
| Level 3 Intraocular ProceduresAPC 5493 | 14 | $19,123 | $3,421 | $4,004 | |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 11 | 11 | $59,987 | $20,699 | $17,052 |
| Level 3 Neurostimulator and Related ProceduresAPC 5463 | 11 | 11 | $41,718 | $14,004 | $11,550 |
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.