Tobey Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Tobey Hospital, Wareham, MA in 2024, from traditional Medicare claims. Back to the Tobey Hospital profile, with quality ratings, finances and negotiated rates.
9,806
Medicare inpatient discharges
In 193 published DRGs
1.77
Case mix index
IPPS FY 2027
21%
Surgical stays
71%
Stays with complications
In DRGs with a CC or MCC
7,665
Medicare outpatient services
In 44 service groups
Inpatient stays by major diagnostic category
Circulatory system2,379 discharges in 43 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 716 | $26,277 | $9,644 | $9,092 | 1.28 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 147 | $16,046 | $5,000 | $5,552 | 0.74 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 138 | $24,322 | $8,832 | $8,416 | 1.20 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 137 | $139,984 | $38,382 | $48,434 | 4.88 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 101 | $36,700 | $11,818 | $12,698 | 1.59 |
| Syncope and collapseMS-DRG 312, medical | 93 | $23,282 | $6,003 | $8,056 | 0.86 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 82 | $97,896 | $24,887 | $33,872 | 3.24 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 74 | $89,046 | $13,601 | $30,810 | 1.82 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 64 | $28,262 | $6,067 | $9,779 | 0.91 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 62 | $13,044 | $3,367 | $4,513 | 0.55 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 46 | $154,056 | $49,665 | $53,303 | 6.25 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 42 | $95,944 | $25,541 | $33,197 | 3.46 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 39 | $34,890 | $7,757 | $12,072 | 1.08 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 38 | $51,023 | $16,868 | $17,654 | 2.16 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 38 | $32,108 | $16,056 | $11,109 | 2.09 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 36 | $104,176 | $27,053 | $36,045 | 3.35 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 35 | $101,323 | $22,122 | $35,058 | 2.87 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 34 | $175,455 | $44,091 | $60,707 | 5.06 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 33 | $74,172 | $16,769 | $25,663 | 2.28 |
| Hypertension without MCCMS-DRG 305, medical | 30 | $16,983 | $5,086 | $5,876 | 0.75 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 28 | $24,613 | $4,447 | $8,516 | 0.72 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 26 | $143,221 | $28,504 | $49,555 | 3.46 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 24 | $22,566 | $8,023 | $7,808 | 1.07 |
| Coronary intravascular lithotripsy with intraluminal device with MCCMS-DRG 323, surgical | 24 | $138,948 | $33,819 | $48,076 | 4.14 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 22 | $140,011 | $23,062 | $48,444 | 2.97 |
| Other vascular procedures with CCMS-DRG 253, surgical | 19 | $87,209 | $18,989 | $30,174 | 2.55 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 18 | $218,290 | $57,147 | $75,528 | 7.80 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 18 | $128,369 | $31,496 | $44,416 | 4.04 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 18 | $108,284 | $29,582 | $37,466 | 3.90 |
| Chest painMS-DRG 313, medical | 18 | $20,125 | $4,924 | $6,963 | 0.72 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 17 | $268,782 | $66,131 | $92,998 | 7.71 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 16 | $68,851 | $14,163 | $23,822 | 1.83 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 16 | $146,382 | $30,938 | $50,648 | 4.16 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 16 | $17,085 | $7,338 | $5,912 | 0.97 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 15 | $163,171 | $41,886 | $56,457 | 5.88 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 14 | $186,244 | $40,645 | $64,440 | 5.20 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 14 | $59,488 | $23,535 | $20,583 | 3.27 |
| Heart failure and shock with CCMS-DRG 292, medical | 14 | $20,289 | $5,506 | $7,020 | 0.86 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 13 | $41,114 | $10,719 | $14,225 | 1.58 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 11 | $186,635 | $42,187 | $64,576 | 5.24 |
| Other vascular procedures without cc/mccMS-DRG 254, surgical | 11 | $57,319 | $12,306 | $19,832 | 1.74 |
| Cardiac pacemaker revision except device replacement with CCMS-DRG 261, surgical | 11 | $57,024 | $14,070 | $19,730 | 1.88 |
| Atherosclerosis without MCCMS-DRG 303, medical | 11 | $13,488 | $4,539 | $4,667 | 0.66 |
Respiratory system1,780 discharges in 26 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 392 | $34,952 | $12,515 | $12,094 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 304 | $30,795 | $9,991 | $10,655 | 1.33 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 177 | $27,213 | $7,937 | $9,416 | 1.10 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 147 | $19,761 | $5,585 | $6,837 | 0.82 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 127 | $23,173 | $6,965 | $8,018 | 0.99 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 122 | $28,317 | $9,142 | $9,798 | 1.23 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 87 | $18,110 | $5,878 | $6,266 | 0.85 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 37 | $66,328 | $20,665 | $22,949 | 2.70 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 36 | $20,045 | $6,673 | $6,936 | 0.96 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 35 | $33,259 | $9,977 | $11,507 | 1.40 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 29 | $21,737 | $5,748 | $7,521 | 0.82 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 28 | $33,920 | $13,608 | $11,736 | 1.74 |
| Chronic obstructive pulmonary disease without cc/mccMS-DRG 192, medical | 27 | $14,786 | $4,456 | $5,116 | 0.64 |
| Major chest procedures with CCMS-DRG 164, surgical | 26 | $89,476 | $19,391 | $30,959 | 2.55 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 25 | $176,771 | $53,877 | $61,163 | 6.91 |
| Major chest trauma with MCCMS-DRG 183, medical | 24 | $36,160 | $11,761 | $12,511 | 1.57 |
| Respiratory infections and inflammations without cc/mccMS-DRG 179, medical | 23 | $19,343 | $5,049 | $6,693 | 0.76 |
| Respiratory neoplasms with CCMS-DRG 181, medical | 19 | $22,195 | $8,436 | $7,680 | 1.10 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 18 | $76,641 | $12,793 | $26,518 | 1.88 |
| Simple pneumonia and pleurisy without cc/mccMS-DRG 195, medical | 18 | $15,923 | $3,977 | $5,509 | 0.63 |
| Major chest trauma with CCMS-DRG 184, medical | 17 | $27,865 | $7,612 | $9,641 | 1.05 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 14 | $32,587 | $13,919 | $11,275 | 1.90 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 13 | $45,133 | $14,274 | $15,616 | 1.81 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 12 | $79,135 | $28,246 | $27,381 | 4.06 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 12 | $16,372 | $6,397 | $5,665 | 0.91 |
| Major chest procedures with MCCMS-DRG 163, surgical | 11 | $165,773 | $37,068 | $57,357 | 4.71 |
Infectious and parasitic diseases1,019 discharges in 7 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 | 731 | $41,770 | $14,710 | $14,452 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 128 | $23,812 | $7,293 | $8,239 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 86 | $121,413 | $40,664 | $42,009 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 27 | $152,748 | $52,750 | $52,851 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 22 | $42,814 | $15,285 | $14,814 | 2.04 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 13 | $19,103 | $6,968 | $6,610 | 1.01 |
| Fever and inflammatory conditionsMS-DRG 864, medical | 12 | $19,861 | $5,786 | $6,872 | 0.88 |
Digestive system904 discharges in 18 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 | 151 | $19,006 | $5,331 | $6,576 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 121 | $31,062 | $7,283 | $10,747 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 91 | $29,466 | $9,313 | $10,195 | 1.28 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 84 | $44,399 | $14,061 | $15,362 | 1.79 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 70 | $25,069 | $5,452 | $8,674 | 0.80 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 58 | $76,062 | $17,771 | $26,317 | 2.37 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 55 | $25,529 | $6,781 | $8,833 | 0.94 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 38 | $119,219 | $34,161 | $41,250 | 4.52 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 37 | $30,985 | $12,921 | $10,721 | 1.62 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 33 | $24,439 | $7,686 | $8,456 | 1.04 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 31 | $15,930 | $3,253 | $5,512 | 0.56 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 27 | $39,902 | $13,794 | $13,806 | 1.75 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 25 | $30,934 | $10,421 | $10,703 | 1.45 |
| Digestive malignancy with MCCMS-DRG 374, medical | 22 | $44,153 | $16,450 | $15,277 | 2.10 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 17 | $52,992 | $12,819 | $18,335 | 1.67 |
| Digestive malignancy with CCMS-DRG 375, medical | 17 | $34,767 | $8,807 | $12,029 | 1.20 |
| Complicated peptic ulcer with CCMS-DRG 381, medical | 14 | $29,910 | $7,802 | $10,349 | 1.07 |
| Inflammatory bowel disease with CCMS-DRG 386, medical | 13 | $21,087 | $5,999 | $7,296 | 0.97 |
Musculoskeletal system and connective tissue820 discharges in 23 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 | 203 | $56,416 | $14,087 | $19,520 | 1.88 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 116 | $57,797 | $15,648 | $19,998 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 70 | $20,141 | $6,611 | $6,969 | 0.97 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 55 | $56,756 | $16,157 | $19,638 | 2.11 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 36 | $62,116 | $21,767 | $21,492 | 2.95 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 32 | $24,492 | $5,967 | $8,474 | 0.90 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 28 | $17,078 | $5,305 | $5,909 | 0.79 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 26 | $63,379 | $17,387 | $21,929 | 2.40 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 24 | $105,363 | $24,356 | $36,456 | 3.49 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 24 | $24,663 | $7,600 | $8,533 | 1.09 |
| Medical back problems with MCCMS-DRG 551, medical | 23 | $34,186 | $12,779 | $11,828 | 1.70 |
| Fractures of hip and pelvis with MCCMS-DRG 535, medical | 21 | $24,617 | $9,450 | $8,517 | 1.30 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 20 | $87,509 | $24,052 | $30,278 | 2.99 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 19 | $39,362 | $11,424 | $13,619 | 1.59 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 16 | $79,072 | $21,694 | $27,359 | 2.96 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCMS-DRG 562, medical | 16 | $35,128 | $10,646 | $12,154 | 1.52 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 14 | $99,834 | $28,846 | $34,543 | 3.66 |
| Tendonitis, myositis and bursitis without MCCMS-DRG 558, medical | 14 | $17,035 | $4,887 | $5,894 | 0.88 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 14 | $28,330 | $6,872 | $9,802 | 1.00 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 13 | $15,381 | $5,898 | $5,322 | 0.82 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 12 | $48,727 | $14,092 | $16,860 | 1.87 |
| Soft tissue procedures with CCMS-DRG 501, surgical | 12 | $47,305 | $12,961 | $16,367 | 1.74 |
| Tendonitis, myositis and bursitis with MCCMS-DRG 557, medical | 12 | $30,420 | $11,533 | $10,525 | 1.56 |
Kidney and urinary tract789 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 153 | $24,813 | $8,375 | $8,585 | 1.17 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 151 | $17,957 | $5,579 | $6,213 | 0.81 |
| Renal failure with CCMS-DRG 683, medical | 129 | $19,776 | $6,367 | $6,843 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 111 | $32,030 | $10,827 | $11,083 | 1.50 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 79 | $32,420 | $12,434 | $11,217 | 1.65 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 46 | $21,130 | $7,377 | $7,311 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 41 | $32,517 | $9,745 | $11,251 | 1.35 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 23 | $45,170 | $20,247 | $15,629 | 2.59 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 23 | $29,796 | $7,402 | $10,310 | 1.05 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 19 | $96,812 | $31,363 | $33,497 | 3.70 |
| Renal failure without cc/mccMS-DRG 684, medical | 14 | $18,663 | $3,882 | $6,457 | 0.61 |
Nervous system687 discharges in 21 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 112 | $24,553 | $7,188 | $8,495 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 96 | $36,208 | $13,998 | $12,528 | 2.00 |
| Seizures with MCCMS-DRG 100, medical | 45 | $40,855 | $15,013 | $14,136 | 1.98 |
| Seizures without MCCMS-DRG 101, medical | 45 | $23,483 | $6,443 | $8,125 | 0.91 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 36 | $59,569 | $13,978 | $20,611 | 1.81 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 36 | $39,253 | $8,677 | $13,581 | 1.36 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 36 | $19,398 | $4,274 | $6,712 | 0.69 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 29 | $24,125 | $5,364 | $8,347 | 0.80 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 27 | $48,708 | $14,490 | $16,853 | 1.79 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 27 | $26,300 | $6,922 | $9,100 | 1.03 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 25 | $34,072 | $13,191 | $11,789 | 1.79 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 23 | $45,811 | $17,332 | $15,851 | 2.39 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 22 | $34,248 | $10,317 | $11,850 | 1.36 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 21 | $117,276 | $35,310 | $40,578 | 4.42 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 19 | $26,547 | $10,082 | $9,185 | 1.47 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 18 | $29,299 | $8,113 | $10,138 | 1.06 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 15 | $70,088 | $18,524 | $24,250 | 2.30 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 15 | $45,620 | $17,961 | $15,784 | 2.28 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 14 | $20,171 | $7,584 | $6,979 | 1.03 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 14 | $29,564 | $8,800 | $10,229 | 1.32 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 12 | $47,736 | $7,670 | $16,517 | 1.14 |
Endocrine, nutritional and metabolic410 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 | 133 | $26,977 | $9,794 | $9,334 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 95 | $16,733 | $5,203 | $5,790 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 68 | $20,518 | $6,502 | $7,099 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 44 | $39,161 | $11,530 | $13,550 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 25 | $37,362 | $11,540 | $12,927 | 1.65 |
| Endocrine disorders with CCMS-DRG 644, medical | 18 | $17,602 | $7,527 | $6,090 | 1.06 |
| O.r. procedures for obesity without cc/mccMS-DRG 621, surgical | 16 | $44,778 | $10,402 | $15,493 | 1.52 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 11 | $28,993 | $13,601 | $10,032 | 1.98 |
Liver, gallbladder and pancreas330 discharges in 12 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 43 | $53,116 | $12,385 | $18,378 | 1.63 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 36 | $37,596 | $15,075 | $13,008 | 1.92 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 36 | $33,590 | $7,815 | $11,622 | 1.09 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 29 | $53,415 | $14,545 | $18,482 | 1.76 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 27 | $27,316 | $7,796 | $9,451 | 1.03 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 26 | $47,376 | $8,878 | $16,392 | 1.31 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 24 | $45,808 | $12,067 | $15,850 | 1.63 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 23 | $25,496 | $5,649 | $8,822 | 0.86 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 23 | $36,791 | $13,524 | $12,730 | 1.83 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 22 | $43,817 | $13,327 | $15,161 | 1.67 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 22 | $26,316 | $6,909 | $9,105 | 0.95 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 19 | $67,194 | $18,608 | $23,249 | 2.32 |
Blood and immune system182 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 62 | $30,965 | $10,929 | $10,714 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 56 | $27,059 | $6,664 | $9,363 | 0.90 |
| Coagulation disordersMS-DRG 813, medical | 35 | $30,410 | $12,182 | $10,522 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 18 | $31,722 | $8,509 | $10,976 | 1.20 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 11 | $50,354 | $17,904 | $17,422 | 2.19 |
Skin, subcutaneous tissue and breast173 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 106 | $18,408 | $6,094 | $6,369 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 41 | $27,967 | $10,781 | $9,676 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 26 | $22,620 | $6,130 | $7,826 | 0.91 |
Injuries, poisonings and toxic effects of drugs85 discharges in 5 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 | 31 | $36,580 | $11,963 | $12,657 | 1.60 |
| Complications of treatment with MCCMS-DRG 919, medical | 16 | $22,744 | $14,129 | $7,869 | 1.82 |
| Poisoning and toxic effects of drugs without MCCMS-DRG 918, medical | 13 | $21,283 | $5,928 | $7,364 | 0.86 |
| Complications of treatment with CCMS-DRG 920, medical | 13 | $23,526 | $7,798 | $8,140 | 1.03 |
| Allergic reactions without MCCMS-DRG 916, medical | 12 | $20,154 | $4,342 | $6,973 | 0.66 |
Alcohol and drug use78 discharges in 2 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 | 47 | $20,768 | $6,183 | $7,186 | 0.86 |
| Alcohol, drug abuse or dependence without rehabilitation therapy with MCCMS-DRG 896, medical | 31 | $46,955 | $13,783 | $16,247 | 1.78 |
Other65 discharges in 3 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 | $108,927 | $34,362 | $37,689 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 17 | $53,844 | $19,686 | $18,630 | 2.49 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 13 | $76,094 | $28,617 | $26,329 | 3.38 |
Factors influencing health status44 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 23 | $19,788 | $5,359 | $6,847 | 0.80 |
| Other factors influencing health statusMS-DRG 951, medical | 21 | $11,399 | $4,041 | $3,944 | 0.59 |
Mental diseases and disorders21 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 | 21 | $43,442 | $12,377 | $15,031 | 1.76 |
Ear, nose, mouth and throat17 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 17 | $17,697 | $4,834 | $6,123 | 0.74 |
Blood cancers and poorly differentiated neoplasms12 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 12 | $36,217 | $21,789 | $12,531 | 3.13 |
Multiple significant trauma11 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 | 11 | $95,084 | $28,023 | $32,899 | 3.88 |
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 | 2,598 | 2,185 | $12,395 | $2,320 | $2,090 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 432 | 384 | $8,197 | $1,362 | $1,220 |
| Level 1 Endovascular ProceduresAPC 5191 | 339 | 339 | $22,925 | $2,501 | $2,208 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 274 | 273 | $24,844 | $4,884 | $4,358 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 271 | 257 | $29,317 | $6,039 | $5,339 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 263 | 258 | $139,226 | $23,488 | $21,117 |
| Level 3 Urology and Related ServicesAPC 5373 | 239 | 188 | $7,163 | $1,712 | $1,516 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 237 | 225 | $5,458 | $1,348 | $1,196 |
| Level 2 Upper GI ProceduresAPC 5302 | 220 | 195 | $10,440 | $1,625 | $1,445 |
| Level 4 Urology and Related ServicesAPC 5374 | 220 | 175 | $13,028 | $2,983 | $2,629 |
| Level 1 Nerve ProceduresAPC 5431 | 217 | 190 | $4,757 | $1,636 | $1,407 |
| Level 3 Endovascular ProceduresAPC 5193 | 216 | 199 | $72,716 | $10,047 | $8,874 |
| Level 3 Vascular ProceduresAPC 5183 | 199 | 194 | $16,453 | $2,692 | $2,405 |
| Level 5 Urology and Related ServicesAPC 5375 | 196 | 175 | $18,360 | $4,404 | $3,918 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 186 | 178 | $43,077 | $12,347 | $10,772 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 140 | 139 | $13,200 | $2,716 | $2,373 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 122 | 121 | $16,914 | $2,391 | $2,141 |
| Level 4 Endovascular ProceduresAPC 5194 | 103 | 90 | $118,992 | $16,823 | $14,606 |
| Level 2 Endovascular ProceduresAPC 5192 | 97 | 82 | $30,446 | $4,854 | $4,338 |
| Level 4 Gynecologic ProceduresAPC 5414 | 96 | 95 | $9,749 | $2,675 | $2,389 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 93 | 93 | $48,356 | $9,822 | $8,569 |
| Level 3 Lower GI ProceduresAPC 5313 | 73 | 72 | $12,366 | $2,409 | $2,176 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 73 | 59 | $17,059 | $2,913 | $2,636 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 69 | 69 | $44,803 | $7,376 | $6,514 |
| Level 4 Vascular ProceduresAPC 5184 | 68 | 63 | $23,246 | $4,637 | $3,946 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 65 | 64 | $28,679 | $5,494 | $4,982 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 54 | 53 | $19,136 | $3,262 | $2,930 |
| Level 2 Vascular ProceduresAPC 5182 | 52 | 51 | $7,491 | $1,370 | $1,204 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 48 | 48 | $50,421 | $9,406 | $8,164 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 45 | 44 | $12,575 | $5,849 | $4,524 |
| Level 4 Airway EndoscopyAPC 5154 | 44 | 43 | $15,877 | $3,095 | $2,833 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 44 | 43 | $145,847 | $32,825 | $29,375 |
| Level 5 Gynecologic ProceduresAPC 5415 | 37 | 37 | $17,845 | $4,256 | $3,792 |
| Level 2 Urology and Related ServicesAPC 5372 | 35 | 20 | $4,480 | $570 | $502 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 34 | 33 | $80,454 | $18,334 | $15,763 |
| Level 1 Intraocular ProceduresAPC 5491 | 27 | 21 | $6,543 | $1,994 | $1,752 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 25 | 24 | $70,134 | $31,614 | $26,719 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 22 | 22 | $62,138 | $21,799 | $18,465 |
| Level 3 Upper GI ProceduresAPC 5303 | 20 | 20 | $18,467 | $3,277 | $2,888 |
| Level 5 ENT ProceduresAPC 5165 | 19 | 19 | $25,784 | $4,747 | $4,436 |
| Level 3 ENT ProceduresAPC 5163 | 16 | 13 | $8,685 | $1,305 | $1,106 |
| Level 3 Airway EndoscopyAPC 5153 | 13 | 13 | $7,600 | $1,442 | $1,264 |
| Level 6 Gynecologic ProceduresAPC 5416 | 12 | 12 | $32,885 | $6,483 | $5,836 |
| Implantation of Drug Infusion DeviceAPC 5471 | 12 | 12 | $42,556 | $17,476 | $14,829 |
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.