Tri-City Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Tri-City Medical Center, Oceanside, CA in 2024, from traditional Medicare claims. Back to the Tri-City Medical Center profile, with quality ratings, finances and negotiated rates.
1,266
Medicare inpatient discharges
In 46 published DRGs
1.93
Case mix index
IPPS FY 2027
17%
Surgical stays
70%
Stays with complications
In DRGs with a CC or MCC
1,099
Medicare outpatient services
In 23 service groups
Inpatient stays by major diagnostic category
Circulatory system321 discharges in 14 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 62 | $62,091 | $11,334 | $10,493 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 54 | $111,893 | $29,660 | $18,910 | 3.24 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 25 | $84,216 | $12,850 | $14,232 | 1.59 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 20 | $356,491 | $59,618 | $60,247 | 6.25 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 20 | $40,267 | $7,081 | $6,805 | 0.91 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 20 | $74,808 | $15,324 | $12,643 | 1.82 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 19 | $333,879 | $46,915 | $56,425 | 4.88 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 19 | $52,742 | $6,406 | $8,913 | 0.74 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 16 | $119,315 | $24,357 | $20,164 | 2.87 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 15 | $35,526 | $4,384 | $6,004 | 0.55 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 14 | $49,576 | $10,389 | $8,378 | 1.20 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 13 | $132,106 | $30,894 | $22,326 | 3.35 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 13 | $89,893 | $19,004 | $15,192 | 2.09 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 11 | $111,216 | $17,909 | $18,796 | 2.16 |
Infectious and parasitic diseases311 discharges in 3 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 | 228 | $99,655 | $16,868 | $16,842 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 63 | $55,756 | $8,847 | $9,423 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 20 | $210,700 | $44,411 | $35,608 | 5.00 |
Respiratory system189 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 82 | $71,957 | $10,987 | $12,161 | 1.23 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 38 | $87,866 | $13,891 | $14,849 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 35 | $72,645 | $11,325 | $12,277 | 1.33 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 20 | $61,410 | $8,898 | $10,378 | 1.10 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 14 | $113,355 | $23,637 | $19,157 | 2.70 |
Nervous system173 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 32 | $90,233 | $16,537 | $15,249 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 32 | $71,321 | $8,447 | $12,053 | 1.02 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 22 | $83,462 | $14,526 | $14,105 | 1.79 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 22 | $56,779 | $8,548 | $9,596 | 1.06 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 17 | $82,191 | $15,461 | $13,890 | 1.79 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 14 | $48,818 | $6,476 | $8,250 | 0.80 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 12 | $60,199 | $5,385 | $10,174 | 0.69 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 11 | $63,520 | $9,210 | $10,735 | 1.03 |
| Seizures with MCCMS-DRG 100, medical | 11 | $75,614 | $14,876 | $12,779 | 1.98 |
Kidney and urinary tract102 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 29 | $51,788 | $6,622 | $8,752 | 0.81 |
| Renal failure with CCMS-DRG 683, medical | 22 | $43,155 | $7,333 | $7,293 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 19 | $118,435 | $14,607 | $20,015 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 18 | $56,482 | $13,385 | $9,545 | 1.50 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 14 | $44,416 | $9,390 | $7,506 | 1.17 |
Musculoskeletal system and connective tissue57 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 20 | $75,695 | $17,722 | $12,793 | 2.07 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 14 | $107,799 | $16,622 | $18,218 | 1.88 |
| Medical back problems without MCCMS-DRG 552, medical | 12 | $40,857 | $7,688 | $6,905 | 0.97 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 11 | $113,697 | $22,401 | $19,215 | 2.95 |
Endocrine, nutritional and metabolic45 discharges in 2 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 | 29 | $54,533 | $10,814 | $9,216 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 16 | $36,062 | $5,291 | $6,094 | 0.78 |
Digestive system36 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 20 | $46,753 | $8,120 | $7,901 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 16 | $93,989 | $16,115 | $15,884 | 1.79 |
Skin, subcutaneous tissue and breast19 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 19 | $41,466 | $7,612 | $7,008 | 0.88 |
Other13 discharges in 1 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 | 13 | $297,469 | $48,093 | $50,272 | 4.74 |
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 | 198 | 192 | $23,816 | $2,676 | $2,090 |
| Level 3 Endovascular ProceduresAPC 5193 | 87 | 68 | $39,145 | $11,625 | $8,874 |
| Level 5 Urology and Related ServicesAPC 5375 | 83 | 76 | $33,953 | $4,982 | $3,918 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 74 | 72 | $84,573 | $13,783 | $10,772 |
| Level 1 Endovascular ProceduresAPC 5191 | 65 | 65 | $14,725 | $2,877 | $2,208 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 60 | 58 | $8,645 | $1,559 | $1,220 |
| Level 2 Endovascular ProceduresAPC 5192 | 56 | 44 | $14,688 | $5,588 | $4,338 |
| Level 3 Vascular ProceduresAPC 5183 | 53 | 52 | $14,754 | $3,119 | $2,405 |
| Level 4 Urology and Related ServicesAPC 5374 | 53 | 44 | $27,862 | $3,378 | $2,629 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 45 | 44 | $46,714 | $5,651 | $4,358 |
| Level 2 Vascular ProceduresAPC 5182 | 38 | 34 | $4,789 | $1,561 | $1,204 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 37 | 33 | $90,369 | $26,764 | $21,117 |
| Level 3 Urology and Related ServicesAPC 5373 | 36 | 21 | $9,793 | $1,829 | $1,516 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 33 | 31 | $18,164 | $2,778 | $2,141 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 29 | 29 | $56,196 | $11,462 | $8,569 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 25 | 25 | $40,644 | $7,147 | $5,339 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 23 | 23 | $101,126 | $21,219 | $15,763 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 20 | 18 | $11,284 | $1,538 | $1,196 |
| Level 4 Vascular ProceduresAPC 5184 | 20 | 17 | $35,904 | $4,845 | $3,946 |
| Level 4 Endovascular ProceduresAPC 5194 | 19 | 19 | $72,492 | $19,865 | $14,606 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 18 | 18 | $25,277 | $3,171 | $2,373 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 14 | 13 | $58,668 | $6,388 | $4,982 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 13 | 13 | $36,393 | $3,384 | $2,636 |
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.