Uc San Diego Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Uc San Diego Medical Center, San Diego, CA in 2024, from traditional Medicare claims. Back to the Uc San Diego Medical Center profile, with quality ratings, finances and negotiated rates.
6,146
Medicare inpatient discharges
In 185 published DRGs
2.58
Case mix index
IPPS FY 2027
32%
Surgical stays
77%
Stays with complications
In DRGs with a CC or MCC
12,719
Medicare outpatient services
In 58 service groups
Inpatient stays by major diagnostic category
Circulatory system1,148 discharges in 29 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 237 | $100,370 | $17,251 | $24,691 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 79 | $80,840 | $39,657 | $19,887 | 3.24 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 69 | $138,950 | $26,494 | $34,182 | 2.09 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 67 | $173,345 | $59,834 | $42,643 | 4.88 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 62 | $153,353 | $27,340 | $37,725 | 2.16 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 59 | $122,930 | $20,860 | $30,241 | 1.59 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 47 | $95,602 | $21,357 | $23,518 | 1.82 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 43 | $400,313 | $97,253 | $98,477 | 7.71 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 42 | $83,109 | $13,154 | $20,445 | 1.08 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 38 | $238,332 | $46,340 | $58,630 | 3.35 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 37 | $154,561 | $35,697 | $38,022 | 2.87 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 32 | $413,917 | $73,996 | $101,824 | 5.06 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 32 | $54,639 | $8,940 | $13,441 | 0.74 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 31 | $79,565 | $14,527 | $19,573 | 1.20 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 27 | $355,491 | $74,479 | $87,451 | 5.88 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 27 | $55,105 | $11,431 | $13,556 | 0.97 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 21 | $64,233 | $10,882 | $15,801 | 0.91 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 21 | $173,195 | $24,892 | $42,606 | 1.58 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 19 | $157,727 | $40,008 | $38,801 | 3.18 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 18 | $352,062 | $69,731 | $86,607 | 5.04 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 18 | $74,685 | $12,470 | $18,372 | 1.07 |
| Syncope and collapseMS-DRG 312, medical | 18 | $53,397 | $10,646 | $13,136 | 0.86 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 17 | $515,811 | $97,259 | $126,889 | 7.80 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 17 | $338,473 | $80,866 | $83,264 | 6.25 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 16 | $221,395 | $50,986 | $54,463 | 4.16 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 14 | $245,859 | $51,777 | $60,481 | 4.81 |
| Other vascular procedures with CCMS-DRG 253, surgical | 14 | $172,891 | $32,351 | $42,531 | 2.55 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 13 | $194,082 | $42,507 | $47,744 | 3.46 |
| Heart failure and shock with CCMS-DRG 292, medical | 13 | $53,793 | $9,131 | $13,233 | 0.86 |
Infectious and parasitic diseases888 discharges in 8 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 | 585 | $143,869 | $25,661 | $35,392 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 129 | $74,444 | $12,651 | $18,313 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 71 | $438,442 | $78,910 | $107,857 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 39 | $442,482 | $83,215 | $108,851 | 6.96 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 25 | $114,408 | $24,396 | $28,144 | 1.84 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 17 | $133,489 | $23,846 | $32,838 | 2.04 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 11 | $541,194 | $89,261 | $133,134 | 4.43 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 11 | $193,203 | $28,686 | $47,528 | 2.14 |
Respiratory system677 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 118 | $109,529 | $21,061 | $26,944 | 1.70 |
| Major chest procedures with CCMS-DRG 164, surgical | 68 | $142,173 | $30,359 | $34,975 | 2.55 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 65 | $118,952 | $17,671 | $29,262 | 1.23 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 64 | $91,147 | $16,002 | $22,422 | 1.33 |
| Major chest procedures with MCCMS-DRG 163, surgical | 43 | $432,560 | $76,451 | $106,410 | 4.71 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 41 | $145,235 | $22,841 | $35,728 | 1.74 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 35 | $103,536 | $15,630 | $25,470 | 0.99 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 33 | $167,677 | $27,598 | $41,248 | 1.81 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 29 | $49,118 | $9,482 | $12,083 | 0.82 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 26 | $117,735 | $13,381 | $28,963 | 1.10 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 25 | $228,649 | $51,607 | $56,248 | 4.06 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 25 | $225,837 | $34,453 | $55,556 | 2.70 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 22 | $176,363 | $23,989 | $43,385 | 1.90 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 17 | $119,224 | $16,963 | $29,329 | 1.40 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 15 | $85,262 | $10,240 | $20,974 | 0.85 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 14 | $462,652 | $84,154 | $113,812 | 6.91 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 13 | $55,345 | $10,321 | $13,615 | 0.82 |
| Major chest trauma with MCCMS-DRG 183, medical | 12 | $160,273 | $19,206 | $39,427 | 1.57 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 12 | $92,527 | $11,430 | $22,762 | 0.91 |
Digestive system654 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 73 | $188,617 | $28,307 | $46,400 | 2.37 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 66 | $108,707 | $21,694 | $26,742 | 1.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 64 | $63,119 | $11,976 | $15,527 | 0.98 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 61 | $368,020 | $59,066 | $90,533 | 4.52 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 51 | $52,115 | $9,353 | $12,820 | 0.79 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 36 | $134,432 | $22,474 | $33,070 | 1.62 |
| Digestive malignancy with MCCMS-DRG 374, medical | 33 | $164,968 | $26,227 | $40,582 | 2.10 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 33 | $56,405 | $9,446 | $13,876 | 0.80 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 30 | $169,343 | $31,731 | $41,658 | 2.50 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 30 | $96,111 | $16,076 | $23,643 | 1.28 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 27 | $64,828 | $11,590 | $15,948 | 0.94 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 23 | $445,972 | $85,416 | $109,709 | 5.08 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 23 | $110,862 | $18,441 | $27,272 | 1.45 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 18 | $93,487 | $19,266 | $22,998 | 1.75 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 17 | $45,440 | $6,683 | $11,178 | 0.56 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 16 | $74,817 | $13,084 | $18,405 | 1.04 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 14 | $340,286 | $65,373 | $83,710 | 4.28 |
| Digestive malignancy with CCMS-DRG 375, medical | 14 | $76,744 | $13,419 | $18,879 | 1.20 |
| Complicated peptic ulcer with MCCMS-DRG 380, medical | 13 | $86,484 | $22,399 | $21,275 | 1.95 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 12 | $149,338 | $25,768 | $36,737 | 2.11 |
Musculoskeletal system and connective tissue596 discharges in 25 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 | 66 | $156,812 | $24,709 | $38,576 | 2.07 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 52 | $122,076 | $22,567 | $30,031 | 1.88 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 45 | $451,322 | $84,851 | $111,025 | 6.12 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 41 | $235,542 | $36,898 | $57,943 | 2.95 |
| Medical back problems without MCCMS-DRG 552, medical | 37 | $74,070 | $11,601 | $18,221 | 0.97 |
| Combined anterior and posterior spinal fusion with MCCMS-DRG 453, surgical | 31 | $708,006 | $134,547 | $174,170 | 8.86 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 28 | $145,607 | $24,662 | $35,819 | 2.11 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 26 | $222,706 | $39,630 | $54,786 | 3.49 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 23 | $146,493 | $25,794 | $36,037 | 2.04 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 21 | $167,024 | $23,094 | $41,088 | 1.82 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 19 | $307,311 | $55,340 | $75,598 | 4.61 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 18 | $271,064 | $49,018 | $66,682 | 3.66 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 18 | $167,489 | $29,277 | $41,202 | 2.40 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 17 | $240,302 | $37,307 | $59,114 | 3.00 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 17 | $222,955 | $38,112 | $54,847 | 2.96 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 17 | $142,610 | $23,402 | $35,082 | 1.97 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 16 | $123,954 | $14,908 | $30,493 | 1.09 |
| Connective tissue disorders with MCCMS-DRG 545, medical | 15 | $122,777 | $30,488 | $30,203 | 2.49 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 456, surgical | 14 | $700,565 | $122,131 | $172,339 | 8.43 |
| Medical back problems with MCCMS-DRG 551, medical | 14 | $124,666 | $21,962 | $30,668 | 1.70 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 14 | $60,743 | $10,156 | $14,943 | 0.90 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 13 | $278,107 | $38,730 | $68,414 | 2.99 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 12 | $45,485 | $9,409 | $11,189 | 0.79 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 11 | $153,552 | $30,206 | $37,774 | 2.67 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCMS-DRG 562, medical | 11 | $103,571 | $18,115 | $25,479 | 1.52 |
Nervous system592 discharges in 25 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 73 | $155,385 | $25,663 | $38,225 | 2.00 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 66 | $325,022 | $58,712 | $79,955 | 4.42 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 54 | $81,593 | $12,634 | $20,072 | 1.02 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 34 | $173,188 | $30,012 | $42,604 | 2.39 |
| Seizures without MCCMS-DRG 101, medical | 30 | $57,700 | $11,061 | $14,194 | 0.91 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 29 | $174,126 | $17,567 | $42,835 | 1.47 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 24 | $121,242 | $20,730 | $29,826 | 1.79 |
| Seizures with MCCMS-DRG 100, medical | 24 | $143,791 | $26,375 | $35,373 | 1.98 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 23 | $318,216 | $72,406 | $78,281 | 5.67 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 22 | $184,717 | $31,222 | $45,440 | 2.43 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 20 | $120,324 | $16,443 | $29,600 | 1.36 |
| Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurMS-DRG 041, surgical | 19 | $147,005 | $27,514 | $36,163 | 2.23 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 18 | $184,978 | $35,170 | $45,505 | 2.95 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 17 | $73,337 | $15,704 | $18,041 | 1.36 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 15 | $142,612 | $18,163 | $35,083 | 1.32 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 15 | $49,008 | $12,601 | $12,056 | 1.03 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 13 | $57,278 | $9,080 | $14,090 | 0.80 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 13 | $90,380 | $12,106 | $22,233 | 1.06 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 13 | $114,351 | $12,966 | $28,130 | 1.03 |
| Intracranial vascular procedures with principal diagnosis hemorrhage with MCCMS-DRG 020, surgical | 12 | $348,353 | $110,081 | $85,695 | 8.45 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 12 | $115,525 | $23,196 | $28,419 | 1.79 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 12 | $154,456 | $28,439 | $37,996 | 2.28 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 12 | $154,485 | $28,016 | $38,003 | 2.27 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 11 | $237,845 | $46,815 | $58,510 | 3.79 |
| Ventricular shunt procedures with MCCMS-DRG 031, surgical | 11 | $270,952 | $55,695 | $66,654 | 4.12 |
Kidney and urinary tract549 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 | 131 | $106,665 | $21,010 | $26,240 | 1.65 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 72 | $69,265 | $12,365 | $17,039 | 1.02 |
| Renal failure with CCMS-DRG 683, medical | 66 | $59,115 | $10,893 | $14,542 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 61 | $102,754 | $18,327 | $25,278 | 1.50 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 57 | $51,192 | $9,602 | $12,593 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 37 | $71,131 | $13,979 | $17,498 | 1.17 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 31 | $123,632 | $18,412 | $30,413 | 1.35 |
| Kidney transplantMS-DRG 652, surgical | 27 | $301,581 | $36,865 | $74,189 | 3.00 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 21 | $267,108 | $42,607 | $65,709 | 2.59 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 19 | $173,206 | $22,575 | $42,609 | 1.84 |
| Kidney transplant with hemodialysis with MCCMS-DRG 650, surgical | 14 | $328,630 | $55,752 | $80,843 | 4.50 |
| Major bladder procedures with CCMS-DRG 654, surgical | 13 | $313,638 | $40,313 | $77,155 | 2.74 |
Liver, gallbladder and pancreas246 discharges in 12 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 | 36 | $112,657 | $23,024 | $27,714 | 1.83 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 33 | $175,957 | $34,055 | $43,285 | 2.89 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 31 | $120,295 | $22,075 | $29,592 | 1.76 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 23 | $99,568 | $20,719 | $24,494 | 1.63 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 22 | $193,378 | $32,882 | $47,571 | 1.92 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 20 | $74,467 | $13,038 | $18,319 | 1.09 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 17 | $66,305 | $12,302 | $16,311 | 0.95 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 16 | $62,059 | $10,342 | $15,266 | 0.86 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 13 | $591,614 | $109,446 | $145,537 | 5.51 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 12 | $89,582 | $12,983 | $22,037 | 1.03 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 12 | $82,408 | $21,027 | $20,272 | 1.67 |
| Malignancy of hepatobiliary system or pancreas with CCMS-DRG 436, medical | 11 | $87,008 | $13,746 | $21,404 | 1.10 |
Endocrine, nutritional and metabolic193 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 57 | $56,377 | $9,709 | $13,869 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 49 | $98,573 | $15,670 | $24,249 | 1.32 |
| Endocrine disorders with MCCMS-DRG 643, medical | 28 | $103,082 | $20,030 | $25,358 | 1.65 |
| Diabetes with CCMS-DRG 638, medical | 21 | $78,224 | $12,784 | $19,243 | 0.90 |
| Endocrine disorders with CCMS-DRG 644, medical | 20 | $76,633 | $12,658 | $18,852 | 1.06 |
| Diabetes with MCCMS-DRG 637, medical | 18 | $79,472 | $16,435 | $19,550 | 1.45 |
Transplants, ECMO and tracheostomy (pre-MDC)123 discharges in 5 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 | 34 | $1,320,251 | $300,707 | $324,782 | 21.32 |
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 29 | $1,414,593 | $376,938 | $347,990 | 27.10 |
| Chimeric antigen receptor (car) t-cell and other immunotherapiesMS-DRG 018, medical | 24 | $1,973,835 | $453,124 | $485,563 | 36.84 |
| Liver transplant with MCC or intestinal transplantMS-DRG 005, surgical | 21 | $729,919 | $137,970 | $179,560 | 10.35 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 15 | $783,255 | $156,818 | $192,681 | 14.70 |
Blood cancers and poorly differentiated neoplasms112 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 33 | $282,186 | $44,630 | $69,418 | 3.13 |
| Acute leukemia with MCCMS-DRG 834, medical | 22 | $384,398 | $81,866 | $94,562 | 5.60 |
| Chemotherapy without acute leukemia as secondary diagnosis with CCMS-DRG 847, medical | 18 | $65,557 | $15,955 | $16,127 | 1.21 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 15 | $155,114 | $21,098 | $38,158 | 1.57 |
| Other myeloproliferative disorders or poorly differentiated neoplastic diagnoses with mcMS-DRG 843, medical | 12 | $144,121 | $21,288 | $35,454 | 1.86 |
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 12 | $144,891 | $37,301 | $35,643 | 2.44 |
Injuries, poisonings and toxic effects of drugs98 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 33 | $148,590 | $26,829 | $36,553 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 20 | $66,466 | $12,736 | $16,351 | 1.03 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 18 | $274,244 | $51,142 | $67,464 | 3.72 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 15 | $129,317 | $22,172 | $31,812 | 1.60 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 12 | $219,367 | $27,440 | $53,964 | 2.00 |
Skin, subcutaneous tissue and breast83 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 63 | $51,717 | $10,470 | $12,722 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 20 | $72,750 | $18,221 | $17,896 | 1.49 |
Blood and immune system59 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 27 | $63,757 | $11,071 | $15,684 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 16 | $155,581 | $22,828 | $38,273 | 1.40 |
| Coagulation disordersMS-DRG 813, medical | 16 | $68,017 | $18,206 | $16,732 | 1.56 |
Other39 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 | 26 | $267,400 | $58,474 | $65,780 | 4.74 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 13 | $212,743 | $43,967 | $52,335 | 3.38 |
Alcohol and drug use30 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 | 17 | $56,007 | $10,351 | $13,778 | 0.86 |
| Alcohol, drug abuse or dependence without rehabilitation therapy with MCCMS-DRG 896, medical | 13 | $104,928 | $20,585 | $25,812 | 1.78 |
HIV infections22 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| HIV with major related condition with MCCMS-DRG 974, medical | 22 | $170,240 | $35,198 | $41,879 | 2.92 |
Female reproductive system22 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Uterine and adnexa procedures for ovarian or adnexal malignancy with CCMS-DRG 737, surgical | 11 | $127,010 | $24,134 | $31,245 | 1.97 |
| Uterine and adnexa procedures for non-malignancy with cc/mccMS-DRG 742, surgical | 11 | $138,192 | $22,075 | $33,995 | 1.78 |
Mental diseases and disorders15 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 | 15 | $168,624 | $25,368 | $41,481 | 1.76 |
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 |
|---|---|---|---|---|---|
| Level 2 Urology and Related ServicesAPC 5372 | 1,381 | 812 | $2,443 | $663 | $502 |
| Level 1 Intraocular ProceduresAPC 5491 | 1,235 | 825 | $13,241 | $2,275 | $1,752 |
| Level 3 Urology and Related ServicesAPC 5373 | 821 | 615 | $9,150 | $1,949 | $1,516 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 693 | 610 | $9,299 | $1,572 | $1,220 |
| Level 2 Upper GI ProceduresAPC 5302 | 674 | 601 | $13,791 | $1,868 | $1,445 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 534 | 505 | $78,549 | $14,459 | $10,772 |
| Comprehensive Observation ServicesAPC 8011 | 534 | 505 | $27,875 | $2,668 | $2,090 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 440 | 384 | $20,461 | $2,757 | $2,141 |
| Level 1 Endovascular ProceduresAPC 5191 | 404 | 392 | $15,815 | $2,873 | $2,208 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 398 | 374 | $17,118 | $2,280 | $1,780 |
| Level 3 Vascular ProceduresAPC 5183 | 392 | 325 | $14,650 | $3,118 | $2,405 |
| Level 4 Urology and Related ServicesAPC 5374 | 300 | 261 | $25,648 | $3,403 | $2,629 |
| Level 1 Nerve ProceduresAPC 5431 | 278 | 242 | $11,596 | $1,891 | $1,407 |
| Level 2 Intraocular ProceduresAPC 5492 | 273 | 239 | $30,684 | $3,981 | $3,116 |
| Level 5 Urology and Related ServicesAPC 5375 | 271 | 262 | $40,433 | $5,065 | $3,918 |
| Level 3 Endovascular ProceduresAPC 5193 | 261 | 216 | $47,607 | $11,846 | $8,874 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 251 | 246 | $51,754 | $5,627 | $4,358 |
| Level 3 Lower GI ProceduresAPC 5313 | 219 | 202 | $18,709 | $2,828 | $2,176 |
| Level 5 Airway EndoscopyAPC 5155 | 215 | 210 | $73,285 | $6,781 | $5,183 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 212 | 209 | $139,966 | $27,480 | $21,117 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 206 | 192 | $57,597 | $6,813 | $5,339 |
| Level 4 Airway EndoscopyAPC 5154 | 161 | 117 | $32,297 | $3,666 | $2,833 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 148 | 147 | $102,844 | $10,953 | $8,164 |
| Level 4 Vascular ProceduresAPC 5184 | 146 | 115 | $39,363 | $4,385 | $3,946 |
| Level 5 ENT ProceduresAPC 5165 | 143 | 141 | $55,178 | $5,734 | $4,436 |
| Level 2 Vascular ProceduresAPC 5182 | 138 | 137 | $7,043 | $1,561 | $1,204 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 133 | 112 | $27,191 | $3,309 | $2,636 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 122 | 121 | $60,744 | $6,387 | $4,982 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 122 | 112 | $16,109 | $1,519 | $1,196 |
| Complex GI ProceduresAPC 5331 | 114 | 69 | $36,430 | $4,947 | $4,263 |
| Level 2 Endovascular ProceduresAPC 5192 | 105 | 98 | $30,201 | $5,597 | $4,338 |
| Level 3 Airway EndoscopyAPC 5153 | 101 | 85 | $15,520 | $1,652 | $1,264 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 96 | 96 | $28,099 | $8,793 | $6,514 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 93 | 89 | $39,589 | $3,698 | $2,930 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 92 | 90 | $31,953 | $3,171 | $2,373 |
| Level 6 Urology and Related ServicesAPC 5376 | 78 | 76 | $54,804 | $9,554 | $7,291 |
| Level 4 Endovascular ProceduresAPC 5194 | 77 | 72 | $71,230 | $19,350 | $14,606 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 76 | 74 | $48,652 | $11,348 | $8,569 |
| Level 3 Upper GI ProceduresAPC 5303 | 71 | 61 | $27,399 | $3,626 | $2,888 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 66 | 65 | $83,950 | $21,216 | $15,763 |
| Level 4 Extraocular, Repair, and Plastic Eye ProceduresAPC 5504 | 64 | 64 | $34,201 | $3,783 | $2,969 |
| Level 4 Gynecologic ProceduresAPC 5414 | 57 | 56 | $25,023 | $3,059 | $2,389 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 54 | 53 | $84,460 | $22,259 | $17,052 |
| Level 5 Gynecologic ProceduresAPC 5415 | 54 | 53 | $40,270 | $4,872 | $3,792 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 53 | 53 | $116,620 | $38,682 | $29,375 |
| Level 6 Gynecologic ProceduresAPC 5416 | 40 | 38 | $106,380 | $7,645 | $5,836 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 40 | 40 | $103,249 | $36,415 | $26,719 |
| Cochlear Implant ProcedureAPC 5166 | 39 | 39 | $137,671 | $39,462 | $29,489 |
| Level 8 Urology and Related ServicesAPC 5378 | 37 | 35 | $98,795 | $23,096 | $17,428 |
| Level 3 ENT ProceduresAPC 5163 | 32 | 30 | $8,763 | $1,375 | $1,106 |
| Level 4 ENT ProceduresAPC 5164 | 30 | 30 | $30,138 | $3,098 | $2,217 |
| Level 7 Radiation TherapyAPC 5627 | 30 | 29 | $79,957 | $7,936 | $6,121 |
| Level 3 Intraocular ProceduresAPC 5493 | 28 | 22 | $38,370 | $5,120 | $4,004 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 25 | 22 | $27,833 | $5,952 | $4,524 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 19 | 19 | $84,962 | $25,174 | $18,465 |
| Level 3 Breast/Lymphatic Surgery and Related ProceduresAPC 5093 | 15 | 15 | $72,305 | $9,927 | $7,546 |
| Level 2 Nerve ProceduresAPC 5432 | 15 | 11 | $45,959 | $4,809 | $4,674 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 13 | 13 | $75,308 | $27,263 | $21,011 |
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.