Unc Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Unc Medical Center, Chapel Hill, NC in 2024, from traditional Medicare claims. Back to the Unc Medical Center profile, with quality ratings, finances and negotiated rates.
4,708
Medicare inpatient discharges
In 170 published DRGs
2.30
Case mix index
IPPS FY 2027
30%
Surgical stays
70%
Stays with complications
In DRGs with a CC or MCC
7,469
Medicare outpatient services
In 52 service groups
Inpatient stays by major diagnostic category
Circulatory system894 discharges in 30 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 147 | $44,739 | $12,780 | $16,151 | 1.28 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 54 | $88,539 | $42,948 | $31,962 | 4.88 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 49 | $102,850 | $25,693 | $37,129 | 2.09 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 46 | $68,657 | $16,703 | $24,785 | 1.82 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 43 | $25,770 | $7,991 | $9,303 | 0.74 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 42 | $95,675 | $22,841 | $34,539 | 2.16 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 41 | $51,693 | $14,075 | $18,661 | 1.20 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 39 | $65,710 | $28,409 | $23,721 | 3.24 |
| Syncope and collapseMS-DRG 312, medical | 33 | $27,870 | $9,194 | $10,061 | 0.86 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 33 | $36,910 | $10,160 | $13,325 | 0.97 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 30 | $46,018 | $15,538 | $16,613 | 1.59 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 30 | $40,320 | $10,563 | $14,556 | 1.08 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 29 | $126,597 | $37,959 | $45,702 | 4.16 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 28 | $30,845 | $9,592 | $11,135 | 0.91 |
| Heart failure and shock with CCMS-DRG 292, medical | 23 | $30,036 | $9,245 | $10,843 | 0.86 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 23 | $83,954 | $25,092 | $30,307 | 2.87 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 20 | $159,721 | $47,412 | $57,659 | 5.24 |
| Other vascular procedures with CCMS-DRG 253, surgical | 19 | $55,038 | $22,870 | $19,869 | 2.55 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 19 | $31,736 | $10,052 | $11,457 | 1.07 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 15 | $20,202 | $6,232 | $7,293 | 0.55 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 14 | $291,053 | $85,814 | $105,070 | 7.71 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 14 | $118,604 | $37,801 | $42,816 | 3.35 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 14 | $168,425 | $64,234 | $60,802 | 6.25 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 14 | $198,920 | $47,507 | $71,810 | 5.06 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 14 | $102,258 | $32,453 | $36,915 | 3.46 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 14 | $126,111 | $17,968 | $45,526 | 1.58 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 13 | $66,718 | $21,768 | $24,085 | 2.28 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 12 | $73,318 | $17,623 | $26,468 | 1.97 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 11 | $136,787 | $39,401 | $49,380 | 5.88 |
| Other vascular procedures without cc/mccMS-DRG 254, surgical | 11 | $55,138 | $13,566 | $19,905 | 1.74 |
Respiratory system631 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 | 101 | $50,625 | $15,524 | $18,276 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 66 | $41,951 | $12,969 | $15,144 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 60 | $63,237 | $13,896 | $22,829 | 1.23 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 52 | $31,977 | $9,604 | $11,544 | 0.99 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 45 | $24,187 | $8,491 | $8,731 | 0.82 |
| Major chest procedures with CCMS-DRG 164, surgical | 43 | $74,166 | $23,342 | $26,774 | 2.55 |
| Major chest procedures with MCCMS-DRG 163, surgical | 35 | $108,576 | $38,011 | $39,196 | 4.71 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 31 | $40,194 | $10,320 | $14,510 | 1.10 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 31 | $29,172 | $8,048 | $10,531 | 0.85 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 24 | $46,410 | $13,804 | $16,754 | 1.40 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 22 | $66,910 | $15,908 | $24,154 | 1.81 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 21 | $137,936 | $29,536 | $49,795 | 2.70 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 18 | $61,872 | $16,043 | $22,336 | 1.88 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 16 | $26,137 | $9,442 | $9,435 | 0.96 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 15 | $31,697 | $6,418 | $11,442 | 0.82 |
| Major chest trauma with CCMS-DRG 184, medical | 14 | $44,532 | $10,618 | $16,076 | 1.05 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 13 | $42,930 | $16,376 | $15,498 | 1.74 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 13 | $32,733 | $9,759 | $11,817 | 0.91 |
| Respiratory neoplasms with CCMS-DRG 181, medical | 11 | $29,131 | $11,393 | $10,516 | 1.10 |
Digestive system504 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 | 69 | $23,270 | $8,021 | $8,401 | 0.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 48 | $83,424 | $22,266 | $30,116 | 2.37 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 42 | $133,212 | $42,903 | $48,090 | 4.52 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 40 | $40,451 | $9,865 | $14,603 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 37 | $118,849 | $32,964 | $42,905 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 32 | $40,577 | $13,249 | $14,648 | 1.28 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 31 | $34,387 | $9,778 | $12,414 | 0.94 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 28 | $61,915 | $21,104 | $22,351 | 2.50 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 25 | $45,212 | $14,819 | $16,322 | 1.67 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 21 | $80,463 | $21,490 | $29,047 | 1.75 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 21 | $51,001 | $15,704 | $18,411 | 1.62 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 19 | $33,756 | $10,755 | $12,186 | 1.04 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 19 | $32,089 | $7,789 | $11,584 | 0.80 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 15 | $45,303 | $15,457 | $16,354 | 1.60 |
| Digestive malignancy with MCCMS-DRG 374, medical | 15 | $92,537 | $25,231 | $33,406 | 2.10 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 15 | $18,816 | $6,100 | $6,792 | 0.56 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 14 | $41,825 | $14,339 | $15,099 | 1.45 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 13 | $162,123 | $50,490 | $58,527 | 5.08 |
Kidney and urinary tract459 discharges in 13 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 67 | $56,451 | $12,617 | $20,379 | 1.02 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 63 | $27,985 | $8,214 | $10,103 | 0.81 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 63 | $61,320 | $17,202 | $22,136 | 1.65 |
| Renal failure with CCMS-DRG 683, medical | 59 | $32,884 | $9,270 | $11,871 | 0.90 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 40 | $41,888 | $11,546 | $15,121 | 1.17 |
| Renal failure with MCCMS-DRG 682, medical | 31 | $63,330 | $14,903 | $22,862 | 1.50 |
| Kidney transplantMS-DRG 652, surgical | 26 | $233,314 | $28,216 | $84,227 | 3.00 |
| Kidney transplant with hemodialysis with MCCMS-DRG 650, surgical | 20 | $277,887 | $39,498 | $100,317 | 4.50 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 20 | $32,462 | $9,422 | $11,719 | 1.05 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 19 | $66,305 | $20,660 | $23,936 | 2.38 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 18 | $52,338 | $10,510 | $18,894 | 1.35 |
| Major bladder procedures with CCMS-DRG 654, surgical | 17 | $64,672 | $25,082 | $23,347 | 2.74 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 16 | $40,942 | $16,643 | $14,780 | 1.84 |
Nervous system447 discharges in 19 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 | 53 | $43,232 | $8,930 | $15,607 | 1.02 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 45 | $112,860 | $34,881 | $40,743 | 4.42 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 43 | $71,144 | $16,334 | $25,683 | 2.00 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 31 | $61,373 | $19,942 | $22,156 | 2.43 |
| Seizures without MCCMS-DRG 101, medical | 31 | $45,512 | $8,705 | $16,430 | 0.91 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 26 | $157,421 | $54,848 | $56,829 | 5.67 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 26 | $39,358 | $12,028 | $14,208 | 1.36 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 21 | $66,488 | $21,287 | $24,002 | 2.95 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 20 | $38,014 | $10,024 | $13,723 | 1.03 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 19 | $41,695 | $13,253 | $15,052 | 1.47 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 18 | $84,899 | $19,716 | $30,648 | 2.39 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 17 | $32,834 | $7,142 | $11,853 | 0.69 |
| Intracranial vascular procedures with principal diagnosis hemorrhage with MCCMS-DRG 020, surgical | 16 | $185,865 | $80,141 | $67,097 | 8.45 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 16 | $78,589 | $17,779 | $28,371 | 1.79 |
| Seizures with MCCMS-DRG 100, medical | 16 | $68,664 | $19,316 | $24,788 | 1.98 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 13 | $92,204 | $30,373 | $33,286 | 3.79 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 12 | $47,103 | $17,208 | $17,004 | 1.81 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 12 | $38,498 | $10,434 | $13,898 | 1.14 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 12 | $52,329 | $20,997 | $18,891 | 2.27 |
Infectious and parasitic diseases414 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 | 250 | $80,528 | $19,297 | $29,071 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 49 | $36,415 | $10,581 | $13,146 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 37 | $188,309 | $46,021 | $67,980 | 5.00 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 25 | $58,713 | $16,973 | $21,195 | 1.84 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 17 | $260,658 | $72,711 | $94,098 | 6.96 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 12 | $45,548 | $7,981 | $16,443 | 1.01 |
| Fever and inflammatory conditionsMS-DRG 864, medical | 12 | $34,602 | $8,963 | $12,491 | 0.88 |
| Viral illness with MCCMS-DRG 865, medical | 12 | $44,671 | $15,782 | $16,126 | 1.64 |
Musculoskeletal system and connective tissue264 discharges in 11 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 | 51 | $57,990 | $17,251 | $20,934 | 1.88 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 47 | $66,396 | $19,404 | $23,969 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 35 | $64,184 | $19,501 | $23,170 | 2.11 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 26 | $35,376 | $9,943 | $12,771 | 1.09 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 24 | $92,839 | $25,916 | $33,515 | 2.95 |
| Medical back problems without MCCMS-DRG 552, medical | 19 | $32,092 | $9,780 | $11,585 | 0.97 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 14 | $103,540 | $28,380 | $37,378 | 3.66 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 14 | $86,061 | $19,612 | $31,068 | 2.40 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 12 | $100,301 | $19,547 | $36,209 | 2.48 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 11 | $105,293 | $42,021 | $38,011 | 4.61 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 11 | $58,921 | $15,530 | $21,271 | 1.82 |
Endocrine, nutritional and metabolic229 discharges in 9 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 | 68 | $54,626 | $12,943 | $19,720 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 66 | $26,903 | $7,886 | $9,712 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 16 | $35,759 | $8,351 | $12,909 | 0.90 |
| Endocrine disorders with MCCMS-DRG 643, medical | 15 | $70,550 | $16,790 | $25,468 | 1.65 |
| Adrenal and pituitary procedures with cc/mccMS-DRG 614, surgical | 14 | $83,520 | $24,495 | $30,151 | 2.25 |
| Endocrine disorders with CCMS-DRG 644, medical | 14 | $37,905 | $10,921 | $13,684 | 1.06 |
| Diabetes with MCCMS-DRG 637, medical | 13 | $47,875 | $13,961 | $17,283 | 1.45 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 12 | $126,186 | $21,634 | $45,553 | 1.98 |
| Thyroid, parathyroid and thyroglossal procedures with CCMS-DRG 626, surgical | 11 | $47,717 | $13,157 | $17,226 | 1.49 |
Blood cancers and poorly differentiated neoplasms200 discharges in 7 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 | 63 | $50,609 | $15,309 | $18,270 | 1.21 |
| Acute leukemia with MCCMS-DRG 834, medical | 29 | $145,279 | $55,462 | $52,446 | 5.60 |
| Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy aMS-DRG 837, medical | 28 | $207,638 | $60,363 | $74,957 | 4.84 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 27 | $114,188 | $32,662 | $41,222 | 3.13 |
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 25 | $92,019 | $27,620 | $33,219 | 2.44 |
| Chemotherapy with acute leukemia as secondary diagnosis with CC or high dose chemotherapMS-DRG 838, medical | 17 | $39,310 | $20,506 | $14,191 | 2.00 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 11 | $63,682 | $15,224 | $22,989 | 1.57 |
Transplants, ECMO and tracheostomy (pre-MDC)142 discharges in 8 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 | 40 | $959,410 | $255,544 | $346,347 | 21.32 |
| Tracheostomy for face, mouth and neck diagnoses or laryngectomy with CCMS-DRG 012, surgical | 18 | $116,629 | $37,589 | $42,103 | 4.00 |
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 15 | $703,072 | $203,349 | $253,809 | 27.10 |
| Allogeneic bone marrow transplantMS-DRG 014, medical | 15 | $208,912 | $98,526 | $75,417 | 11.46 |
| Autologous bone marrow transplant with cc/mccMS-DRG 016, medical | 15 | $197,536 | $58,337 | $71,311 | 6.18 |
| Tracheostomy for face, mouth and neck diagnoses or laryngectomy with MCCMS-DRG 011, surgical | 14 | $142,601 | $43,137 | $51,479 | 5.16 |
| Chimeric antigen receptor (car) t-cell and other immunotherapiesMS-DRG 018, medical | 14 | $1,354,277 | $423,100 | $488,894 | 36.84 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 11 | $478,799 | $151,411 | $172,846 | 14.70 |
Liver, gallbladder and pancreas110 discharges in 7 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 | 29 | $109,791 | $20,721 | $39,635 | 1.83 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 18 | $55,585 | $14,698 | $20,066 | 1.76 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 16 | $49,053 | $14,906 | $17,708 | 1.63 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 12 | $66,323 | $25,061 | $23,942 | 2.89 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 12 | $34,418 | $9,930 | $12,425 | 0.95 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 12 | $43,705 | $10,286 | $15,778 | 1.09 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 11 | $29,785 | $7,976 | $10,752 | 0.86 |
Blood and immune system99 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 36 | $32,749 | $9,238 | $11,823 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 34 | $37,679 | $14,048 | $13,602 | 1.40 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 15 | $27,154 | $12,573 | $9,803 | 1.20 |
| Reticuloendothelial and immunity disorders with MCCMS-DRG 814, medical | 14 | $90,280 | $23,096 | $32,591 | 2.13 |
Skin, subcutaneous tissue and breast78 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 52 | $27,652 | $8,271 | $9,983 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 15 | $63,201 | $12,841 | $22,816 | 1.49 |
| Minor skin disorders without MCCMS-DRG 607, medical | 11 | $35,322 | $9,810 | $12,751 | 0.89 |
Injuries, poisonings and toxic effects of drugs75 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 | 23 | $95,086 | $27,420 | $34,326 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 15 | $69,024 | $18,048 | $24,918 | 1.03 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 14 | $81,727 | $34,189 | $29,504 | 3.72 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 12 | $42,277 | $15,793 | $15,262 | 1.60 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 11 | $123,710 | $38,573 | $44,659 | 2.00 |
Other37 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 | 25 | $150,000 | $47,002 | $54,150 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 12 | $85,468 | $25,458 | $30,854 | 2.49 |
Mental diseases and disorders36 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 | 36 | $61,583 | $15,798 | $22,232 | 1.76 |
Burns30 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Non-extensive burnsMS-DRG 935, medical | 17 | $40,146 | $18,772 | $14,493 | 2.04 |
| Full thickness burn with skin graft or inhalation injury with cc/mccMS-DRG 928, surgical | 13 | $326,431 | $110,624 | $117,842 | 6.92 |
Ear, nose, mouth and throat18 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major head and neck procedures with CCMS-DRG 141, surgical | 18 | $65,899 | $18,678 | $23,790 | 2.07 |
Alcohol and drug use15 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 | 15 | $22,260 | $9,241 | $8,036 | 0.86 |
Factors influencing health status14 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 14 | $24,178 | $8,061 | $8,728 | 0.80 |
Female reproductive system12 discharges in 1 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 | 12 | $51,473 | $12,724 | $18,582 | 1.97 |
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 | 1,052 | 546 | $2,965 | $460 | $502 |
| Level 3 Urology and Related ServicesAPC 5373 | 519 | 410 | $7,222 | $1,422 | $1,516 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 495 | 439 | $7,469 | $1,137 | $1,220 |
| Level 1 Intraocular ProceduresAPC 5491 | 407 | 264 | $11,803 | $1,680 | $1,752 |
| Level 2 Upper GI ProceduresAPC 5302 | 397 | 333 | $7,694 | $1,351 | $1,445 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 360 | 249 | $11,404 | $2,049 | $2,141 |
| Comprehensive Observation ServicesAPC 8011 | 289 | 279 | $13,129 | $1,943 | $2,090 |
| Level 3 Vascular ProceduresAPC 5183 | 229 | 191 | $10,380 | $2,286 | $2,405 |
| Level 5 Urology and Related ServicesAPC 5375 | 225 | 211 | $22,004 | $3,723 | $3,918 |
| Level 1 Endovascular ProceduresAPC 5191 | 224 | 220 | $14,175 | $2,098 | $2,208 |
| Level 4 Urology and Related ServicesAPC 5374 | 191 | 159 | $13,198 | $2,473 | $2,629 |
| Level 5 ENT ProceduresAPC 5165 | 179 | 173 | $20,970 | $4,199 | $4,436 |
| Level 3 Endovascular ProceduresAPC 5193 | 159 | 145 | $38,062 | $8,191 | $8,874 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 156 | 153 | $106,118 | $19,615 | $21,117 |
| Level 1 Nerve ProceduresAPC 5431 | 153 | 126 | $8,188 | $1,075 | $1,407 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 149 | 146 | $22,275 | $4,084 | $4,358 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 133 | 126 | $17,158 | $2,752 | $2,930 |
| Level 4 Airway EndoscopyAPC 5154 | 128 | 110 | $12,018 | $2,660 | $2,833 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 113 | 111 | $26,696 | $4,886 | $5,339 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 112 | 111 | $28,999 | $7,552 | $8,164 |
| Level 3 Upper GI ProceduresAPC 5303 | 107 | 78 | $11,230 | $2,785 | $2,888 |
| Level 5 Airway EndoscopyAPC 5155 | 106 | 104 | $24,059 | $4,886 | $5,183 |
| Level 4 Vascular ProceduresAPC 5184 | 102 | 84 | $19,189 | $3,366 | $3,946 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 101 | 100 | $42,287 | $9,754 | $10,772 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 90 | 88 | $10,752 | $1,156 | $1,196 |
| Level 3 Lower GI ProceduresAPC 5313 | 86 | 85 | $12,046 | $1,986 | $2,176 |
| Complex GI ProceduresAPC 5331 | 83 | 76 | $17,434 | $4,046 | $4,263 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 82 | 78 | $17,197 | $2,297 | $2,373 |
| Cochlear Implant ProcedureAPC 5166 | 82 | 77 | $56,050 | $27,932 | $29,489 |
| Level 2 Intraocular ProceduresAPC 5492 | 78 | 72 | $15,739 | $2,881 | $3,116 |
| Level 2 Vascular ProceduresAPC 5182 | 69 | 69 | $3,702 | $1,106 | $1,204 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 67 | 67 | $23,030 | $4,603 | $4,982 |
| Level 2 Endovascular ProceduresAPC 5192 | 67 | 62 | $23,685 | $4,095 | $4,338 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 61 | 61 | $42,927 | $8,109 | $8,569 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 61 | 59 | $16,404 | $2,517 | $2,636 |
| Level 4 Gynecologic ProceduresAPC 5414 | 58 | 58 | $11,792 | $2,155 | $2,389 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 52 | 51 | $10,275 | $1,700 | $1,780 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 50 | 49 | $55,951 | $15,349 | $15,763 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 46 | 46 | $59,020 | $26,061 | $26,719 |
| Level 4 Endovascular ProceduresAPC 5194 | 43 | 38 | $51,599 | $14,343 | $14,606 |
| Level 3 Airway EndoscopyAPC 5153 | 42 | 39 | $11,004 | $1,232 | $1,264 |
| Level 3 Intraocular ProceduresAPC 5493 | 34 | 23 | $16,696 | $3,579 | $4,004 |
| Level 4 ENT ProceduresAPC 5164 | 32 | 31 | $13,941 | $2,342 | $2,217 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 30 | 30 | $76,707 | $28,320 | $29,375 |
| Level 6 Urology and Related ServicesAPC 5376 | 29 | 27 | $31,865 | $6,779 | $7,291 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 26 | 26 | $25,284 | $4,040 | $6,514 |
| Level 7 Radiation TherapyAPC 5627 | 25 | 25 | $28,401 | $5,666 | $6,121 |
| Level 3 ENT ProceduresAPC 5163 | 23 | 22 | $6,397 | $1,108 | $1,106 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 22 | 19 | $25,774 | $4,026 | $4,524 |
| Level 4 Extraocular, Repair, and Plastic Eye ProceduresAPC 5504 | 17 | 15 | $12,677 | $2,647 | $2,969 |
| Level 8 Urology and Related ServicesAPC 5378 | 16 | 15 | $46,573 | $15,700 | $17,428 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 12 | 12 | $39,298 | $5,433 | $5,682 |
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.