University Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for University Hospital, Lexington, KY in 2024, from traditional Medicare claims. Back to the University Hospital profile, with quality ratings, finances and negotiated rates.
4,931
Medicare inpatient discharges
In 173 published DRGs
2.49
Case mix index
IPPS FY 2027
31%
Surgical stays
76%
Stays with complications
In DRGs with a CC or MCC
5,359
Medicare outpatient services
In 53 service groups
Inpatient stays by major diagnostic category
Circulatory system777 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 | 149 | $50,711 | $9,572 | $13,388 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 49 | $87,006 | $11,533 | $22,970 | 1.59 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 46 | $232,536 | $43,245 | $61,390 | 5.88 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 43 | $85,555 | $15,344 | $22,587 | 2.09 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 38 | $203,169 | $36,860 | $53,637 | 4.88 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 34 | $108,090 | $23,489 | $28,536 | 3.24 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 30 | $131,455 | $17,375 | $34,704 | 2.16 |
| Other vascular procedures with CCMS-DRG 253, surgical | 26 | $145,544 | $19,188 | $38,424 | 2.55 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 25 | $378,981 | $63,813 | $100,051 | 7.71 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 24 | $159,698 | $26,099 | $42,160 | 3.35 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 24 | $77,593 | $16,228 | $20,484 | 1.58 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 24 | $47,587 | $6,043 | $12,563 | 0.97 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 23 | $231,358 | $45,705 | $61,078 | 5.06 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 21 | $32,242 | $5,125 | $8,512 | 0.74 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 21 | $97,287 | $12,300 | $25,684 | 1.82 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 19 | $40,952 | $5,476 | $10,811 | 0.91 |
| Syncope and collapseMS-DRG 312, medical | 19 | $52,165 | $5,991 | $13,772 | 0.86 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 18 | $301,604 | $46,403 | $79,623 | 5.24 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 16 | $49,238 | $8,791 | $12,999 | 1.20 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 16 | $22,079 | $3,552 | $5,829 | 0.55 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 14 | $183,880 | $27,385 | $48,544 | 4.04 |
| Aortic and heart assist procedures except pulsation balloon with MCCMS-DRG 268, surgical | 13 | $297,690 | $65,627 | $78,590 | 6.85 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 13 | $67,296 | $7,185 | $17,766 | 1.08 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 13 | $163,213 | $26,256 | $43,088 | 2.87 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 12 | $168,364 | $29,120 | $44,448 | 4.16 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 12 | $143,716 | $26,672 | $37,941 | 3.46 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 12 | $83,272 | $17,657 | $21,984 | 1.97 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 12 | $58,479 | $7,690 | $15,438 | 1.07 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 11 | $116,860 | $21,581 | $30,851 | 3.27 |
Nervous system701 discharges in 22 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 113 | $108,930 | $16,381 | $28,757 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 74 | $50,277 | $7,305 | $13,273 | 1.02 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 60 | $135,965 | $33,088 | $35,895 | 4.42 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 47 | $271,745 | $46,647 | $71,741 | 5.67 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 39 | $48,368 | $8,710 | $12,769 | 1.36 |
| Seizures without MCCMS-DRG 101, medical | 37 | $40,049 | $6,315 | $10,573 | 0.91 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 36 | $38,439 | $7,699 | $10,148 | 1.03 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 29 | $84,116 | $15,075 | $22,207 | 1.79 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 27 | $110,345 | $14,039 | $29,131 | 1.79 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 26 | $96,339 | $18,010 | $25,433 | 2.39 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 26 | $102,495 | $18,739 | $27,059 | 2.28 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 25 | $129,017 | $19,767 | $34,061 | 2.43 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 22 | $70,953 | $9,496 | $18,731 | 1.36 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 22 | $39,905 | $9,530 | $10,535 | 1.32 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 19 | $96,249 | $15,445 | $25,410 | 2.27 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 16 | $170,929 | $25,188 | $45,125 | 3.79 |
| Seizures with MCCMS-DRG 100, medical | 16 | $102,188 | $13,209 | $26,978 | 1.98 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 15 | $63,595 | $8,708 | $16,789 | 1.06 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 14 | $48,065 | $6,575 | $12,689 | 1.03 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 13 | $114,733 | $21,377 | $30,289 | 2.95 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 13 | $79,676 | $10,277 | $21,034 | 1.47 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 12 | $78,506 | $13,707 | $20,726 | 1.81 |
Digestive system582 discharges in 18 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 | 74 | $91,035 | $15,995 | $24,033 | 2.37 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 66 | $33,190 | $5,469 | $8,762 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 57 | $42,808 | $7,396 | $11,301 | 0.98 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 55 | $201,560 | $32,936 | $53,212 | 4.52 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 46 | $68,054 | $13,310 | $17,966 | 1.79 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 35 | $66,398 | $12,052 | $17,529 | 1.62 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 30 | $101,294 | $17,673 | $26,742 | 2.50 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 30 | $53,695 | $9,875 | $14,175 | 1.28 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 30 | $43,062 | $6,687 | $11,368 | 0.94 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 22 | $226,439 | $40,306 | $59,780 | 5.08 |
| Digestive malignancy with MCCMS-DRG 374, medical | 21 | $75,744 | $14,821 | $19,996 | 2.10 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 19 | $53,010 | $11,832 | $13,995 | 1.67 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 17 | $52,643 | $10,418 | $13,898 | 1.60 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 17 | $99,502 | $15,476 | $26,268 | 1.75 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 17 | $28,279 | $5,166 | $7,466 | 0.80 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 16 | $197,305 | $26,817 | $52,088 | 4.28 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 16 | $34,296 | $7,748 | $9,054 | 1.04 |
| Digestive malignancy with CCMS-DRG 375, medical | 14 | $45,713 | $7,552 | $12,068 | 1.20 |
Respiratory system578 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 67 | $74,725 | $12,380 | $19,727 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 66 | $54,155 | $10,010 | $14,297 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 63 | $52,368 | $9,199 | $13,825 | 1.23 |
| Major chest procedures with CCMS-DRG 164, surgical | 41 | $91,480 | $15,469 | $24,151 | 2.55 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 34 | $117,955 | $21,051 | $31,140 | 2.70 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 32 | $89,062 | $15,016 | $23,512 | 1.81 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 31 | $145,400 | $32,734 | $38,386 | 4.06 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 29 | $51,683 | $10,383 | $13,644 | 1.40 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 25 | $69,873 | $12,798 | $18,447 | 1.74 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 23 | $61,068 | $6,420 | $16,122 | 0.99 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 23 | $223,829 | $37,029 | $59,091 | 6.91 |
| Major chest trauma with MCCMS-DRG 183, medical | 20 | $82,232 | $11,398 | $21,709 | 1.57 |
| Major chest procedures with MCCMS-DRG 163, surgical | 19 | $275,169 | $44,741 | $72,645 | 4.71 |
| Pneumothorax with MCCMS-DRG 199, medical | 18 | $75,727 | $13,649 | $19,992 | 1.77 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 17 | $80,484 | $12,474 | $21,248 | 1.88 |
| Other respiratory system o.r. procedures with CCMS-DRG 167, surgical | 16 | $78,099 | $13,082 | $20,618 | 1.82 |
| Major chest trauma with CCMS-DRG 184, medical | 15 | $65,179 | $6,420 | $17,207 | 1.05 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 14 | $31,808 | $6,419 | $8,397 | 0.82 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 14 | $43,799 | $2,349 | $11,563 | 0.82 |
| Pneumothorax with CCMS-DRG 200, medical | 11 | $46,005 | $7,684 | $12,145 | 1.08 |
Infectious and parasitic diseases574 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 | 332 | $96,856 | $14,723 | $25,570 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 90 | $233,829 | $39,104 | $61,731 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 48 | $44,213 | $7,662 | $11,672 | 1.03 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 39 | $291,951 | $54,164 | $77,075 | 6.96 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 21 | $132,679 | $18,656 | $35,027 | 1.84 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 17 | $38,185 | $7,909 | $10,081 | 1.01 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 15 | $73,950 | $13,440 | $19,523 | 2.14 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 12 | $170,382 | $30,489 | $44,981 | 4.43 |
Musculoskeletal system and connective tissue435 discharges in 17 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 | 77 | $94,830 | $15,006 | $25,035 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 55 | $41,866 | $6,474 | $11,053 | 0.97 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 39 | $132,480 | $18,424 | $34,975 | 2.40 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 33 | $53,906 | $8,011 | $14,231 | 1.09 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 30 | $139,233 | $22,109 | $36,758 | 2.95 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 25 | $87,404 | $13,453 | $23,075 | 1.82 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 21 | $87,868 | $15,807 | $23,197 | 2.11 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 20 | $158,834 | $24,576 | $41,932 | 3.46 |
| Medical back problems with MCCMS-DRG 551, medical | 20 | $77,011 | $12,927 | $20,331 | 1.70 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 17 | $171,270 | $28,963 | $45,215 | 3.66 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 16 | $101,111 | $22,218 | $26,693 | 3.49 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 15 | $132,049 | $43,271 | $34,861 | 6.12 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 15 | $130,361 | $21,324 | $34,415 | 2.99 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 15 | $39,230 | $5,820 | $10,357 | 0.90 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 14 | $120,697 | $17,826 | $31,864 | 2.96 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 12 | $27,495 | $6,326 | $7,259 | 0.82 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 11 | $128,056 | $14,269 | $33,807 | 1.97 |
Kidney and urinary tract315 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with MCCMS-DRG 682, medical | 54 | $66,846 | $11,277 | $17,647 | 1.50 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 54 | $82,098 | $13,246 | $21,674 | 1.65 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 49 | $32,281 | $6,370 | $8,522 | 0.81 |
| Renal failure with CCMS-DRG 683, medical | 42 | $34,668 | $6,286 | $9,152 | 0.90 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 31 | $58,104 | $7,033 | $15,339 | 1.17 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 24 | $46,700 | $6,040 | $12,329 | 1.02 |
| Kidney transplantMS-DRG 652, surgical | 20 | $361,106 | $15,211 | $95,332 | 3.00 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 18 | $61,985 | $10,543 | $16,364 | 1.35 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 12 | $78,184 | $12,722 | $20,641 | 1.84 |
| Kidney transplant with hemodialysis with MCCMS-DRG 650, surgical | 11 | $378,422 | $28,077 | $99,904 | 4.50 |
Liver, gallbladder and pancreas268 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 55 | $89,997 | $14,090 | $23,759 | 1.92 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 38 | $74,682 | $14,604 | $19,716 | 1.76 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 32 | $44,290 | $6,890 | $11,693 | 0.95 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 29 | $69,346 | $13,088 | $18,307 | 1.83 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 22 | $123,305 | $22,200 | $32,553 | 2.89 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 22 | $41,804 | $8,382 | $11,036 | 1.09 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 17 | $32,842 | $5,328 | $8,670 | 0.86 |
| Malignancy of hepatobiliary system or pancreas with CCMS-DRG 436, medical | 14 | $51,910 | $8,569 | $13,704 | 1.10 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 14 | $59,883 | $12,619 | $15,809 | 1.63 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 13 | $30,191 | $7,714 | $7,970 | 1.03 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 12 | $209,105 | $41,779 | $55,204 | 5.51 |
Endocrine, nutritional and metabolic119 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 with MCCMS-DRG 640, medical | 38 | $54,401 | $9,822 | $14,362 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 27 | $43,123 | $5,669 | $11,385 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 19 | $36,276 | $6,772 | $9,577 | 0.90 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 12 | $119,472 | $14,703 | $31,541 | 1.98 |
| Diabetes with MCCMS-DRG 637, medical | 12 | $73,590 | $10,845 | $19,428 | 1.45 |
| Endocrine disorders with CCMS-DRG 644, medical | 11 | $35,805 | $7,986 | $9,452 | 1.06 |
Transplants, ECMO and tracheostomy (pre-MDC)92 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 | 35 | $653,835 | $141,949 | $172,612 | 21.32 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 19 | $401,032 | $85,315 | $105,872 | 14.70 |
| Liver transplant with MCC or intestinal transplantMS-DRG 005, surgical | 14 | $844,699 | $73,267 | $223,001 | 10.35 |
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 12 | $1,073,525 | $248,704 | $283,411 | 27.10 |
| Tracheostomy for face, mouth and neck diagnoses or laryngectomy with CCMS-DRG 012, surgical | 12 | $171,251 | $30,879 | $45,210 | 4.00 |
Blood cancers and poorly differentiated neoplasms89 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 24 | $111,349 | $24,166 | $29,396 | 3.13 |
| Acute leukemia with MCCMS-DRG 834, medical | 23 | $242,276 | $50,524 | $63,961 | 5.60 |
| Chemotherapy without acute leukemia as secondary diagnosis with CCMS-DRG 847, medical | 17 | $77,452 | $11,466 | $20,447 | 1.21 |
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 14 | $74,696 | $21,706 | $19,720 | 2.44 |
| Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy aMS-DRG 837, medical | 11 | $202,635 | $38,408 | $53,496 | 4.84 |
Injuries, poisonings and toxic effects of drugs85 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 | 25 | $62,261 | $14,847 | $16,437 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 23 | $40,108 | $7,520 | $10,588 | 1.03 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 14 | $90,447 | $9,361 | $23,878 | 1.60 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 12 | $175,224 | $32,761 | $46,259 | 3.72 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 11 | $105,541 | $15,573 | $27,863 | 2.00 |
Multiple significant trauma68 discharges in 4 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 | 18 | $215,364 | $38,506 | $56,856 | 3.88 |
| Other o.r. procedures for multiple significant trauma with MCCMS-DRG 957, surgical | 18 | $295,130 | $61,175 | $77,914 | 7.23 |
| Other multiple significant trauma with MCCMS-DRG 963, medical | 17 | $117,066 | $19,610 | $30,906 | 2.73 |
| Other multiple significant trauma with CCMS-DRG 964, medical | 15 | $66,727 | $9,924 | $17,616 | 1.50 |
Skin, subcutaneous tissue and breast66 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 43 | $34,644 | $5,950 | $9,146 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 12 | $94,512 | $7,533 | $24,951 | 1.49 |
| Other skin, subcutaneous tissue and breast procedures with CCMS-DRG 580, surgical | 11 | $55,419 | $12,349 | $14,631 | 1.75 |
Blood and immune system65 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 19 | $53,886 | $9,185 | $14,226 | 1.20 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 17 | $46,403 | $9,766 | $12,250 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 17 | $51,498 | $7,233 | $13,595 | 0.90 |
| Coagulation disordersMS-DRG 813, medical | 12 | $56,781 | $11,891 | $14,990 | 1.56 |
Mental diseases and disorders27 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 | 27 | $80,372 | $11,109 | $21,218 | 1.76 |
Alcohol and drug use24 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 | 24 | $33,812 | $6,015 | $8,926 | 0.86 |
Factors influencing health status20 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 | 20 | $31,479 | $5,266 | $8,311 | 0.80 |
Other18 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 | 18 | $182,460 | $31,094 | $48,169 | 4.74 |
Eye15 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Neurological eye disordersMS-DRG 123, medical | 15 | $36,843 | $6,146 | $9,727 | 0.80 |
Ear, nose, mouth and throat13 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 | 13 | $82,657 | $15,775 | $21,821 | 2.07 |
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 | 638 | 229 | $2,131 | $462 | $502 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 416 | 375 | $12,272 | $1,083 | $1,220 |
| Comprehensive Observation ServicesAPC 8011 | 330 | 297 | $16,968 | $1,802 | $2,090 |
| Level 2 Upper GI ProceduresAPC 5302 | 256 | 193 | $11,879 | $1,255 | $1,445 |
| Level 3 Vascular ProceduresAPC 5183 | 215 | 189 | $18,125 | $2,076 | $2,405 |
| Level 4 Airway EndoscopyAPC 5154 | 209 | 175 | $21,505 | $2,424 | $2,833 |
| Level 3 Urology and Related ServicesAPC 5373 | 193 | 146 | $10,413 | $1,351 | $1,516 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 173 | 140 | $21,966 | $1,807 | $2,141 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 169 | 159 | $50,967 | $9,579 | $10,772 |
| Level 4 Urology and Related ServicesAPC 5374 | 151 | 119 | $19,744 | $2,354 | $2,629 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 148 | 142 | $36,816 | $3,847 | $4,358 |
| Level 1 Nerve ProceduresAPC 5431 | 141 | 134 | $11,475 | $1,269 | $1,407 |
| Level 2 Intraocular ProceduresAPC 5492 | 140 | 126 | $16,815 | $2,660 | $3,116 |
| Level 1 Intraocular ProceduresAPC 5491 | 134 | 96 | $13,141 | $1,567 | $1,752 |
| Level 1 Endovascular ProceduresAPC 5191 | 128 | 121 | $32,711 | $1,869 | $2,208 |
| Level 5 ENT ProceduresAPC 5165 | 122 | 119 | $34,294 | $3,889 | $4,436 |
| Level 4 Vascular ProceduresAPC 5184 | 118 | 107 | $35,972 | $3,437 | $3,946 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 105 | 92 | $13,177 | $1,543 | $1,780 |
| Level 5 Urology and Related ServicesAPC 5375 | 104 | 94 | $26,533 | $3,499 | $3,918 |
| Level 3 Endovascular ProceduresAPC 5193 | 96 | 81 | $61,097 | $7,558 | $8,874 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 95 | 94 | $34,210 | $4,624 | $5,339 |
| Complex GI ProceduresAPC 5331 | 94 | 47 | $20,446 | $2,338 | $4,263 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 92 | 92 | $72,495 | $6,962 | $8,164 |
| Level 2 Endovascular ProceduresAPC 5192 | 83 | 62 | $56,731 | $3,845 | $4,338 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 62 | 54 | $21,612 | $1,902 | $2,373 |
| Level 5 Airway EndoscopyAPC 5155 | 58 | 58 | $37,060 | $4,411 | $5,183 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 57 | 57 | $39,439 | $4,420 | $4,982 |
| Level 2 Vascular ProceduresAPC 5182 | 56 | 56 | $12,185 | $1,007 | $1,204 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 55 | 49 | $12,492 | $1,004 | $1,196 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 45 | 38 | $18,541 | $2,120 | $2,636 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 44 | 42 | $29,130 | $2,468 | $2,930 |
| Level 3 Airway EndoscopyAPC 5153 | 44 | 38 | $13,799 | $1,100 | $1,264 |
| Level 3 Upper GI ProceduresAPC 5303 | 44 | 43 | $19,634 | $2,576 | $2,888 |
| Level 5 Gynecologic ProceduresAPC 5415 | 43 | 33 | $23,054 | $3,352 | $3,792 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 38 | 36 | $66,891 | $14,090 | $15,763 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 36 | 36 | $153,692 | $18,885 | $21,117 |
| Level 4 ENT ProceduresAPC 5164 | 35 | 32 | $20,839 | $2,020 | $2,217 |
| Level 4 Endovascular ProceduresAPC 5194 | 34 | 32 | $76,715 | $13,126 | $14,606 |
| Level 3 Intraocular ProceduresAPC 5493 | 33 | 29 | $22,402 | $3,605 | $4,004 |
| Level 4 Gynecologic ProceduresAPC 5414 | 32 | 32 | $17,672 | $2,155 | $2,389 |
| Level 3 Lower GI ProceduresAPC 5313 | 30 | 29 | $17,126 | $1,622 | $2,176 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 30 | 25 | $21,103 | $3,766 | $4,524 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 27 | 26 | $112,088 | $16,624 | $18,465 |
| Level 4 Extraocular, Repair, and Plastic Eye ProceduresAPC 5504 | 26 | 26 | $20,187 | $2,660 | $2,969 |
| Cochlear Implant ProcedureAPC 5166 | 25 | 25 | $113,158 | $27,317 | $29,489 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 25 | 25 | $38,474 | $5,854 | $6,514 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 25 | 25 | $58,755 | $7,610 | $8,569 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 24 | 23 | $120,141 | $25,660 | $29,375 |
| Level 7 Radiation TherapyAPC 5627 | 23 | 22 | $85,691 | $4,906 | $6,121 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 18 | 17 | $116,789 | $23,783 | $26,719 |
| Level 8 Urology and Related ServicesAPC 5378 | 16 | 16 | $92,054 | $15,798 | $17,428 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 12 | 12 | $86,265 | $13,939 | $17,052 |
| Implantation of Drug Infusion DeviceAPC 5471 | 12 | 12 | $70,775 | $12,634 | $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.