University Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for University Hospital, Columbia, MO in 2024, from traditional Medicare claims. Back to the University Hospital profile, with quality ratings, finances and negotiated rates.
4,858
Medicare inpatient discharges
In 150 published DRGs
2.04
Case mix index
IPPS FY 2027
28%
Surgical stays
68%
Stays with complications
In DRGs with a CC or MCC
6,794
Medicare outpatient services
In 54 service groups
Inpatient stays by major diagnostic category
Circulatory system953 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 | 214 | $49,012 | $10,177 | $10,047 | 1.28 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 72 | $32,833 | $6,110 | $6,731 | 0.74 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 67 | $104,898 | $14,100 | $21,504 | 1.82 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 44 | $185,943 | $25,881 | $38,118 | 3.24 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 38 | $280,564 | $40,871 | $57,516 | 4.88 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 37 | $43,005 | $8,618 | $8,816 | 1.08 |
| Other vascular procedures with CCMS-DRG 253, surgical | 34 | $101,351 | $17,959 | $20,777 | 2.55 |
| Syncope and collapseMS-DRG 312, medical | 33 | $31,518 | $7,062 | $6,461 | 0.86 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 30 | $85,142 | $15,608 | $17,454 | 2.09 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 28 | $164,172 | $24,321 | $33,655 | 2.16 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 26 | $64,589 | $12,598 | $13,241 | 1.59 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 25 | $93,917 | $28,208 | $19,253 | 3.35 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 24 | $272,090 | $35,052 | $55,778 | 4.16 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 24 | $58,368 | $9,484 | $11,966 | 1.20 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 22 | $351,932 | $53,528 | $72,146 | 6.25 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 22 | $164,632 | $26,431 | $33,750 | 3.46 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 21 | $21,996 | $4,425 | $4,509 | 0.55 |
| Other vascular procedures without cc/mccMS-DRG 254, surgical | 19 | $98,677 | $14,398 | $20,229 | 1.74 |
| Hypertension without MCCMS-DRG 305, medical | 19 | $32,988 | $5,752 | $6,762 | 0.75 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 19 | $169,401 | $26,136 | $34,727 | 2.87 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 17 | $168,034 | $25,173 | $34,447 | 3.18 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 17 | $40,978 | $7,038 | $8,401 | 0.91 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 17 | $33,144 | $7,958 | $6,794 | 1.07 |
| Hypertension with MCCMS-DRG 304, medical | 16 | $53,540 | $9,624 | $10,976 | 1.15 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 15 | $397,395 | $63,966 | $81,466 | 7.71 |
| Heart failure and shock with CCMS-DRG 292, medical | 15 | $36,786 | $6,845 | $7,541 | 0.86 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 14 | $109,762 | $18,274 | $22,501 | 2.28 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 13 | $160,359 | $23,630 | $32,874 | 2.97 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 11 | $30,534 | $8,081 | $6,259 | 0.97 |
Respiratory system708 discharges in 16 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 104 | $65,226 | $13,411 | $13,371 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 103 | $45,848 | $9,954 | $9,399 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 99 | $88,159 | $11,221 | $18,073 | 1.23 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 79 | $43,496 | $8,660 | $8,917 | 1.10 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 76 | $31,324 | $6,609 | $6,421 | 0.82 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 46 | $43,929 | $7,486 | $9,005 | 0.99 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 29 | $28,152 | $6,534 | $5,771 | 0.85 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 28 | $139,675 | $23,419 | $28,633 | 2.70 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 26 | $34,833 | $6,800 | $7,141 | 0.82 |
| Major chest procedures with CCMS-DRG 164, surgical | 25 | $108,705 | $17,101 | $22,285 | 2.55 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 19 | $55,449 | $11,599 | $11,367 | 1.40 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 19 | $40,340 | $7,245 | $8,270 | 0.96 |
| Pneumothorax with CCMS-DRG 200, medical | 16 | $35,574 | $7,544 | $7,293 | 1.08 |
| Major chest procedures with MCCMS-DRG 163, surgical | 15 | $165,049 | $36,490 | $33,835 | 4.71 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 13 | $236,189 | $51,407 | $48,419 | 6.91 |
| Simple pneumonia and pleurisy without cc/mccMS-DRG 195, medical | 11 | $21,654 | $4,425 | $4,439 | 0.63 |
Nervous system673 discharges in 24 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 | 81 | $56,382 | $8,114 | $11,558 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 78 | $87,651 | $15,226 | $17,969 | 2.00 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 54 | $207,052 | $36,359 | $42,446 | 4.42 |
| Seizures without MCCMS-DRG 101, medical | 50 | $38,024 | $7,283 | $7,795 | 0.91 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 46 | $42,161 | $8,524 | $8,643 | 1.06 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 39 | $39,494 | $10,098 | $8,096 | 1.36 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 36 | $242,546 | $46,293 | $49,722 | 5.67 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 28 | $98,784 | $19,445 | $20,251 | 2.28 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 24 | $79,300 | $15,919 | $16,257 | 1.79 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 23 | $60,025 | $10,617 | $12,305 | 1.36 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 21 | $67,240 | $8,204 | $13,784 | 1.14 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 18 | $102,392 | $15,526 | $20,990 | 1.79 |
| Seizures with MCCMS-DRG 100, medical | 18 | $65,697 | $16,140 | $13,468 | 1.98 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 17 | $85,316 | $14,860 | $17,490 | 1.81 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 17 | $55,842 | $11,871 | $11,448 | 1.47 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 062, medical | 16 | $84,795 | $14,011 | $17,383 | 1.87 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 16 | $35,792 | $5,677 | $7,337 | 0.69 |
| Extracranial procedures with CCMS-DRG 038, surgical | 15 | $62,742 | $10,325 | $12,862 | 1.60 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 14 | $53,884 | $11,139 | $11,046 | 1.32 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 13 | $132,189 | $19,724 | $27,099 | 2.43 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 13 | $115,415 | $17,098 | $23,660 | 2.39 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 13 | $70,174 | $12,463 | $14,386 | 1.03 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 12 | $79,563 | $16,985 | $16,310 | 2.27 |
| Headaches without MCCMS-DRG 103, medical | 11 | $37,953 | $5,251 | $7,780 | 0.84 |
Musculoskeletal system and connective tissue576 discharges in 23 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 | 76 | $91,579 | $16,090 | $18,774 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 58 | $37,612 | $7,803 | $7,710 | 0.97 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 52 | $101,776 | $15,747 | $20,864 | 2.11 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 36 | $99,913 | $14,576 | $20,482 | 1.88 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 30 | $104,798 | $19,107 | $21,484 | 2.40 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 28 | $150,887 | $23,481 | $30,932 | 2.95 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 27 | $161,941 | $29,085 | $33,198 | 3.49 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 26 | $121,030 | $21,049 | $24,811 | 2.67 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 26 | $33,777 | $6,097 | $6,924 | 0.79 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 21 | $110,613 | $22,619 | $22,676 | 2.96 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 19 | $84,532 | $16,326 | $17,329 | 2.04 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 18 | $168,336 | $29,078 | $34,509 | 3.66 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 18 | $89,139 | $12,488 | $18,274 | 1.59 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 17 | $278,677 | $51,989 | $57,129 | 6.12 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 17 | $115,190 | $19,512 | $23,614 | 2.48 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 17 | $95,967 | $15,462 | $19,673 | 1.97 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 16 | $30,381 | $7,305 | $6,228 | 0.90 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 15 | $151,207 | $31,395 | $30,997 | 4.61 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 463, surgical | 13 | $240,010 | $42,265 | $49,202 | 5.66 |
| Medical back problems with MCCMS-DRG 551, medical | 13 | $74,039 | $12,511 | $15,178 | 1.70 |
| Cervical spinal fusion without cc/mccMS-DRG 473, surgical | 11 | $94,467 | $17,637 | $19,366 | 2.46 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 11 | $180,071 | $28,238 | $36,915 | 3.46 |
| Tendonitis, myositis and bursitis without MCCMS-DRG 558, medical | 11 | $38,253 | $6,661 | $7,842 | 0.88 |
Infectious and parasitic diseases420 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical | 247 | $89,141 | $15,931 | $18,274 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 63 | $225,964 | $41,574 | $46,323 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 46 | $39,242 | $7,711 | $8,045 | 1.03 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 20 | $71,978 | $17,606 | $14,756 | 2.14 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 19 | $315,802 | $51,617 | $64,739 | 6.96 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 13 | $111,476 | $30,099 | $22,853 | 4.43 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 12 | $39,952 | $9,084 | $8,190 | 1.01 |
Kidney and urinary tract378 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with CCMS-DRG 683, medical | 82 | $37,392 | $6,947 | $7,665 | 0.90 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 70 | $31,435 | $6,605 | $6,444 | 0.81 |
| Renal failure with MCCMS-DRG 682, medical | 59 | $46,668 | $11,747 | $9,567 | 1.50 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 50 | $40,620 | $9,125 | $8,327 | 1.17 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 40 | $71,302 | $13,478 | $14,617 | 1.65 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 26 | $59,274 | $10,818 | $12,151 | 1.35 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 23 | $33,885 | $8,977 | $6,946 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 16 | $95,227 | $21,084 | $19,522 | 2.59 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 12 | $81,593 | $11,482 | $16,727 | 1.84 |
Digestive system368 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 86 | $47,024 | $8,054 | $9,640 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 48 | $93,306 | $14,561 | $19,128 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 45 | $29,897 | $6,451 | $6,129 | 0.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 41 | $91,015 | $18,664 | $18,658 | 2.37 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 38 | $25,163 | $6,269 | $5,158 | 0.80 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 30 | $55,141 | $11,351 | $11,304 | 1.28 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 28 | $181,256 | $37,697 | $37,157 | 4.52 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 22 | $47,031 | $8,789 | $9,641 | 1.04 |
| Digestive malignancy with MCCMS-DRG 374, medical | 18 | $101,144 | $15,630 | $20,735 | 2.10 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 12 | $59,626 | $11,529 | $12,223 | 1.75 |
Endocrine, nutritional and metabolic316 discharges in 7 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 | 105 | $29,872 | $6,097 | $6,124 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 86 | $53,742 | $11,086 | $11,017 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 58 | $34,109 | $7,193 | $6,992 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 26 | $57,429 | $11,134 | $11,773 | 1.45 |
| Endocrine disorders with CCMS-DRG 644, medical | 15 | $45,371 | $8,155 | $9,301 | 1.06 |
| O.r. procedures for obesity without cc/mccMS-DRG 621, surgical | 14 | $64,424 | $11,124 | $13,207 | 1.52 |
| Endocrine disorders with MCCMS-DRG 643, medical | 12 | $66,688 | $13,089 | $13,671 | 1.65 |
Liver, gallbladder and pancreas112 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 CCMS-DRG 442, medical | 27 | $32,749 | $8,041 | $6,714 | 0.95 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 20 | $85,558 | $16,106 | $17,539 | 1.92 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 19 | $38,390 | $8,308 | $7,870 | 1.09 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 12 | $64,751 | $12,744 | $13,274 | 1.63 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 12 | $84,744 | $16,626 | $17,372 | 1.83 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 11 | $29,069 | $9,154 | $5,959 | 1.03 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 11 | $41,371 | $11,995 | $8,481 | 1.63 |
Blood and immune system79 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 | 49 | $35,697 | $7,552 | $7,318 | 0.90 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 19 | $69,553 | $9,912 | $14,258 | 1.20 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 11 | $70,167 | $11,904 | $14,384 | 1.40 |
Skin, subcutaneous tissue and breast70 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 41 | $32,715 | $7,369 | $6,707 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 17 | $44,552 | $11,320 | $9,133 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 12 | $40,965 | $7,507 | $8,398 | 0.91 |
Injuries, poisonings and toxic effects of drugs42 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Poisoning and toxic effects of drugs without MCCMS-DRG 918, medical | 15 | $33,315 | $7,364 | $6,829 | 0.86 |
| Complications of treatment with MCCMS-DRG 919, medical | 15 | $57,679 | $15,510 | $11,824 | 1.82 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 12 | $123,871 | $28,675 | $25,393 | 3.72 |
Alcohol and drug use37 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 | 37 | $32,639 | $7,906 | $6,691 | 0.86 |
Mental diseases and disorders35 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| PsychosesMS-DRG 885, medical | 18 | $39,354 | $10,853 | $8,068 | 1.37 |
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 17 | $39,760 | $13,515 | $8,151 | 1.76 |
Transplants, ECMO and tracheostomy (pre-MDC)30 discharges in 2 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 | 19 | $655,533 | $161,619 | $134,384 | 21.32 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 11 | $488,788 | $91,486 | $100,201 | 14.70 |
Other25 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 | 13 | $269,606 | $43,880 | $55,269 | 4.74 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 12 | $133,864 | $28,235 | $27,442 | 3.38 |
Blood cancers and poorly differentiated neoplasms24 discharges in 1 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 | 24 | $41,736 | $10,840 | $8,556 | 1.21 |
Multiple significant trauma12 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other o.r. procedures for multiple significant trauma with MCCMS-DRG 957, surgical | 12 | $270,703 | $58,337 | $55,494 | 7.23 |
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 | 790 | 714 | $14,490 | $1,817 | $2,090 |
| Level 2 Urology and Related ServicesAPC 5372 | 567 | 315 | $3,068 | $456 | $502 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 485 | 457 | $9,144 | $1,039 | $1,220 |
| Level 1 Intraocular ProceduresAPC 5491 | 390 | 249 | $12,311 | $1,555 | $1,752 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 353 | 339 | $69,478 | $9,302 | $10,772 |
| Level 3 Urology and Related ServicesAPC 5373 | 352 | 283 | $8,813 | $1,374 | $1,516 |
| Level 3 Vascular ProceduresAPC 5183 | 279 | 231 | $19,329 | $2,118 | $2,405 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 212 | 206 | $35,311 | $3,837 | $4,358 |
| Level 1 Nerve ProceduresAPC 5431 | 212 | 164 | $10,145 | $1,269 | $1,407 |
| Level 2 Upper GI ProceduresAPC 5302 | 204 | 179 | $9,540 | $1,262 | $1,445 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 203 | 201 | $45,410 | $4,762 | $5,339 |
| Level 1 Endovascular ProceduresAPC 5191 | 185 | 183 | $19,148 | $1,953 | $2,208 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 169 | 160 | $21,461 | $2,122 | $2,373 |
| Level 2 Intraocular ProceduresAPC 5492 | 167 | 139 | $23,929 | $2,723 | $3,116 |
| Level 4 Urology and Related ServicesAPC 5374 | 160 | 133 | $18,320 | $2,333 | $2,629 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 157 | 149 | $19,597 | $1,882 | $2,141 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 130 | 121 | $9,102 | $1,021 | $1,196 |
| Level 3 Endovascular ProceduresAPC 5193 | 130 | 122 | $62,092 | $7,562 | $8,874 |
| Level 5 Urology and Related ServicesAPC 5375 | 128 | 119 | $28,769 | $3,453 | $3,918 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 84 | 83 | $103,676 | $13,663 | $15,763 |
| Level 4 Vascular ProceduresAPC 5184 | 84 | 72 | $47,312 | $3,276 | $3,946 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 72 | 68 | $16,323 | $1,583 | $1,780 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 70 | 70 | $61,564 | $7,007 | $8,164 |
| Level 3 Airway EndoscopyAPC 5153 | 67 | 59 | $8,401 | $1,098 | $1,264 |
| Level 5 ENT ProceduresAPC 5165 | 67 | 66 | $31,745 | $3,892 | $4,436 |
| Level 4 Airway EndoscopyAPC 5154 | 66 | 51 | $15,486 | $2,395 | $2,833 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 65 | 65 | $153,700 | $18,243 | $21,117 |
| Level 2 Vascular ProceduresAPC 5182 | 63 | 55 | $6,750 | $1,048 | $1,204 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 60 | 52 | $21,307 | $2,548 | $2,930 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 59 | 50 | $20,693 | $2,295 | $2,636 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 58 | 58 | $35,194 | $4,364 | $4,982 |
| Level 4 Endovascular ProceduresAPC 5194 | 58 | 55 | $108,325 | $13,227 | $14,606 |
| Level 5 Airway EndoscopyAPC 5155 | 55 | 54 | $31,099 | $4,560 | $5,183 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 53 | 46 | $105,941 | $16,939 | $18,465 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 50 | 50 | $60,346 | $7,366 | $8,569 |
| Level 5 Gynecologic ProceduresAPC 5415 | 47 | 47 | $28,616 | $3,299 | $3,792 |
| Level 4 Gynecologic ProceduresAPC 5414 | 46 | 46 | $18,858 | $2,073 | $2,389 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 41 | 41 | $51,659 | $5,593 | $6,514 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 37 | 37 | $175,461 | $24,716 | $26,719 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 36 | 35 | $36,174 | $4,502 | $4,524 |
| Level 3 Intraocular ProceduresAPC 5493 | 34 | 28 | $29,386 | $3,444 | $4,004 |
| Level 3 Lower GI ProceduresAPC 5313 | 31 | 29 | $16,863 | $1,844 | $2,176 |
| Level 4 ENT ProceduresAPC 5164 | 25 | 23 | $15,311 | $2,091 | $2,217 |
| Level 3 ENT ProceduresAPC 5163 | 24 | 16 | $8,987 | $979 | $1,106 |
| Level 2 Endovascular ProceduresAPC 5192 | 24 | 23 | $33,418 | $3,863 | $4,338 |
| Level 7 Radiation TherapyAPC 5627 | 23 | 22 | $32,533 | $5,280 | $6,121 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 21 | 21 | $204,107 | $26,250 | $29,375 |
| Level 6 Gynecologic ProceduresAPC 5416 | 19 | 19 | $35,984 | $5,123 | $5,836 |
| Level 2 Nerve ProceduresAPC 5432 | 16 | 16 | $39,041 | $4,503 | $4,674 |
| Level 3 Upper GI ProceduresAPC 5303 | 15 | 13 | $19,494 | $2,480 | $2,888 |
| Cochlear Implant ProcedureAPC 5166 | 13 | 13 | $125,829 | $26,820 | $29,489 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 13 | 13 | $116,265 | $14,868 | $17,052 |
| Level 8 Urology and Related ServicesAPC 5378 | 13 | 13 | $145,416 | $15,495 | $17,428 |
| Complex GI ProceduresAPC 5331 | 12 | 11 | $32,619 | $3,864 | $4,263 |
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.