University Of Alabama Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for University Of Alabama Hospital, Birmingham, AL in 2024, from traditional Medicare claims. Back to the University Of Alabama Hospital profile, with quality ratings, finances and negotiated rates.
7,197
Medicare inpatient discharges
In 222 published DRGs
2.93
Case mix index
IPPS FY 2027
42%
Surgical stays
66%
Stays with complications
In DRGs with a CC or MCC
8,233
Medicare outpatient services
In 51 service groups
Inpatient stays by major diagnostic category
Circulatory system1,770 discharges in 39 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 167 | $56,844 | $9,685 | $11,710 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 162 | $97,106 | $22,420 | $20,004 | 3.24 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 132 | $137,745 | $33,450 | $28,375 | 4.88 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 104 | $89,154 | $12,665 | $18,366 | 1.59 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 99 | $243,581 | $33,593 | $50,178 | 5.24 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 96 | $111,581 | $15,014 | $22,986 | 2.16 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 86 | $196,680 | $25,929 | $40,516 | 4.04 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 79 | $265,145 | $38,755 | $54,620 | 5.88 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 78 | $477,875 | $72,333 | $98,442 | 7.71 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 73 | $169,848 | $45,156 | $34,989 | 6.25 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 48 | $93,445 | $8,370 | $19,250 | 1.08 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 46 | $50,083 | $7,111 | $10,317 | 0.91 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 39 | $59,773 | $8,680 | $12,313 | 0.74 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 39 | $93,901 | $15,035 | $19,344 | 2.09 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 38 | $265,626 | $39,318 | $54,719 | 5.06 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 36 | $197,596 | $27,351 | $40,705 | 4.16 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 34 | $56,109 | $7,227 | $11,558 | 0.97 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 28 | $331,155 | $50,410 | $68,218 | 7.80 |
| Heart failure and shock with CCMS-DRG 292, medical | 28 | $57,769 | $6,583 | $11,900 | 0.86 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 28 | $65,217 | $8,006 | $13,435 | 1.07 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 27 | $128,464 | $12,933 | $26,464 | 1.82 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 24 | $459,516 | $72,772 | $94,660 | 9.71 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 24 | $189,959 | $25,795 | $39,132 | 3.35 |
| Other vascular procedures with CCMS-DRG 253, surgical | 24 | $143,396 | $18,029 | $29,540 | 2.55 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 23 | $48,179 | $9,353 | $9,925 | 1.20 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 22 | $99,908 | $14,767 | $20,581 | 1.58 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 19 | $182,217 | $24,201 | $37,537 | 3.46 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 19 | $210,172 | $27,773 | $43,295 | 3.90 |
| Syncope and collapseMS-DRG 312, medical | 19 | $47,815 | $6,985 | $9,850 | 0.86 |
| Atherosclerosis without MCCMS-DRG 303, medical | 16 | $24,567 | $4,890 | $5,061 | 0.66 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 14 | $42,492 | $6,073 | $8,753 | 0.72 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 14 | $148,639 | $20,007 | $30,620 | 2.87 |
| Other vascular procedures without cc/mccMS-DRG 254, surgical | 13 | $106,929 | $12,086 | $22,027 | 1.74 |
| Aortic and heart assist procedures except pulsation balloon with MCCMS-DRG 268, surgical | 13 | $329,885 | $48,628 | $67,956 | 6.85 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 13 | $145,134 | $16,428 | $29,898 | 1.97 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 217, surgical | 12 | $274,163 | $49,920 | $56,477 | 6.37 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 12 | $27,614 | $4,573 | $5,689 | 0.55 |
| Amputation for circulatory system disorders except upper limb and toe with CCMS-DRG 240, surgical | 11 | $198,980 | $23,421 | $40,990 | 2.81 |
| Hypertension with MCCMS-DRG 304, medical | 11 | $43,418 | $8,998 | $8,944 | 1.15 |
Nervous system911 discharges in 27 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 119 | $117,852 | $15,399 | $24,278 | 2.00 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 95 | $218,684 | $29,777 | $45,049 | 4.42 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 66 | $102,425 | $16,624 | $21,100 | 2.43 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 55 | $66,269 | $7,344 | $13,651 | 1.02 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 51 | $250,218 | $37,968 | $51,545 | 5.67 |
| Seizures without MCCMS-DRG 101, medical | 50 | $42,020 | $7,097 | $8,656 | 0.91 |
| Seizures with MCCMS-DRG 100, medical | 44 | $172,578 | $15,948 | $35,551 | 1.98 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 42 | $98,808 | $13,398 | $20,354 | 1.79 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 35 | $45,648 | $8,314 | $9,404 | 1.06 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 31 | $135,772 | $17,519 | $27,969 | 2.28 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 30 | $66,679 | $8,927 | $13,736 | 1.36 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 29 | $124,929 | $19,693 | $25,735 | 2.95 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 28 | $126,903 | $9,847 | $26,142 | 1.36 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 26 | $89,357 | $11,122 | $18,408 | 1.47 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 26 | $51,398 | $7,978 | $10,588 | 1.03 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 24 | $124,160 | $14,805 | $25,577 | 1.79 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 20 | $80,869 | $6,325 | $16,659 | 1.03 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 19 | $43,120 | $5,444 | $8,883 | 0.69 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 17 | $72,236 | $7,834 | $14,881 | 1.32 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 15 | $134,016 | $23,594 | $27,607 | 3.79 |
| Cranial and peripheral nerve disorders with MCCMS-DRG 073, medical | 15 | $119,113 | $16,626 | $24,537 | 1.51 |
| Ventricular shunt procedures without cc/mccMS-DRG 033, surgical | 14 | $71,898 | $12,025 | $14,811 | 1.62 |
| Traumatic stupor and coma <1 hour without cc/mccMS-DRG 087, medical | 13 | $82,581 | $6,915 | $17,012 | 0.89 |
| Ventricular shunt procedures with CCMS-DRG 032, surgical | 12 | $100,950 | $12,461 | $20,796 | 2.15 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 12 | $38,483 | $5,930 | $7,928 | 0.80 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 12 | $120,863 | $16,105 | $24,898 | 2.27 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 11 | $77,249 | $8,884 | $15,913 | 1.14 |
Musculoskeletal system and connective tissue711 discharges in 26 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 88 | $121,066 | $21,284 | $24,940 | 3.49 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 65 | $128,286 | $14,128 | $26,427 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 49 | $72,299 | $7,133 | $14,894 | 0.97 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 48 | $165,761 | $23,355 | $34,147 | 3.66 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 44 | $142,999 | $20,612 | $29,458 | 2.96 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 35 | $129,461 | $15,631 | $26,669 | 2.40 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 31 | $96,788 | $15,131 | $19,938 | 2.67 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 27 | $121,074 | $14,996 | $24,941 | 2.11 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 26 | $167,147 | $20,199 | $34,432 | 3.00 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 26 | $104,207 | $12,367 | $21,467 | 1.97 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 24 | $103,696 | $11,012 | $21,361 | 1.88 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 23 | $245,951 | $39,723 | $50,666 | 6.12 |
| Revision of hip or knee replacement with MCCMS-DRG 466, surgical | 22 | $234,931 | $41,550 | $48,396 | 5.19 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 22 | $205,821 | $25,149 | $42,399 | 2.95 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 21 | $99,494 | $16,427 | $20,496 | 2.48 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 21 | $118,360 | $13,926 | $24,382 | 2.04 |
| Medical back problems with MCCMS-DRG 551, medical | 18 | $107,461 | $13,513 | $22,137 | 1.70 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 463, surgical | 17 | $282,644 | $44,042 | $58,225 | 5.66 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 16 | $152,357 | $17,280 | $31,386 | 2.99 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 15 | $58,733 | $5,984 | $12,099 | 0.79 |
| Spinal fusion except cervical with MCCMS-DRG 459, surgical | 14 | $266,757 | $44,216 | $54,952 | 6.63 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 14 | $129,639 | $17,103 | $26,706 | 2.38 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 12 | $89,868 | $10,708 | $18,513 | 1.59 |
| Amputation for musculoskeletal system and connective tissue disorders with CCMS-DRG 475, surgical | 11 | $103,047 | $13,663 | $21,228 | 2.14 |
| Soft tissue procedures with CCMS-DRG 501, surgical | 11 | $117,381 | $12,141 | $24,180 | 1.74 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 11 | $73,481 | $11,327 | $15,137 | 1.49 |
Respiratory system660 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 88 | $88,602 | $9,677 | $18,252 | 1.23 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 79 | $82,548 | $12,645 | $17,005 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 76 | $54,927 | $9,384 | $11,315 | 1.33 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 45 | $175,579 | $22,324 | $36,169 | 1.90 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 43 | $55,138 | $8,276 | $11,358 | 1.10 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 37 | $62,952 | $6,435 | $12,968 | 0.99 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 36 | $168,457 | $20,351 | $34,702 | 2.70 |
| Major chest procedures with CCMS-DRG 164, surgical | 35 | $101,961 | $15,257 | $21,004 | 2.55 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 29 | $62,031 | $6,257 | $12,778 | 0.85 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 27 | $75,368 | $11,849 | $15,526 | 1.88 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 25 | $53,278 | $9,921 | $10,975 | 1.40 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 24 | $41,234 | $6,294 | $8,494 | 0.82 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 24 | $102,053 | $12,369 | $21,023 | 1.81 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 23 | $427,832 | $64,616 | $88,133 | 6.91 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 15 | $50,914 | $6,779 | $10,488 | 0.82 |
| Pleural effusion with MCCMS-DRG 186, medical | 15 | $77,798 | $10,710 | $16,026 | 1.55 |
| Major chest procedures with MCCMS-DRG 163, surgical | 14 | $192,239 | $30,653 | $39,601 | 4.71 |
| Major chest trauma with CCMS-DRG 184, medical | 14 | $95,628 | $8,207 | $19,699 | 1.05 |
| Other respiratory system o.r. procedures with CCMS-DRG 167, surgical | 11 | $87,836 | $13,234 | $18,094 | 1.82 |
Digestive system569 discharges in 19 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 | 81 | $108,159 | $15,439 | $22,281 | 2.37 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 73 | $36,816 | $5,813 | $7,584 | 0.79 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 52 | $78,187 | $11,215 | $16,107 | 1.67 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 48 | $49,882 | $8,178 | $10,276 | 0.98 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 34 | $356,964 | $44,257 | $73,535 | 4.52 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 33 | $40,709 | $9,698 | $8,386 | 1.28 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 32 | $100,749 | $15,123 | $20,754 | 1.79 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 32 | $32,248 | $7,651 | $6,643 | 0.94 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 31 | $42,640 | $6,086 | $8,784 | 0.80 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 28 | $73,471 | $11,273 | $15,135 | 1.62 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 17 | $106,948 | $14,027 | $22,031 | 2.11 |
| Digestive malignancy with MCCMS-DRG 374, medical | 17 | $57,941 | $14,799 | $11,936 | 2.10 |
| Hernia procedures except inguinal and femoral with CCMS-DRG 354, surgical | 16 | $113,096 | $14,158 | $23,298 | 1.72 |
| Hernia procedures except inguinal and femoral without cc/mccMS-DRG 355, surgical | 14 | $78,329 | $7,356 | $16,136 | 1.36 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 13 | $145,278 | $14,231 | $29,927 | 2.50 |
| Digestive malignancy with CCMS-DRG 375, medical | 13 | $44,957 | $7,526 | $9,261 | 1.20 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 13 | $55,725 | $8,726 | $11,479 | 1.45 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 11 | $293,561 | $42,324 | $60,473 | 5.08 |
| Other digestive system o.r. procedures with CCMS-DRG 357, surgical | 11 | $110,661 | $15,489 | $22,796 | 2.20 |
Infectious and parasitic diseases566 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 | 329 | $94,600 | $14,207 | $19,488 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 76 | $48,446 | $7,979 | $9,980 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 61 | $267,228 | $39,923 | $55,049 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 25 | $409,955 | $56,736 | $84,451 | 6.96 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 23 | $52,976 | $12,162 | $10,913 | 1.84 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 22 | $111,528 | $16,232 | $22,975 | 2.14 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 16 | $304,445 | $40,341 | $62,716 | 4.43 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 14 | $37,843 | $6,680 | $7,796 | 1.01 |
Kidney and urinary tract472 discharges in 12 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with CCMS-DRG 683, medical | 80 | $37,712 | $6,832 | $7,769 | 0.90 |
| Kidney transplantMS-DRG 652, surgical | 75 | $305,629 | $19,681 | $62,960 | 3.00 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 72 | $34,336 | $6,330 | $7,073 | 0.81 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 65 | $45,011 | $7,903 | $9,272 | 1.02 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 43 | $58,208 | $11,849 | $11,991 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 36 | $71,422 | $11,615 | $14,713 | 1.50 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 36 | $48,727 | $8,438 | $10,038 | 1.17 |
| Kidney transplant with hemodialysis with MCCMS-DRG 650, surgical | 17 | $372,799 | $32,966 | $76,797 | 4.50 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 14 | $116,682 | $13,544 | $24,037 | 1.84 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 12 | $96,062 | $16,470 | $19,789 | 2.38 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 11 | $78,115 | $10,761 | $16,092 | 1.35 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 11 | $58,754 | $7,915 | $12,103 | 1.05 |
Transplants, ECMO and tracheostomy (pre-MDC)257 discharges in 11 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 | 53 | $1,282,615 | $180,553 | $264,219 | 21.32 |
| Chimeric antigen receptor (car) t-cell and other immunotherapiesMS-DRG 018, medical | 45 | $2,435,969 | $458,298 | $501,810 | 36.84 |
| Autologous bone marrow transplant with cc/mccMS-DRG 016, medical | 36 | $184,482 | $39,587 | $38,003 | 6.18 |
| Tracheostomy for face, mouth and neck diagnoses or laryngectomy with CCMS-DRG 012, surgical | 23 | $200,667 | $27,244 | $41,337 | 4.00 |
| Tracheostomy for face, mouth and neck diagnoses or laryngectomy without cc/mccMS-DRG 013, surgical | 21 | $148,185 | $17,720 | $30,526 | 2.69 |
| Allogeneic bone marrow transplantMS-DRG 014, medical | 19 | $397,369 | $82,480 | $81,858 | 11.46 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 13 | $542,522 | $94,655 | $111,760 | 14.70 |
| Liver transplant without MCCMS-DRG 006, surgical | 13 | $335,551 | $24,416 | $69,123 | 4.84 |
| Tracheostomy for face, mouth and neck diagnoses or laryngectomy with MCCMS-DRG 011, surgical | 12 | $308,391 | $35,137 | $63,528 | 5.16 |
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 11 | $1,346,295 | $242,985 | $277,337 | 27.10 |
| Liver transplant with MCC or intestinal transplantMS-DRG 005, surgical | 11 | $722,885 | $78,908 | $148,914 | 10.35 |
Endocrine, nutritional and metabolic234 discharges in 8 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 | 73 | $64,957 | $9,798 | $13,381 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 59 | $42,464 | $5,405 | $8,748 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 26 | $35,710 | $6,891 | $7,356 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 25 | $74,106 | $10,999 | $15,266 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 16 | $93,555 | $11,281 | $19,272 | 1.65 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 13 | $94,657 | $14,443 | $19,499 | 1.98 |
| Adrenal and pituitary procedures without cc/mccMS-DRG 615, surgical | 11 | $58,454 | $8,082 | $12,042 | 1.47 |
| Endocrine disorders with CCMS-DRG 644, medical | 11 | $53,099 | $7,693 | $10,938 | 1.06 |
Liver, gallbladder and pancreas219 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 | 36 | $102,413 | $14,176 | $21,097 | 1.92 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 31 | $77,038 | $11,296 | $15,870 | 1.83 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 27 | $46,192 | $6,884 | $9,516 | 0.95 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 25 | $145,991 | $18,530 | $30,074 | 2.89 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 18 | $73,924 | $12,173 | $15,228 | 1.63 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 17 | $39,961 | $7,697 | $8,232 | 1.03 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 15 | $39,440 | $7,458 | $8,125 | 0.86 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 14 | $83,075 | $12,833 | $17,113 | 1.76 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 13 | $47,702 | $7,883 | $9,827 | 1.09 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 12 | $299,105 | $49,020 | $61,616 | 5.51 |
| Malignancy of hepatobiliary system or pancreas with CCMS-DRG 436, medical | 11 | $36,255 | $8,025 | $7,469 | 1.10 |
Blood cancers and poorly differentiated neoplasms174 discharges in 8 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 | 66 | $45,945 | $10,289 | $9,465 | 1.21 |
| Acute leukemia with MCCMS-DRG 834, medical | 25 | $264,320 | $39,804 | $54,450 | 5.60 |
| Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy aMS-DRG 837, medical | 17 | $132,007 | $31,229 | $27,193 | 4.84 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 16 | $147,112 | $24,762 | $30,305 | 3.13 |
| Chemotherapy with acute leukemia as secondary diagnosis with CC or high dose chemotherapMS-DRG 838, medical | 13 | $106,270 | $13,376 | $21,892 | 2.00 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 13 | $99,544 | $8,990 | $20,506 | 1.57 |
| Myeloproliferative disorders or poorly differentiated neoplasms with major o.r. procedurMS-DRG 828, surgical | 12 | $70,891 | $9,066 | $14,603 | 1.64 |
| Myeloproliferative disorders or poorly differentiated neoplasms with other procedures wiMS-DRG 829, surgical | 12 | $120,382 | $23,682 | $24,799 | 3.15 |
Injuries, poisonings and toxic effects of drugs115 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 | 28 | $96,547 | $13,601 | $19,889 | 1.82 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 25 | $177,179 | $26,112 | $36,499 | 3.72 |
| Complications of treatment with CCMS-DRG 920, medical | 22 | $57,642 | $8,816 | $11,874 | 1.03 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 20 | $98,111 | $13,675 | $20,211 | 2.00 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 20 | $112,186 | $12,447 | $23,110 | 1.60 |
Other100 discharges in 5 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 | 42 | $304,927 | $40,867 | $62,815 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 23 | $103,835 | $17,789 | $21,390 | 2.49 |
| Multiple level spinal fusion except cervical without MCCMS-DRG 448 | 13 | $183,255 | $25,080 | $37,751 | |
| Single level spinal fusion except cervical without MCCMS-DRG 451 | 11 | $146,358 | $22,480 | $30,150 | |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 11 | $187,609 | $29,118 | $38,647 | 3.38 |
Blood and immune system84 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 | 41 | $37,954 | $7,559 | $7,818 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 26 | $64,059 | $9,902 | $13,196 | 1.40 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 17 | $37,259 | $8,702 | $7,675 | 1.20 |
Multiple significant trauma82 discharges in 5 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 | 22 | $396,015 | $59,776 | $81,579 | 7.23 |
| Limb reattachment, hip and femur procedures for multiple significant traumaMS-DRG 956, surgical | 18 | $330,523 | $42,785 | $68,088 | 3.88 |
| Other o.r. procedures for multiple significant trauma with CCMS-DRG 958, surgical | 16 | $221,398 | $29,863 | $45,608 | 4.04 |
| Other multiple significant trauma with MCCMS-DRG 963, medical | 13 | $159,988 | $18,975 | $32,957 | 2.73 |
| Other multiple significant trauma with CCMS-DRG 964, medical | 13 | $106,187 | $10,408 | $21,875 | 1.50 |
Ear, nose, mouth and throat75 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major head and neck procedures with CCMS-DRG 141, surgical | 24 | $104,634 | $13,613 | $21,555 | 2.07 |
| Major head and neck procedures without cc/mccMS-DRG 142, surgical | 21 | $92,579 | $10,967 | $19,071 | 1.54 |
| Other ear, nose, mouth and throat o.r. procedures without cc/mccMS-DRG 145, surgical | 18 | $68,147 | $8,566 | $14,038 | 1.22 |
| Other ear, nose, mouth and throat o.r. procedures with CCMS-DRG 144, surgical | 12 | $66,213 | $12,173 | $13,640 | 1.73 |
Mental diseases and disorders55 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Acute adjustment reaction and psychosocial dysfunctionMS-DRG 880, medical | 21 | $37,419 | $6,700 | $7,708 | 0.95 |
| PsychosesMS-DRG 885, medical | 19 | $82,063 | $8,094 | $16,905 | 1.37 |
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 15 | $46,676 | $13,418 | $9,615 | 1.76 |
Skin, subcutaneous tissue and breast53 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 28 | $38,083 | $6,974 | $7,845 | 0.88 |
| Other skin, subcutaneous tissue and breast procedures with CCMS-DRG 580, surgical | 13 | $103,039 | $12,660 | $21,226 | 1.75 |
| Cellulitis with MCCMS-DRG 602, medical | 12 | $95,216 | $9,317 | $19,614 | 1.49 |
Female reproductive system35 discharges in 3 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 | $76,204 | $14,911 | $15,698 | 1.97 |
| Malignancy, female reproductive system with MCCMS-DRG 754, medical | 12 | $44,922 | $13,060 | $9,254 | 1.85 |
| Uterine and adnexa procedures for non-malignancy with cc/mccMS-DRG 742, surgical | 11 | $90,728 | $12,393 | $18,690 | 1.78 |
Factors influencing health status23 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 | 23 | $45,343 | $6,069 | $9,341 | 0.80 |
Alcohol and drug use21 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 | 21 | $29,574 | $6,684 | $6,092 | 0.86 |
Burns11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Non-extensive burnsMS-DRG 935, medical | 11 | $97,474 | $16,451 | $20,080 | 2.04 |
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 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 991 | 848 | $9,111 | $1,048 | $1,220 |
| Level 1 Endovascular ProceduresAPC 5191 | 696 | 656 | $31,856 | $1,902 | $2,208 |
| Level 2 Urology and Related ServicesAPC 5372 | 669 | 434 | $3,315 | $450 | $502 |
| Level 2 Upper GI ProceduresAPC 5302 | 452 | 379 | $14,117 | $1,205 | $1,445 |
| Comprehensive Observation ServicesAPC 8011 | 442 | 421 | $23,654 | $1,798 | $2,090 |
| Level 3 Airway EndoscopyAPC 5153 | 441 | 276 | $8,501 | $1,118 | $1,264 |
| Level 3 Urology and Related ServicesAPC 5373 | 392 | 325 | $12,684 | $1,310 | $1,516 |
| Level 3 Vascular ProceduresAPC 5183 | 344 | 294 | $17,649 | $2,034 | $2,405 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 308 | 295 | $169,637 | $17,380 | $21,117 |
| Level 5 ENT ProceduresAPC 5165 | 225 | 210 | $43,052 | $3,760 | $4,436 |
| Level 3 Endovascular ProceduresAPC 5193 | 204 | 172 | $69,736 | $7,398 | $8,874 |
| Level 4 Airway EndoscopyAPC 5154 | 203 | 168 | $27,321 | $2,432 | $2,833 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 199 | 184 | $20,380 | $1,862 | $2,141 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 185 | 184 | $46,576 | $3,817 | $4,358 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 167 | 162 | $67,902 | $9,343 | $10,772 |
| Level 4 Urology and Related ServicesAPC 5374 | 162 | 121 | $27,798 | $2,253 | $2,629 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 154 | 153 | $62,299 | $6,808 | $8,164 |
| Level 5 Urology and Related ServicesAPC 5375 | 149 | 134 | $39,239 | $3,246 | $3,918 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 141 | 138 | $52,553 | $4,623 | $5,339 |
| Level 4 Vascular ProceduresAPC 5184 | 135 | 98 | $36,797 | $2,843 | $3,946 |
| Level 1 Nerve ProceduresAPC 5431 | 108 | 95 | $11,048 | $1,284 | $1,407 |
| Level 2 Vascular ProceduresAPC 5182 | 107 | 104 | $7,830 | $1,001 | $1,204 |
| Level 5 Airway EndoscopyAPC 5155 | 100 | 97 | $46,577 | $4,507 | $5,183 |
| Level 2 Endovascular ProceduresAPC 5192 | 91 | 79 | $35,094 | $3,720 | $4,338 |
| Level 3 Lower GI ProceduresAPC 5313 | 84 | 78 | $21,146 | $1,787 | $2,176 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 82 | 74 | $32,431 | $2,023 | $2,373 |
| Complex GI ProceduresAPC 5331 | 76 | 60 | $36,450 | $3,736 | $4,263 |
| Level 4 ENT ProceduresAPC 5164 | 68 | 56 | $20,093 | $2,141 | $2,217 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 67 | 48 | $25,528 | $2,266 | $2,636 |
| Level 4 Gynecologic ProceduresAPC 5414 | 61 | 61 | $28,655 | $2,008 | $2,389 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 51 | 51 | $55,613 | $7,278 | $8,569 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 50 | 50 | $94,641 | $13,339 | $15,763 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 48 | 48 | $132,338 | $25,216 | $29,375 |
| Level 7 Radiation TherapyAPC 5627 | 48 | 44 | $70,060 | $5,071 | $6,121 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 46 | 46 | $58,688 | $4,243 | $4,982 |
| Level 6 Gynecologic ProceduresAPC 5416 | 46 | 46 | $49,225 | $5,023 | $5,836 |
| Level 4 Endovascular ProceduresAPC 5194 | 45 | 44 | $95,937 | $11,825 | $14,606 |
| Level 3 Upper GI ProceduresAPC 5303 | 45 | 44 | $28,164 | $2,519 | $2,888 |
| Level 5 Gynecologic ProceduresAPC 5415 | 44 | 43 | $35,065 | $3,251 | $3,792 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 42 | 42 | $26,839 | $5,651 | $6,514 |
| Level 3 ENT ProceduresAPC 5163 | 40 | 32 | $11,834 | $1,014 | $1,106 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 37 | 37 | $92,019 | $22,908 | $26,719 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 36 | 36 | $39,954 | $2,394 | $2,930 |
| Level 8 Urology and Related ServicesAPC 5378 | 29 | 27 | $62,039 | $13,622 | $17,428 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 27 | 27 | $21,121 | $966 | $1,196 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 25 | 24 | $95,879 | $14,122 | $17,052 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 20 | 18 | $29,114 | $4,321 | $4,524 |
| Cochlear Implant ProcedureAPC 5166 | 16 | 16 | $73,731 | $26,281 | $29,489 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 12 | 12 | $67,172 | $4,967 | $5,682 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 12 | 11 | $66,995 | $15,766 | $18,465 |
| Level 6 Urology and Related ServicesAPC 5376 | 11 | 11 | $41,046 | $6,127 | $7,291 |
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.