University Of Chicago Hospitals Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for University Of Chicago Hospitals, Chicago, IL in 2024, from traditional Medicare claims. Back to the University Of Chicago Hospitals profile, with quality ratings, finances and negotiated rates.
5,502
Medicare inpatient discharges
In 169 published DRGs
2.89
Case mix index
IPPS FY 2027
27%
Surgical stays
70%
Stays with complications
In DRGs with a CC or MCC
7,442
Medicare outpatient services
In 53 service groups
Inpatient stays by major diagnostic category
Circulatory system1,238 discharges in 30 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 247 | $78,214 | $13,843 | $14,078 | 1.28 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 71 | $232,518 | $52,171 | $41,853 | 4.88 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 67 | $173,790 | $22,700 | $31,282 | 2.16 |
| Syncope and collapseMS-DRG 312, medical | 63 | $51,569 | $9,396 | $9,282 | 0.86 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 59 | $163,571 | $22,917 | $29,443 | 2.09 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 58 | $46,697 | $7,454 | $8,405 | 0.74 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 57 | $371,324 | $75,599 | $66,838 | 7.71 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 57 | $233,894 | $38,347 | $42,101 | 4.04 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 49 | $114,211 | $17,730 | $20,558 | 1.59 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 47 | $68,737 | $11,840 | $12,373 | 1.20 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 40 | $175,629 | $35,676 | $31,613 | 3.24 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 39 | $72,304 | $10,515 | $13,015 | 0.97 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 35 | $216,283 | $37,945 | $38,931 | 3.35 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 33 | $329,526 | $56,775 | $59,315 | 5.88 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 28 | $455,170 | $71,896 | $81,931 | 6.25 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 28 | $66,022 | $10,759 | $11,884 | 1.07 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 27 | $215,259 | $29,396 | $38,747 | 2.87 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 24 | $335,909 | $54,026 | $60,464 | 5.24 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 24 | $110,852 | $12,143 | $19,953 | 1.08 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 23 | $35,970 | $5,506 | $6,475 | 0.55 |
| Hypertension with MCCMS-DRG 304, medical | 22 | $70,935 | $12,431 | $12,768 | 1.15 |
| Other vascular procedures with CCMS-DRG 253, surgical | 19 | $185,531 | $28,141 | $33,396 | 2.55 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 19 | $438,356 | $60,434 | $78,904 | 5.06 |
| Heart failure and shock with CCMS-DRG 292, medical | 18 | $101,766 | $9,668 | $18,318 | 0.86 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 18 | $78,223 | $16,642 | $14,080 | 1.58 |
| Chest painMS-DRG 313, medical | 17 | $36,115 | $7,810 | $6,501 | 0.72 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 13 | $440,147 | $60,908 | $79,227 | 7.80 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 13 | $179,252 | $40,367 | $32,265 | 3.27 |
| Hypertension without MCCMS-DRG 305, medical | 12 | $38,106 | $7,953 | $6,859 | 0.75 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 11 | $230,991 | $34,775 | $41,578 | 3.46 |
Respiratory system684 discharges in 21 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 88 | $107,269 | $17,104 | $19,308 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 68 | $93,862 | $13,713 | $16,895 | 1.33 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 66 | $116,224 | $13,931 | $20,920 | 1.10 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 51 | $104,906 | $13,799 | $18,883 | 1.23 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 42 | $50,552 | $9,183 | $9,099 | 0.85 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 41 | $216,114 | $28,154 | $38,901 | 2.70 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 40 | $53,768 | $8,428 | $9,678 | 0.82 |
| Major chest procedures with CCMS-DRG 164, surgical | 37 | $149,154 | $26,362 | $26,848 | 2.55 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 31 | $84,349 | $11,170 | $15,183 | 0.99 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 27 | $106,534 | $14,061 | $19,176 | 1.40 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 27 | $77,375 | $16,642 | $13,928 | 1.81 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 23 | $63,086 | $8,083 | $11,355 | 0.82 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 23 | $182,022 | $17,321 | $32,764 | 1.74 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 22 | $73,681 | $9,938 | $13,263 | 0.96 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 19 | $140,233 | $19,081 | $25,242 | 1.88 |
| Major chest procedures with MCCMS-DRG 163, surgical | 16 | $265,340 | $48,922 | $47,761 | 4.71 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 15 | $252,189 | $40,014 | $45,394 | 4.06 |
| Respiratory neoplasms with CCMS-DRG 181, medical | 13 | $49,902 | $11,103 | $8,982 | 1.10 |
| Pneumothorax with CCMS-DRG 200, medical | 12 | $90,618 | $12,644 | $16,311 | 1.08 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 12 | $453,165 | $75,313 | $81,570 | 6.91 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 11 | $77,796 | $19,108 | $14,003 | 1.90 |
Digestive system586 discharges in 17 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 79 | $74,834 | $10,558 | $13,470 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 75 | $57,660 | $8,143 | $10,379 | 0.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 58 | $181,458 | $25,640 | $32,662 | 2.37 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 49 | $157,600 | $21,833 | $28,368 | 1.79 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 49 | $53,679 | $9,469 | $9,662 | 0.94 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 36 | $81,047 | $13,058 | $14,588 | 1.28 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 30 | $52,749 | $8,547 | $9,495 | 0.80 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 30 | $115,234 | $18,157 | $20,742 | 1.62 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 28 | $324,538 | $48,246 | $58,417 | 4.52 |
| Digestive malignancy with CCMS-DRG 375, medical | 23 | $69,497 | $12,976 | $12,509 | 1.20 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 23 | $96,274 | $13,677 | $17,329 | 1.45 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 22 | $67,406 | $9,799 | $12,133 | 1.04 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 19 | $85,922 | $17,000 | $15,466 | 1.75 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 18 | $326,236 | $51,852 | $58,723 | 5.08 |
| Digestive malignancy with MCCMS-DRG 374, medical | 17 | $102,009 | $21,911 | $18,362 | 2.10 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 16 | $156,258 | $27,037 | $28,126 | 2.50 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 14 | $104,069 | $17,753 | $18,732 | 1.67 |
Kidney and urinary tract572 discharges in 15 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 90 | $62,630 | $10,806 | $11,273 | 1.02 |
| Renal failure with CCMS-DRG 683, medical | 76 | $56,022 | $9,211 | $10,084 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 65 | $108,260 | $17,182 | $19,487 | 1.65 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 60 | $56,829 | $7,985 | $10,229 | 0.81 |
| Renal failure with MCCMS-DRG 682, medical | 55 | $97,421 | $14,429 | $17,536 | 1.50 |
| Kidney transplantMS-DRG 652, surgical | 50 | $414,461 | $34,106 | $74,603 | 3.00 |
| Kidney transplant with hemodialysis with MCCMS-DRG 650, surgical | 25 | $552,357 | $51,060 | $99,424 | 4.50 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 23 | $81,278 | $13,328 | $14,630 | 1.17 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 22 | $124,052 | $16,273 | $22,329 | 1.84 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 21 | $126,097 | $13,790 | $22,698 | 1.35 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 19 | $220,387 | $29,490 | $39,670 | 2.59 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 19 | $222,743 | $40,496 | $40,094 | 3.70 |
| Kidney transplant with hemodialysis without MCCMS-DRG 651, surgical | 18 | $433,509 | $35,851 | $78,032 | 3.46 |
| Major bladder procedures with CCMS-DRG 654, surgical | 16 | $261,887 | $21,989 | $47,140 | 2.74 |
| Kidney and ureter procedures for neoplasm without cc/mccMS-DRG 658, surgical | 13 | $107,818 | $14,536 | $19,407 | 1.48 |
Nervous system490 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 78 | $158,649 | $22,848 | $28,557 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 46 | $96,280 | $10,531 | $17,330 | 1.02 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 44 | $345,359 | $61,403 | $62,165 | 5.67 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 39 | $348,867 | $51,158 | $62,796 | 4.42 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 31 | $89,165 | $14,163 | $16,050 | 1.36 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 31 | $55,360 | $11,301 | $9,965 | 1.03 |
| Seizures without MCCMS-DRG 101, medical | 31 | $53,980 | $9,072 | $9,716 | 0.91 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 28 | $115,606 | $22,862 | $20,809 | 2.39 |
| Seizures with MCCMS-DRG 100, medical | 22 | $124,563 | $19,770 | $22,421 | 1.98 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 21 | $97,928 | $9,920 | $17,627 | 1.03 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 18 | $125,247 | $17,238 | $22,544 | 1.47 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 15 | $163,026 | $21,938 | $29,345 | 2.28 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 14 | $73,884 | $13,687 | $13,299 | 1.32 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 13 | $72,848 | $11,438 | $13,113 | 1.06 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 13 | $172,543 | $22,581 | $31,058 | 1.79 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 12 | $251,430 | $26,989 | $45,257 | 2.95 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 12 | $145,854 | $22,125 | $26,254 | 1.79 |
| Intracranial vascular procedures with principal diagnosis hemorrhage with MCCMS-DRG 020, surgical | 11 | $592,792 | $96,200 | $106,703 | 8.45 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 11 | $86,154 | $13,502 | $15,508 | 1.36 |
Infectious and parasitic diseases351 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 | 183 | $160,065 | $21,952 | $28,812 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 73 | $375,162 | $59,714 | $67,529 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 34 | $81,858 | $9,983 | $14,734 | 1.03 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 17 | $91,680 | $15,760 | $16,502 | 1.84 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 16 | $579,385 | $84,934 | $104,289 | 6.96 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 15 | $466,902 | $50,868 | $84,042 | 4.43 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 13 | $62,172 | $10,715 | $11,191 | 1.01 |
Blood cancers and poorly differentiated neoplasms309 discharges in 11 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 | 74 | $73,559 | $13,378 | $13,241 | 1.21 |
| RadiotherapyMS-DRG 849, medical | 59 | $99,248 | $28,107 | $17,865 | 2.69 |
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 33 | $147,417 | $27,122 | $26,535 | 2.44 |
| Acute leukemia with MCCMS-DRG 834, medical | 29 | $446,381 | $66,659 | $80,349 | 5.60 |
| Myeloproliferative disorders or poorly differentiated neoplasms with other procedures wiMS-DRG 829, surgical | 24 | $134,671 | $30,116 | $24,241 | 3.15 |
| Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy aMS-DRG 837, medical | 21 | $183,994 | $54,729 | $33,119 | 4.84 |
| Chemotherapy with acute leukemia as secondary diagnosis with CC or high dose chemotherapMS-DRG 838, medical | 16 | $138,839 | $20,918 | $24,991 | 2.00 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 16 | $187,489 | $34,869 | $33,748 | 3.13 |
| Myeloproliferative disorders or poorly differentiated neoplasms with major o.r. procedurMS-DRG 827, surgical | 15 | $170,975 | $21,989 | $30,776 | 2.32 |
| Lymphoma and non-acute leukemia with other procedures with MCCMS-DRG 823, surgical | 11 | $309,412 | $50,342 | $55,694 | 4.50 |
| Myeloproliferative disorders or poorly differentiated neoplasms with major o.r. procedurMS-DRG 828, surgical | 11 | $118,140 | $15,919 | $21,265 | 1.64 |
Endocrine, nutritional and metabolic259 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 | 107 | $84,085 | $14,037 | $15,135 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 64 | $60,625 | $8,216 | $10,912 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 32 | $54,941 | $8,106 | $9,889 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 26 | $90,201 | $15,078 | $16,236 | 1.45 |
| Endocrine disorders with CCMS-DRG 644, medical | 16 | $68,839 | $10,352 | $12,391 | 1.06 |
| Endocrine disorders with MCCMS-DRG 643, medical | 14 | $103,980 | $17,487 | $18,716 | 1.65 |
Blood and immune system196 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 105 | $61,139 | $9,631 | $11,005 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 36 | $116,628 | $14,414 | $20,993 | 1.40 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 25 | $82,358 | $12,432 | $14,824 | 1.20 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 16 | $195,729 | $29,469 | $35,231 | 2.19 |
| Coagulation disordersMS-DRG 813, medical | 14 | $126,644 | $20,579 | $22,796 | 1.56 |
Musculoskeletal system and connective tissue190 discharges in 10 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 | 38 | $136,156 | $20,204 | $24,508 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 36 | $61,346 | $9,957 | $11,042 | 0.97 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 26 | $237,572 | $33,541 | $42,763 | 3.49 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 17 | $235,026 | $34,424 | $42,305 | 2.95 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 14 | $48,604 | $8,099 | $8,749 | 0.82 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 13 | $181,710 | $28,816 | $32,708 | 2.67 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 12 | $170,900 | $31,793 | $30,762 | 2.96 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 12 | $142,310 | $22,649 | $25,616 | 2.11 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 463, surgical | 11 | $528,912 | $50,089 | $95,204 | 5.66 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 11 | $53,401 | $8,886 | $9,612 | 0.90 |
Transplants, ECMO and tracheostomy (pre-MDC)171 discharges in 6 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 | 48 | $1,235,245 | $227,571 | $222,344 | 21.32 |
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 44 | $1,550,132 | $315,624 | $279,024 | 27.10 |
| Chimeric antigen receptor (car) t-cell and other immunotherapiesMS-DRG 018, medical | 37 | $2,770,449 | $473,302 | $498,681 | 36.84 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 18 | $600,558 | $127,997 | $108,100 | 14.70 |
| Autologous bone marrow transplant with cc/mccMS-DRG 016, medical | 13 | $256,565 | $62,872 | $46,182 | 6.18 |
| Allogeneic bone marrow transplantMS-DRG 014, medical | 11 | $499,399 | $134,420 | $89,892 | 11.46 |
Liver, gallbladder and pancreas113 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 25 | $157,307 | $23,476 | $28,315 | 1.92 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 25 | $107,123 | $19,714 | $19,282 | 1.76 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 21 | $182,347 | $22,364 | $32,822 | 1.83 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 17 | $187,070 | $29,464 | $33,673 | 2.89 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 13 | $77,994 | $10,125 | $14,039 | 0.95 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 12 | $83,675 | $10,279 | $15,062 | 1.09 |
Injuries, poisonings and toxic effects of drugs97 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 34 | $92,848 | $17,165 | $16,713 | 1.60 |
| Complications of treatment with MCCMS-DRG 919, medical | 27 | $133,954 | $19,229 | $24,112 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 24 | $69,615 | $10,347 | $12,531 | 1.03 |
| Poisoning and toxic effects of drugs without MCCMS-DRG 918, medical | 12 | $43,974 | $9,122 | $7,915 | 0.86 |
Other74 discharges in 3 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 | 38 | $384,320 | $61,797 | $69,178 | 4.74 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 19 | $240,854 | $38,347 | $43,354 | 3.38 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 17 | $199,460 | $28,685 | $35,903 | 2.49 |
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 | 38 | $54,280 | $8,905 | $9,770 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 19 | $75,114 | $14,918 | $13,520 | 1.49 |
| Minor skin disorders without MCCMS-DRG 607, medical | 13 | $56,833 | $9,537 | $10,230 | 0.89 |
Factors influencing health status29 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 | 29 | $58,257 | $8,665 | $10,486 | 0.80 |
Mental diseases and disorders24 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 | 24 | $87,467 | $18,339 | $15,744 | 1.76 |
Ear, nose, mouth and throat23 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 12 | $51,281 | $7,842 | $9,231 | 0.74 |
| Major head and neck procedures with CCMS-DRG 141, surgical | 11 | $195,539 | $21,499 | $35,197 | 2.07 |
Female reproductive system14 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Uterine and adnexa procedures for ovarian or adnexal malignancy with CCMS-DRG 737, surgical | 14 | $161,287 | $21,300 | $29,032 | 1.97 |
Alcohol and drug use12 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 | 12 | $57,596 | $8,276 | $10,367 | 0.86 |
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 | 805 | 436 | $6,232 | $520 | $502 |
| Level 3 Urology and Related ServicesAPC 5373 | 611 | 435 | $20,579 | $1,525 | $1,516 |
| Comprehensive Observation ServicesAPC 8011 | 501 | 443 | $35,765 | $2,101 | $2,090 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 495 | 355 | $30,106 | $2,149 | $2,141 |
| Level 1 Intraocular ProceduresAPC 5491 | 411 | 279 | $24,954 | $1,788 | $1,752 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 383 | 348 | $17,252 | $1,213 | $1,220 |
| Level 2 Upper GI ProceduresAPC 5302 | 341 | 275 | $21,416 | $1,425 | $1,445 |
| Level 3 Vascular ProceduresAPC 5183 | 308 | 254 | $28,101 | $2,385 | $2,405 |
| Level 1 Endovascular ProceduresAPC 5191 | 253 | 244 | $29,835 | $2,197 | $2,208 |
| Level 4 Urology and Related ServicesAPC 5374 | 221 | 171 | $31,795 | $2,664 | $2,629 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 213 | 203 | $95,269 | $10,835 | $10,772 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 172 | 171 | $97,430 | $8,369 | $8,164 |
| Level 4 Airway EndoscopyAPC 5154 | 167 | 138 | $43,736 | $2,867 | $2,833 |
| Level 3 Airway EndoscopyAPC 5153 | 142 | 119 | $14,111 | $1,287 | $1,264 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 140 | 137 | $64,238 | $4,439 | $4,358 |
| Level 5 Urology and Related ServicesAPC 5375 | 140 | 121 | $55,926 | $3,952 | $3,918 |
| Level 3 Endovascular ProceduresAPC 5193 | 136 | 119 | $90,608 | $8,824 | $8,874 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 128 | 124 | $67,515 | $5,457 | $5,339 |
| Level 2 Endovascular ProceduresAPC 5192 | 119 | 103 | $51,894 | $4,219 | $4,338 |
| Level 5 Airway EndoscopyAPC 5155 | 115 | 114 | $64,814 | $5,258 | $5,183 |
| Level 5 ENT ProceduresAPC 5165 | 114 | 112 | $62,068 | $4,438 | $4,436 |
| Level 4 Vascular ProceduresAPC 5184 | 108 | 103 | $50,472 | $4,140 | $3,946 |
| Level 1 Nerve ProceduresAPC 5431 | 107 | 90 | $16,892 | $1,482 | $1,407 |
| Level 2 Intraocular ProceduresAPC 5492 | 80 | 70 | $39,046 | $3,032 | $3,116 |
| Level 2 Vascular ProceduresAPC 5182 | 79 | 77 | $11,579 | $1,209 | $1,204 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 78 | 42 | $30,693 | $2,681 | $2,636 |
| Level 4 Gynecologic ProceduresAPC 5414 | 73 | 71 | $35,512 | $2,403 | $2,389 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 72 | 72 | $70,906 | $4,913 | $4,982 |
| Level 3 Lower GI ProceduresAPC 5313 | 72 | 69 | $27,946 | $2,139 | $2,176 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 70 | 70 | $190,881 | $19,877 | $21,117 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 69 | 63 | $48,440 | $2,868 | $2,930 |
| Complex GI ProceduresAPC 5331 | 55 | 42 | $61,364 | $4,252 | $4,263 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 52 | 50 | $45,778 | $2,407 | $2,373 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 50 | 50 | $134,945 | $16,119 | $15,763 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 46 | 44 | $27,553 | $1,811 | $1,780 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 44 | 42 | $16,694 | $1,245 | $1,196 |
| Level 5 Gynecologic ProceduresAPC 5415 | 40 | 40 | $42,643 | $3,854 | $3,792 |
| Level 4 Endovascular ProceduresAPC 5194 | 39 | 37 | $97,442 | $14,400 | $14,606 |
| Level 3 Upper GI ProceduresAPC 5303 | 39 | 37 | $42,813 | $2,968 | $2,888 |
| Level 3 ENT ProceduresAPC 5163 | 37 | 29 | $14,114 | $1,148 | $1,106 |
| Level 6 Urology and Related ServicesAPC 5376 | 37 | 37 | $63,259 | $7,324 | $7,291 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 36 | 36 | $61,039 | $5,296 | $4,524 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 35 | 35 | $227,222 | $27,665 | $26,719 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 33 | 33 | $240,545 | $30,268 | $29,375 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 28 | 28 | $47,457 | $6,620 | $6,514 |
| Level 4 ENT ProceduresAPC 5164 | 27 | 27 | $40,008 | $2,403 | $2,217 |
| Level 7 Radiation TherapyAPC 5627 | 25 | 25 | $59,838 | $6,034 | $6,121 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 22 | 22 | $82,089 | $8,347 | $8,569 |
| Level 8 Urology and Related ServicesAPC 5378 | 20 | 20 | $187,966 | $17,940 | $17,428 |
| Level 4 Extraocular, Repair, and Plastic Eye ProceduresAPC 5504 | 17 | 15 | $45,134 | $2,644 | $2,969 |
| Level 6 Gynecologic ProceduresAPC 5416 | 13 | 13 | $69,686 | $5,847 | $5,836 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 13 | 13 | $169,188 | $18,083 | $18,465 |
| Cochlear Implant ProcedureAPC 5166 | 11 | 11 | $235,829 | $30,883 | $29,489 |
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.