University Of Iowa Hosp & Clinics Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for University Of Iowa Hosp & Clinics, Iowa City, IA in 2024, from traditional Medicare claims. Back to the University Of Iowa Hosp & Clinics profile, with quality ratings, finances and negotiated rates.
6,003
Medicare inpatient discharges
In 195 published DRGs
2.83
Case mix index
IPPS FY 2027
43%
Surgical stays
73%
Stays with complications
In DRGs with a CC or MCC
13,344
Medicare outpatient services
In 59 service groups
Inpatient stays by major diagnostic category
Circulatory system1,167 discharges in 32 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 158 | $76,938 | $11,373 | $18,004 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 103 | $100,703 | $26,706 | $23,565 | 3.24 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 67 | $217,216 | $53,838 | $50,828 | 6.25 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 64 | $286,390 | $64,647 | $67,015 | 7.71 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 56 | $159,349 | $41,152 | $37,288 | 4.88 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 55 | $124,161 | $18,378 | $29,054 | 2.16 |
| Other vascular procedures with CCMS-DRG 253, surgical | 49 | $146,182 | $23,254 | $34,207 | 2.55 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 49 | $34,165 | $5,298 | $7,995 | 0.74 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 48 | $210,736 | $44,453 | $49,312 | 5.88 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 41 | $279,288 | $49,012 | $65,353 | 5.06 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 40 | $107,670 | $17,458 | $25,195 | 2.09 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 37 | $156,669 | $26,077 | $36,661 | 2.87 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 30 | $99,174 | $13,397 | $23,207 | 1.59 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 29 | $48,527 | $9,891 | $11,355 | 1.20 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 27 | $203,363 | $29,434 | $47,587 | 3.35 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 24 | $187,235 | $36,593 | $43,813 | 4.16 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 23 | $64,066 | $8,582 | $14,991 | 1.08 |
| Heart failure and shock with CCMS-DRG 292, medical | 23 | $63,061 | $7,505 | $14,756 | 0.86 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 22 | $104,662 | $27,744 | $24,491 | 3.46 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 22 | $56,934 | $8,731 | $13,323 | 1.07 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 22 | $111,061 | $14,761 | $25,988 | 1.82 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 21 | $67,415 | $6,795 | $15,775 | 0.91 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 21 | $100,426 | $8,959 | $23,500 | 0.97 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 20 | $174,293 | $32,998 | $40,784 | 3.90 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 17 | $198,786 | $44,181 | $46,516 | 5.04 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 17 | $91,909 | $16,316 | $21,507 | 2.28 |
| Syncope and collapseMS-DRG 312, medical | 16 | $50,113 | $6,319 | $11,726 | 0.86 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 14 | $135,069 | $29,069 | $31,606 | 3.46 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 14 | $35,745 | $3,937 | $8,364 | 0.55 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 13 | $301,454 | $65,645 | $70,540 | 7.80 |
| Other vascular procedures without cc/mccMS-DRG 254, surgical | 13 | $90,225 | $13,004 | $21,113 | 1.74 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 12 | $90,392 | $12,844 | $21,152 | 1.58 |
Nervous system967 discharges in 24 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 148 | $96,035 | $16,210 | $22,472 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 143 | $68,610 | $8,096 | $16,055 | 1.02 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 136 | $163,600 | $35,117 | $38,282 | 4.42 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 55 | $247,145 | $50,721 | $57,832 | 5.67 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 48 | $102,032 | $18,549 | $23,875 | 2.43 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 38 | $102,829 | $18,758 | $24,062 | 2.28 |
| Seizures without MCCMS-DRG 101, medical | 36 | $46,350 | $6,528 | $10,846 | 0.91 |
| Seizures with MCCMS-DRG 100, medical | 35 | $135,172 | $19,438 | $31,630 | 1.98 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 33 | $67,070 | $10,688 | $15,694 | 1.36 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 31 | $104,490 | $13,939 | $24,451 | 1.47 |
| Intracranial vascular procedures with principal diagnosis hemorrhage with MCCMS-DRG 020, surgical | 26 | $268,798 | $70,445 | $62,899 | 8.45 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 26 | $131,567 | $24,759 | $30,787 | 2.95 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 26 | $63,298 | $15,039 | $14,812 | 1.81 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 22 | $71,995 | $11,015 | $16,847 | 1.36 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 22 | $70,407 | $8,346 | $16,475 | 1.03 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 21 | $40,053 | $5,188 | $9,372 | 0.69 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 19 | $154,859 | $30,547 | $36,237 | 3.79 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 17 | $68,060 | $8,884 | $15,926 | 1.14 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 17 | $102,271 | $16,440 | $23,931 | 1.79 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 16 | $88,835 | $15,118 | $20,787 | 1.79 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 15 | $86,339 | $19,087 | $20,203 | 2.30 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 13 | $95,164 | $19,982 | $22,268 | 2.39 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 13 | $63,920 | $8,328 | $14,957 | 1.06 |
| Spinal procedures with CC or spinal neurostimulatorsMS-DRG 029, surgical | 11 | $176,913 | $31,283 | $41,398 | 3.43 |
Musculoskeletal system and connective tissue696 discharges in 24 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 94 | $144,189 | $29,378 | $33,740 | 3.66 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 84 | $100,012 | $16,519 | $23,403 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 49 | $49,516 | $7,241 | $11,587 | 0.97 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 45 | $156,548 | $50,120 | $36,632 | 6.12 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 40 | $131,117 | $23,580 | $30,681 | 2.96 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 457, surgical | 38 | $209,780 | $46,198 | $49,089 | 6.08 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 34 | $147,888 | $28,441 | $34,606 | 3.49 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 34 | $82,160 | $15,454 | $19,226 | 1.88 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 30 | $131,533 | $21,822 | $30,779 | 2.95 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 30 | $99,195 | $16,846 | $23,212 | 2.11 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 26 | $110,093 | $19,426 | $25,762 | 2.40 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 24 | $118,533 | $20,560 | $27,737 | 2.48 |
| Medical back problems with MCCMS-DRG 551, medical | 21 | $101,434 | $14,909 | $23,736 | 1.70 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 17 | $106,807 | $16,957 | $24,993 | 1.97 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 17 | $114,216 | $15,032 | $26,727 | 1.82 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 15 | $90,787 | $23,089 | $21,244 | 3.00 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 463, surgical | 13 | $184,132 | $36,742 | $43,087 | 5.66 |
| Amputation for musculoskeletal system and connective tissue disorders with CCMS-DRG 475, surgical | 13 | $88,038 | $17,194 | $20,601 | 2.14 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 13 | $117,486 | $23,997 | $27,492 | 2.99 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 13 | $84,416 | $8,686 | $19,753 | 1.09 |
| Spinal fusion except cervical with MCCMS-DRG 459, surgical | 12 | $225,689 | $52,549 | $52,811 | 6.63 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 12 | $192,225 | $25,935 | $44,981 | 3.46 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 11 | $99,221 | $21,980 | $23,218 | 2.67 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 11 | $51,782 | $6,629 | $12,117 | 0.90 |
Digestive system571 discharges in 20 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 | 61 | $81,218 | $18,639 | $19,005 | 2.37 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 53 | $84,960 | $15,590 | $19,881 | 1.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 51 | $55,057 | $7,828 | $12,883 | 0.98 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 47 | $188,528 | $38,351 | $44,115 | 4.52 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 37 | $33,729 | $7,646 | $7,892 | 0.94 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 35 | $40,580 | $5,709 | $9,496 | 0.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 34 | $58,902 | $9,765 | $13,783 | 1.28 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 30 | $237,612 | $42,671 | $55,601 | 5.08 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 28 | $87,607 | $13,478 | $20,500 | 1.62 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 24 | $61,859 | $7,653 | $14,475 | 0.80 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 23 | $202,698 | $38,353 | $47,431 | 4.28 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 22 | $82,693 | $12,369 | $19,350 | 1.45 |
| Other digestive system o.r. procedures with CCMS-DRG 357, surgical | 21 | $104,248 | $18,863 | $24,394 | 2.20 |
| Digestive malignancy with MCCMS-DRG 374, medical | 18 | $79,946 | $16,224 | $18,707 | 2.10 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 17 | $56,249 | $13,381 | $13,162 | 1.67 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 16 | $124,163 | $20,589 | $29,054 | 2.50 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 15 | $37,540 | $8,267 | $8,784 | 1.04 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 14 | $73,203 | $12,875 | $17,130 | 1.60 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 14 | $65,221 | $13,613 | $15,262 | 1.75 |
| Complicated peptic ulcer with MCCMS-DRG 380, medical | 11 | $61,541 | $14,842 | $14,401 | 1.95 |
Respiratory system545 discharges in 15 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 148 | $77,225 | $10,688 | $18,071 | 1.23 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 60 | $66,171 | $10,896 | $15,484 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 55 | $68,240 | $13,416 | $15,968 | 1.70 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 54 | $108,927 | $23,439 | $25,489 | 2.70 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 45 | $60,097 | $10,779 | $14,063 | 1.40 |
| Major chest procedures with CCMS-DRG 164, surgical | 31 | $92,174 | $20,315 | $21,569 | 2.55 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 22 | $100,154 | $14,152 | $23,436 | 1.74 |
| Major chest procedures with MCCMS-DRG 163, surgical | 21 | $143,459 | $37,370 | $33,569 | 4.71 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 20 | $96,836 | $15,403 | $22,660 | 1.81 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 19 | $63,513 | $8,677 | $14,862 | 1.10 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 18 | $39,825 | $5,802 | $9,319 | 0.82 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 16 | $70,908 | $14,285 | $16,592 | 1.88 |
| Major chest trauma with CCMS-DRG 184, medical | 13 | $65,534 | $8,185 | $15,335 | 1.05 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 12 | $272,359 | $63,582 | $63,732 | 6.91 |
| Pneumothorax with MCCMS-DRG 199, medical | 11 | $85,588 | $15,323 | $20,028 | 1.77 |
Kidney and urinary tract451 discharges in 15 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with CCMS-DRG 683, medical | 48 | $47,724 | $6,627 | $11,167 | 0.90 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 45 | $44,287 | $6,472 | $10,363 | 0.81 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 40 | $61,562 | $10,600 | $14,405 | 1.35 |
| Renal failure with MCCMS-DRG 682, medical | 39 | $79,386 | $12,650 | $18,576 | 1.50 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 37 | $92,376 | $15,009 | $21,616 | 1.84 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 36 | $76,616 | $10,387 | $17,928 | 1.17 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 36 | $39,794 | $8,369 | $9,312 | 1.02 |
| Major bladder procedures with CCMS-DRG 654, surgical | 34 | $133,170 | $21,895 | $31,162 | 2.74 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 34 | $48,221 | $13,327 | $11,284 | 1.65 |
| Kidney transplantMS-DRG 652, surgical | 27 | $295,561 | $22,273 | $69,161 | 3.00 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 22 | $98,694 | $19,218 | $23,094 | 2.59 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 16 | $203,348 | $31,031 | $47,583 | 3.70 |
| Kidney and ureter procedures for neoplasm with MCCMS-DRG 656, surgical | 13 | $128,977 | $24,794 | $30,181 | 3.14 |
| Kidney and ureter procedures for neoplasm without cc/mccMS-DRG 658, surgical | 13 | $80,306 | $11,881 | $18,792 | 1.48 |
| Major bladder procedures with MCCMS-DRG 653, surgical | 11 | $270,267 | $50,030 | $63,243 | 5.41 |
Infectious and parasitic diseases428 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 | 230 | $98,391 | $16,565 | $23,024 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 84 | $215,545 | $45,777 | $50,438 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 35 | $58,554 | $7,810 | $13,702 | 1.03 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 20 | $201,045 | $41,224 | $47,045 | 4.43 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 17 | $48,847 | $6,660 | $11,430 | 1.01 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 15 | $79,344 | $17,525 | $18,566 | 2.04 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 15 | $113,089 | $17,202 | $26,463 | 2.14 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 12 | $286,056 | $56,286 | $66,937 | 6.96 |
Liver, gallbladder and pancreas254 discharges in 13 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of the biliary tract with CCMS-DRG 445, medical | 35 | $65,946 | $8,307 | $15,431 | 1.09 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 32 | $69,384 | $12,352 | $16,236 | 1.63 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 25 | $68,228 | $14,369 | $15,965 | 1.76 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 21 | $41,233 | $6,483 | $9,648 | 0.95 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 20 | $95,175 | $13,297 | $22,271 | 1.63 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 19 | $95,547 | $14,764 | $22,358 | 1.83 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 18 | $255,265 | $55,565 | $59,732 | 5.51 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 18 | $132,745 | $24,636 | $31,062 | 2.89 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 16 | $114,639 | $11,717 | $26,825 | 1.67 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 15 | $41,650 | $6,139 | $9,746 | 0.86 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 13 | $93,798 | $15,892 | $21,949 | 1.92 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 11 | $104,347 | $19,817 | $24,417 | 2.32 |
| Malignancy of hepatobiliary system or pancreas with CCMS-DRG 436, medical | 11 | $64,527 | $7,869 | $15,099 | 1.10 |
Blood cancers and poorly differentiated neoplasms199 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 | 74 | $45,797 | $8,947 | $10,717 | 1.21 |
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 27 | $67,655 | $18,157 | $15,831 | 2.44 |
| Acute leukemia with MCCMS-DRG 834, medical | 22 | $163,997 | $47,800 | $38,375 | 5.60 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 18 | $126,770 | $27,450 | $29,664 | 3.13 |
| Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy aMS-DRG 837, medical | 17 | $182,552 | $47,825 | $42,717 | 4.84 |
| Myeloproliferative disorders or poorly differentiated neoplasms with other procedures wiMS-DRG 829, surgical | 14 | $114,037 | $27,376 | $26,685 | 3.15 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 14 | $94,816 | $12,204 | $22,187 | 1.57 |
| Myeloproliferative disorders or poorly differentiated neoplasms with major o.r. procedurMS-DRG 827, surgical | 13 | $134,339 | $19,234 | $31,435 | 2.32 |
Endocrine, nutritional and metabolic127 discharges in 4 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 | 49 | $77,101 | $10,341 | $18,042 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 45 | $56,471 | $5,890 | $13,214 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 18 | $79,877 | $11,071 | $18,691 | 1.45 |
| Diabetes with CCMS-DRG 638, medical | 15 | $54,250 | $6,945 | $12,694 | 0.90 |
Transplants, ECMO and tracheostomy (pre-MDC)104 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Chimeric antigen receptor (car) t-cell and other immunotherapiesMS-DRG 018, medical | 50 | $2,089,368 | $442,988 | $488,912 | 36.84 |
| ECMO or tracheostomy with MV >96 hours or principal diagnosis except face, mouth and necMS-DRG 003, surgical | 15 | $585,132 | $164,655 | $136,921 | 21.32 |
| Tracheostomy for face, mouth and neck diagnoses or laryngectomy with CCMS-DRG 012, surgical | 15 | $212,287 | $33,221 | $49,675 | 4.00 |
| Tracheostomy for face, mouth and neck diagnoses or laryngectomy with MCCMS-DRG 011, surgical | 13 | $291,581 | $46,436 | $68,230 | 5.16 |
| Autologous bone marrow transplant with cc/mccMS-DRG 016, medical | 11 | $224,908 | $52,227 | $52,629 | 6.18 |
Other104 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 | 33 | $201,149 | $39,428 | $47,069 | 4.74 |
| Multiple level spinal fusion except cervical without MCCMS-DRG 448 | 23 | $141,470 | $34,303 | $33,104 | |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 19 | $104,879 | $19,277 | $24,542 | 2.49 |
| Multiple level combined anterior and posterior spinal fusion except cervical with CCMS-DRG 427 | 16 | $199,152 | $56,522 | $46,602 | |
| Single level spinal fusion except cervical without MCCMS-DRG 451 | 13 | $132,608 | $26,088 | $31,030 |
Blood and immune system100 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 | 36 | $37,132 | $7,251 | $8,689 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 19 | $115,428 | $14,959 | $27,010 | 1.40 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 17 | $100,169 | $21,095 | $23,440 | 2.19 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 16 | $46,219 | $9,673 | $10,815 | 1.20 |
| Coagulation disordersMS-DRG 813, medical | 12 | $338,246 | $103,465 | $79,150 | 1.56 |
Injuries, poisonings and toxic effects of drugs95 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 | $67,785 | $14,141 | $15,862 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 25 | $48,452 | $8,427 | $11,338 | 1.03 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 15 | $100,012 | $16,675 | $23,403 | 2.00 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 14 | $171,790 | $32,907 | $40,199 | 3.72 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 13 | $112,479 | $13,964 | $26,320 | 1.60 |
Multiple significant trauma59 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other multiple significant trauma with CCMS-DRG 964, medical | 16 | $103,579 | $10,982 | $24,237 | 1.50 |
| Other o.r. procedures for multiple significant trauma with MCCMS-DRG 957, surgical | 15 | $358,640 | $59,862 | $83,922 | 7.23 |
| Other multiple significant trauma with MCCMS-DRG 963, medical | 15 | $159,749 | $25,161 | $37,381 | 2.73 |
| Limb reattachment, hip and femur procedures for multiple significant traumaMS-DRG 956, surgical | 13 | $205,205 | $33,973 | $48,018 | 3.88 |
Skin, subcutaneous tissue and breast44 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 32 | $41,555 | $6,018 | $9,724 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 12 | $83,152 | $12,525 | $19,458 | 1.49 |
Burns31 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Full thickness burn with skin graft or inhalation injury with cc/mccMS-DRG 928, surgical | 18 | $217,015 | $55,076 | $50,781 | 6.92 |
| Non-extensive burnsMS-DRG 935, medical | 13 | $108,506 | $18,859 | $25,390 | 2.04 |
Alcohol and drug use19 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 | 19 | $34,328 | $7,095 | $8,033 | 0.86 |
Female reproductive system18 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 | 18 | $90,195 | $16,269 | $21,106 | 1.97 |
Ear, nose, mouth and throat13 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major head and neck procedures with CCMS-DRG 141, surgical | 13 | $120,269 | $17,412 | $28,143 | 2.07 |
Factors influencing health status11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms with MCCMS-DRG 947, medical | 11 | $103,395 | $9,968 | $24,194 | 1.25 |
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 | 3,128 | 1,056 | $7,443 | $470 | $502 |
| Level 1 Intraocular ProceduresAPC 5491 | 845 | 606 | $11,855 | $1,631 | $1,752 |
| Level 3 Urology and Related ServicesAPC 5373 | 689 | 486 | $9,458 | $1,406 | $1,516 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 670 | 629 | $9,430 | $1,122 | $1,220 |
| Comprehensive Observation ServicesAPC 8011 | 626 | 539 | $25,934 | $1,918 | $2,090 |
| Level 2 Upper GI ProceduresAPC 5302 | 520 | 442 | $10,642 | $1,233 | $1,445 |
| Level 2 Intraocular ProceduresAPC 5492 | 477 | 420 | $27,785 | $2,867 | $3,116 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 412 | 333 | $20,226 | $1,954 | $2,141 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 398 | 388 | $110,861 | $19,364 | $21,117 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 344 | 323 | $59,924 | $9,902 | $10,772 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 343 | 323 | $12,694 | $1,646 | $1,780 |
| Level 1 Endovascular ProceduresAPC 5191 | 342 | 338 | $17,491 | $2,032 | $2,208 |
| Level 4 Urology and Related ServicesAPC 5374 | 300 | 241 | $21,023 | $2,440 | $2,629 |
| Level 3 Vascular ProceduresAPC 5183 | 286 | 259 | $17,035 | $2,195 | $2,405 |
| Level 5 Urology and Related ServicesAPC 5375 | 250 | 234 | $27,684 | $3,656 | $3,918 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 241 | 238 | $57,912 | $7,488 | $8,164 |
| Level 5 ENT ProceduresAPC 5165 | 165 | 162 | $33,998 | $4,139 | $4,436 |
| Level 3 Airway EndoscopyAPC 5153 | 155 | 117 | $7,550 | $1,156 | $1,264 |
| Level 1 Nerve ProceduresAPC 5431 | 155 | 138 | $11,040 | $1,337 | $1,407 |
| Complex GI ProceduresAPC 5331 | 153 | 111 | $35,666 | $3,801 | $4,263 |
| Level 3 Endovascular ProceduresAPC 5193 | 151 | 127 | $56,429 | $7,799 | $8,874 |
| Level 4 Airway EndoscopyAPC 5154 | 138 | 113 | $18,727 | $2,531 | $2,833 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 136 | 134 | $35,420 | $5,087 | $5,339 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 131 | 82 | $15,116 | $2,403 | $2,636 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 131 | 130 | $37,364 | $3,986 | $4,358 |
| Level 2 Vascular ProceduresAPC 5182 | 127 | 121 | $7,021 | $1,109 | $1,204 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 127 | 127 | $41,716 | $7,767 | $8,569 |
| Level 3 Upper GI ProceduresAPC 5303 | 110 | 99 | $21,076 | $2,648 | $2,888 |
| Level 4 Gynecologic ProceduresAPC 5414 | 105 | 102 | $16,230 | $2,157 | $2,389 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 102 | 101 | $86,042 | $14,673 | $15,763 |
| Level 4 Vascular ProceduresAPC 5184 | 97 | 88 | $30,270 | $3,585 | $3,946 |
| Level 3 Intraocular ProceduresAPC 5493 | 97 | 83 | $29,882 | $3,640 | $4,004 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 94 | 92 | $22,455 | $2,253 | $2,373 |
| Level 2 Endovascular ProceduresAPC 5192 | 93 | 78 | $26,237 | $3,933 | $4,338 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 91 | 91 | $78,569 | $25,145 | $26,719 |
| Level 7 Radiation TherapyAPC 5627 | 91 | 78 | $46,760 | $5,537 | $6,121 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 85 | 84 | $87,948 | $27,643 | $29,375 |
| Cochlear Implant ProcedureAPC 5166 | 76 | 74 | $83,772 | $27,129 | $29,489 |
| Level 5 Gynecologic ProceduresAPC 5415 | 74 | 72 | $28,347 | $3,441 | $3,792 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 67 | 67 | $60,215 | $15,717 | $17,052 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 64 | 63 | $8,912 | $1,124 | $1,196 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 58 | 55 | $31,350 | $2,710 | $2,930 |
| Level 6 Gynecologic ProceduresAPC 5416 | 56 | 56 | $32,415 | $5,373 | $5,836 |
| Level 3 ENT ProceduresAPC 5163 | 52 | 34 | $5,585 | $1,062 | $1,106 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 51 | 50 | $60,450 | $16,445 | $18,465 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 48 | 48 | $45,761 | $4,540 | $4,982 |
| Level 4 ENT ProceduresAPC 5164 | 46 | 41 | $17,847 | $2,041 | $2,217 |
| Level 3 Lower GI ProceduresAPC 5313 | 46 | 42 | $14,520 | $1,959 | $2,176 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 45 | 44 | $30,041 | $5,904 | $6,514 |
| Level 4 Endovascular ProceduresAPC 5194 | 44 | 41 | $73,157 | $13,351 | $14,606 |
| Level 4 Extraocular, Repair, and Plastic Eye ProceduresAPC 5504 | 42 | 41 | $23,567 | $2,749 | $2,969 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 41 | 40 | $31,530 | $4,745 | $4,524 |
| Level 5 Airway EndoscopyAPC 5155 | 27 | 27 | $47,803 | $4,687 | $5,183 |
| Level 6 Urology and Related ServicesAPC 5376 | 26 | 26 | $48,899 | $6,336 | $7,291 |
| Level 8 Urology and Related ServicesAPC 5378 | 22 | 22 | $74,492 | $14,846 | $17,428 |
| Level 1 Neurostimulator and Related ProceduresAPC 5461 | 18 | 18 | $22,204 | $2,151 | $2,547 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 13 | 13 | $54,696 | $19,352 | $21,011 |
| Implantation Wireless PA Pressure MonitorAPC 5200 | 12 | 12 | $69,904 | $24,235 | $26,955 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 11 | 11 | $44,404 | $5,311 | $5,682 |
Source: CMS Medicare Outpatient Hospitals by Provider and Service (2024 data, released 2026-06-24), comprehensive APCs for traditional Medicare; CMS omits services with fewer than 11 claims. The US average weights every hospital by its services.