University Of Utah Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for University Of Utah Hospital, Salt Lake City, UT in 2024, from traditional Medicare claims. Back to the University Of Utah Hospital profile, with quality ratings, finances and negotiated rates.
5,085
Medicare inpatient discharges
In 174 published DRGs
2.58
Case mix index
IPPS FY 2027
39%
Surgical stays
70%
Stays with complications
In DRGs with a CC or MCC
11,975
Medicare outpatient services
In 59 service groups
Inpatient stays by major diagnostic category
Circulatory system780 discharges in 26 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 150 | $37,612 | $11,599 | $14,781 | 1.28 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 56 | $152,179 | $40,477 | $59,806 | 4.88 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 47 | $20,578 | $7,026 | $8,087 | 0.74 |
| Syncope and collapseMS-DRG 312, medical | 46 | $27,524 | $8,381 | $10,817 | 0.86 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 40 | $81,827 | $21,853 | $32,158 | 2.16 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 36 | $55,207 | $16,471 | $21,696 | 1.59 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 33 | $59,110 | $20,322 | $23,230 | 2.09 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 32 | $247,026 | $80,728 | $97,081 | 7.71 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 32 | $63,669 | $14,100 | $25,022 | 1.82 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 30 | $63,869 | $17,672 | $25,101 | 1.20 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 28 | $46,467 | $10,320 | $18,261 | 1.08 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 26 | $88,243 | $28,184 | $34,679 | 3.24 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 23 | $88,618 | $25,149 | $34,827 | 2.87 |
| Other vascular procedures with CCMS-DRG 253, surgical | 21 | $93,551 | $26,746 | $36,766 | 2.55 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 19 | $191,118 | $51,571 | $75,109 | 5.24 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 17 | $49,444 | $19,962 | $19,432 | 2.28 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 17 | $35,935 | $9,626 | $14,123 | 0.97 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 16 | $244,564 | $68,184 | $96,114 | 6.25 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 16 | $134,173 | $40,018 | $52,730 | 4.16 |
| Heart failure and shock with CCMS-DRG 292, medical | 16 | $37,889 | $8,173 | $14,890 | 0.86 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 14 | $134,477 | $35,589 | $52,849 | 4.04 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 14 | $127,736 | $38,273 | $50,200 | 3.35 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 14 | $31,656 | $8,320 | $12,441 | 0.91 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 13 | $41,671 | $13,664 | $16,377 | 1.83 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 12 | $33,920 | $10,090 | $13,330 | 1.07 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 12 | $21,323 | $5,260 | $8,380 | 0.55 |
Musculoskeletal system and connective tissue776 discharges in 26 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 131 | $42,423 | $16,362 | $16,672 | 1.88 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 92 | $80,677 | $29,800 | $31,706 | 3.66 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 53 | $92,681 | $29,873 | $36,424 | 3.49 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 46 | $64,771 | $22,483 | $25,455 | 2.48 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 40 | $62,113 | $16,779 | $24,410 | 2.07 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 37 | $83,753 | $23,693 | $32,915 | 2.67 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 34 | $38,116 | $9,917 | $14,980 | 1.09 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 31 | $113,956 | $53,968 | $44,785 | 6.12 |
| Medical back problems without MCCMS-DRG 552, medical | 27 | $30,095 | $9,037 | $11,827 | 0.97 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 26 | $87,344 | $37,993 | $34,326 | 4.61 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 457, surgical | 26 | $118,378 | $47,956 | $46,522 | 6.08 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 25 | $73,396 | $24,764 | $28,845 | 2.96 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 24 | $93,832 | $26,257 | $36,876 | 2.95 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 23 | $57,830 | $21,004 | $22,727 | 2.40 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 22 | $51,441 | $16,182 | $20,216 | 1.82 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 16 | $67,793 | $17,362 | $26,643 | 2.11 |
| Revision of hip or knee replacement with MCCMS-DRG 466, surgical | 14 | $108,268 | $41,441 | $42,549 | 5.19 |
| Major hip and knee joint replacement or reattachment of lower extremity with MCC or totaMS-DRG 469, surgical | 14 | $85,249 | $28,170 | $33,503 | 3.33 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 456, surgical | 13 | $213,161 | $80,092 | $83,772 | 8.43 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 13 | $53,458 | $16,582 | $21,009 | 2.04 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 13 | $30,989 | $7,800 | $12,179 | 0.82 |
| Knee procedures without principal diagnosis of infection without cc/mccMS-DRG 489, surgical | 12 | $34,012 | $11,011 | $13,367 | 1.24 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 11 | $106,677 | $30,539 | $41,924 | 3.00 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 11 | $107,145 | $33,359 | $42,108 | 3.46 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 11 | $41,605 | $16,449 | $16,351 | 1.87 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 11 | $50,012 | $17,222 | $19,655 | 1.97 |
Nervous system585 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 80 | $39,553 | $9,507 | $15,544 | 1.02 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 70 | $121,772 | $38,855 | $47,856 | 4.42 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 56 | $73,812 | $20,132 | $29,008 | 2.00 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 36 | $32,082 | $9,929 | $12,608 | 1.03 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 34 | $151,875 | $53,565 | $59,687 | 5.67 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 30 | $56,060 | $17,638 | $22,032 | 1.79 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 29 | $84,292 | $21,433 | $33,127 | 2.43 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 27 | $27,864 | $6,203 | $10,950 | 0.69 |
| Seizures without MCCMS-DRG 101, medical | 26 | $37,828 | $8,657 | $14,867 | 0.91 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 25 | $22,332 | $11,234 | $8,776 | 1.36 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 22 | $94,361 | $32,541 | $37,084 | 3.79 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 22 | $44,328 | $15,857 | $17,421 | 1.79 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 20 | $56,890 | $13,339 | $22,358 | 1.47 |
| Seizures with MCCMS-DRG 100, medical | 20 | $71,842 | $17,758 | $28,234 | 1.98 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 19 | $87,599 | $23,304 | $34,426 | 2.95 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 18 | $57,437 | $21,302 | $22,573 | 2.39 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 14 | $87,782 | $25,420 | $34,498 | 2.28 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 14 | $41,428 | $12,316 | $16,281 | 1.36 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 12 | $34,598 | $10,087 | $13,597 | 1.06 |
| Ventricular shunt procedures without cc/mccMS-DRG 033, surgical | 11 | $49,591 | $14,689 | $19,489 | 1.62 |
Digestive system527 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 56 | $24,458 | $7,328 | $9,612 | 0.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 47 | $58,432 | $20,330 | $22,964 | 2.37 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 44 | $28,302 | $9,256 | $11,123 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 39 | $33,060 | $11,647 | $12,993 | 1.28 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 38 | $54,709 | $17,278 | $21,501 | 1.79 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 36 | $26,942 | $7,490 | $10,588 | 0.80 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 35 | $119,895 | $37,541 | $47,119 | 4.52 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 32 | $49,072 | $16,175 | $19,285 | 1.62 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 30 | $32,808 | $8,335 | $12,894 | 0.94 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 27 | $31,431 | $14,278 | $12,352 | 1.67 |
| Digestive malignancy with CCMS-DRG 375, medical | 22 | $31,033 | $11,333 | $12,196 | 1.20 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 20 | $24,473 | $9,642 | $9,618 | 1.04 |
| Digestive malignancy with MCCMS-DRG 374, medical | 18 | $53,221 | $17,076 | $20,916 | 2.10 |
| Hernia procedures except inguinal and femoral with CCMS-DRG 354, surgical | 16 | $45,092 | $15,162 | $17,721 | 1.72 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 15 | $55,996 | $13,725 | $22,006 | 1.60 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 14 | $57,341 | $20,434 | $22,535 | 2.50 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 13 | $164,558 | $57,906 | $64,671 | 5.08 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 13 | $55,725 | $15,851 | $21,900 | 1.75 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 12 | $43,889 | $13,004 | $17,248 | 1.45 |
Infectious and parasitic diseases512 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 | 320 | $64,101 | $18,845 | $25,192 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 71 | $26,905 | $8,756 | $10,574 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 54 | $135,334 | $44,846 | $53,186 | 5.00 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 26 | $52,352 | $14,783 | $20,574 | 1.84 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 15 | $114,301 | $43,375 | $44,920 | 4.43 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 13 | $49,641 | $19,033 | $19,509 | 2.14 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 13 | $212,867 | $62,808 | $83,657 | 6.96 |
Respiratory system465 discharges in 16 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 99 | $47,538 | $14,955 | $18,682 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 64 | $31,378 | $11,442 | $12,332 | 1.33 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 38 | $37,819 | $12,055 | $14,863 | 1.40 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 28 | $61,730 | $16,054 | $24,260 | 1.74 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 28 | $33,847 | $11,698 | $13,302 | 1.23 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 28 | $41,261 | $9,465 | $16,215 | 1.10 |
| Major chest procedures with CCMS-DRG 164, surgical | 26 | $65,487 | $22,219 | $25,736 | 2.55 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 23 | $37,062 | $14,777 | $14,566 | 1.81 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 20 | $58,040 | $11,093 | $22,810 | 0.99 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 19 | $75,741 | $23,049 | $29,766 | 2.70 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 17 | $89,176 | $31,764 | $35,046 | 4.06 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 17 | $23,028 | $7,454 | $9,050 | 0.82 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 17 | $28,734 | $8,973 | $11,292 | 0.96 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 16 | $58,992 | $16,591 | $23,184 | 1.88 |
| Other respiratory system o.r. procedures with CCMS-DRG 167, surgical | 13 | $59,673 | $17,750 | $23,452 | 1.82 |
| Major chest procedures with MCCMS-DRG 163, surgical | 12 | $102,616 | $41,460 | $40,328 | 4.71 |
Kidney and urinary tract421 discharges in 13 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 60 | $44,736 | $14,850 | $17,581 | 1.65 |
| Kidney transplantMS-DRG 652, surgical | 49 | $273,876 | $26,496 | $107,633 | 3.00 |
| Renal failure with CCMS-DRG 683, medical | 48 | $21,446 | $8,406 | $8,428 | 0.90 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 46 | $38,753 | $10,111 | $15,230 | 1.02 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 40 | $24,110 | $7,467 | $9,475 | 0.81 |
| Renal failure with MCCMS-DRG 682, medical | 37 | $57,506 | $18,922 | $22,600 | 1.50 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 34 | $35,101 | $10,897 | $13,795 | 1.17 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 22 | $39,851 | $14,716 | $15,661 | 1.84 |
| Kidney and ureter procedures for neoplasm without cc/mccMS-DRG 658, surgical | 20 | $33,639 | $13,352 | $13,220 | 1.48 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 20 | $44,458 | $12,280 | $17,472 | 1.35 |
| Major bladder procedures with CCMS-DRG 654, surgical | 18 | $73,837 | $21,714 | $29,018 | 2.74 |
| Major bladder procedures with MCCMS-DRG 653, surgical | 14 | $121,017 | $46,468 | $47,560 | 5.41 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 13 | $159,449 | $50,063 | $62,664 | 3.70 |
Endocrine, nutritional and metabolic228 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 | 81 | $42,605 | $12,467 | $16,744 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 51 | $23,114 | $7,604 | $9,084 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 23 | $23,987 | $8,533 | $9,427 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 19 | $46,763 | $13,179 | $18,378 | 1.45 |
| Adrenal and pituitary procedures with cc/mccMS-DRG 614, surgical | 15 | $77,845 | $21,127 | $30,593 | 2.25 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 14 | $46,191 | $15,802 | $18,153 | 1.98 |
| Endocrine disorders with CCMS-DRG 644, medical | 13 | $31,282 | $10,166 | $12,294 | 1.06 |
| Endocrine disorders with MCCMS-DRG 643, medical | 12 | $31,796 | $14,783 | $12,496 | 1.65 |
Liver, gallbladder and pancreas152 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 34 | $58,880 | $17,926 | $23,140 | 1.83 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 23 | $49,795 | $14,851 | $19,570 | 1.63 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 23 | $35,285 | $10,045 | $13,867 | 1.09 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 21 | $28,401 | $8,531 | $11,162 | 0.95 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 19 | $63,524 | $16,176 | $24,965 | 1.76 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 17 | $59,295 | $25,005 | $23,303 | 2.89 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 15 | $38,902 | $16,995 | $15,288 | 1.92 |
Blood cancers and poorly differentiated neoplasms126 discharges in 5 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 | 54 | $65,777 | $13,215 | $25,851 | 1.21 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 25 | $142,846 | $41,623 | $56,138 | 3.13 |
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 22 | $129,295 | $36,209 | $50,813 | 2.44 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 13 | $91,382 | $18,870 | $35,913 | 1.57 |
| Acute leukemia with MCCMS-DRG 834, medical | 12 | $200,766 | $68,652 | $78,901 | 5.60 |
Injuries, poisonings and toxic effects of drugs103 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 26 | $57,638 | $19,022 | $22,652 | 2.00 |
| Complications of treatment with MCCMS-DRG 919, medical | 25 | $52,857 | $17,212 | $20,773 | 1.82 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 22 | $116,965 | $38,184 | $45,967 | 3.72 |
| Complications of treatment with CCMS-DRG 920, medical | 18 | $25,419 | $9,304 | $9,990 | 1.03 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 12 | $80,137 | $23,913 | $31,494 | 1.60 |
Other87 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 | 36 | $158,956 | $50,107 | $62,470 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 14 | $60,611 | $21,901 | $23,820 | 2.49 |
| Multiple level spinal fusion except cervical without MCCMS-DRG 448 | 13 | $83,854 | $35,626 | $32,955 | |
| Single level spinal fusion except cervical without MCCMS-DRG 451 | 13 | $66,289 | $27,299 | $26,051 | |
| Multiple level combined anterior and posterior spinal fusion except cervical with CCMS-DRG 427 | 11 | $123,014 | $61,883 | $48,344 |
Transplants, ECMO and tracheostomy (pre-MDC)83 discharges in 4 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 | 29 | $1,096,941 | $457,220 | $431,098 | 36.84 |
| ECMO or tracheostomy with MV >96 hours or principal diagnosis except face, mouth and necMS-DRG 003, surgical | 20 | $726,093 | $266,297 | $285,355 | 21.32 |
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 18 | $1,010,177 | $319,197 | $396,999 | 27.10 |
| Autologous bone marrow transplant with cc/mccMS-DRG 016, medical | 16 | $137,861 | $53,838 | $54,179 | 6.18 |
Male reproductive system63 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major male pelvic procedures without cc/mccMS-DRG 708, surgical | 41 | $30,409 | $12,144 | $11,951 | 1.46 |
| Major male pelvic procedures with cc/mccMS-DRG 707, surgical | 22 | $30,755 | $16,477 | $12,087 | 1.96 |
Skin, subcutaneous tissue and breast55 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 32 | $20,775 | $7,234 | $8,164 | 0.88 |
| Other skin, subcutaneous tissue and breast procedures with CCMS-DRG 580, surgical | 12 | $39,239 | $15,031 | $15,421 | 1.75 |
| Skin graft except for skin ulcer or cellulitis with CCMS-DRG 577, surgical | 11 | $63,726 | $21,102 | $25,044 | 2.65 |
Blood and immune system36 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 13 | $60,376 | $14,033 | $23,728 | 1.40 |
| Coagulation disordersMS-DRG 813, medical | 12 | $112,081 | $32,490 | $44,048 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 11 | $87,373 | $24,220 | $34,338 | 2.19 |
Factors influencing health status25 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 | 25 | $32,037 | $7,806 | $12,591 | 0.80 |
Ear, nose, mouth and throat16 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 | 16 | $84,618 | $21,223 | $33,255 | 2.07 |
Mental diseases and disorders16 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 | 16 | $31,308 | $14,842 | $12,304 | 1.76 |
Alcohol and drug use16 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 | 16 | $20,599 | $8,004 | $8,096 | 0.86 |
Burns13 discharges in 1 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 | 13 | $284,383 | $81,140 | $111,762 | 6.92 |
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 1 Intraocular ProceduresAPC 5491 | 1,739 | 1,126 | $7,056 | $1,641 | $1,752 |
| Level 2 Urology and Related ServicesAPC 5372 | 1,158 | 682 | $2,134 | $409 | $502 |
| Level 1 Nerve ProceduresAPC 5431 | 765 | 616 | $8,051 | $1,364 | $1,407 |
| Level 3 Urology and Related ServicesAPC 5373 | 606 | 478 | $4,748 | $1,327 | $1,516 |
| Level 2 Upper GI ProceduresAPC 5302 | 600 | 464 | $7,343 | $1,282 | $1,445 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 566 | 465 | $12,018 | $2,000 | $2,141 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 562 | 511 | $5,877 | $1,132 | $1,220 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 449 | 419 | $33,674 | $9,851 | $10,772 |
| Level 3 Vascular ProceduresAPC 5183 | 368 | 310 | $11,943 | $2,231 | $2,405 |
| Level 2 Intraocular ProceduresAPC 5492 | 313 | 268 | $12,503 | $2,841 | $3,116 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 282 | 261 | $6,038 | $1,610 | $1,780 |
| Level 1 Endovascular ProceduresAPC 5191 | 280 | 263 | $13,446 | $2,008 | $2,208 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 279 | 269 | $22,425 | $5,035 | $5,339 |
| Level 5 Urology and Related ServicesAPC 5375 | 254 | 245 | $21,746 | $3,664 | $3,918 |
| Level 4 Airway EndoscopyAPC 5154 | 210 | 168 | $14,444 | $2,570 | $2,833 |
| Level 4 Urology and Related ServicesAPC 5374 | 208 | 180 | $10,966 | $2,453 | $2,629 |
| Level 3 Airway EndoscopyAPC 5153 | 175 | 132 | $8,225 | $1,191 | $1,264 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 149 | 140 | $10,545 | $2,213 | $2,373 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 149 | 149 | $65,449 | $19,064 | $21,117 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 145 | 139 | $3,884 | $1,123 | $1,196 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 145 | 144 | $32,875 | $7,335 | $8,164 |
| Comprehensive Observation ServicesAPC 8011 | 143 | 131 | $17,522 | $1,912 | $2,090 |
| Complex GI ProceduresAPC 5331 | 141 | 68 | $17,121 | $3,058 | $4,263 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 136 | 118 | $10,666 | $2,413 | $2,636 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 135 | 131 | $19,846 | $3,905 | $4,358 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 133 | 129 | $52,473 | $14,801 | $15,763 |
| Level 3 Intraocular ProceduresAPC 5493 | 118 | 86 | $20,029 | $3,636 | $4,004 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 115 | 115 | $21,550 | $4,614 | $4,982 |
| Level 4 Vascular ProceduresAPC 5184 | 111 | 95 | $23,055 | $3,357 | $3,946 |
| Level 5 Airway EndoscopyAPC 5155 | 109 | 102 | $33,666 | $4,768 | $5,183 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 107 | 104 | $13,861 | $2,670 | $2,930 |
| Level 2 Vascular ProceduresAPC 5182 | 106 | 91 | $12,973 | $1,122 | $1,204 |
| Level 5 ENT ProceduresAPC 5165 | 101 | 96 | $18,082 | $4,180 | $4,436 |
| Level 3 Endovascular ProceduresAPC 5193 | 100 | 93 | $37,878 | $8,051 | $8,874 |
| Level 2 Endovascular ProceduresAPC 5192 | 86 | 79 | $20,514 | $4,032 | $4,338 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 71 | 62 | $18,084 | $4,813 | $4,524 |
| Level 5 Gynecologic ProceduresAPC 5415 | 68 | 68 | $14,330 | $3,550 | $3,792 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 58 | 58 | $81,922 | $25,652 | $26,719 |
| Level 3 Lower GI ProceduresAPC 5313 | 55 | 54 | $11,123 | $1,729 | $2,176 |
| Level 3 Upper GI ProceduresAPC 5303 | 50 | 45 | $14,415 | $2,732 | $2,888 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 49 | 49 | $21,057 | $5,938 | $6,514 |
| Level 4 Extraocular, Repair, and Plastic Eye ProceduresAPC 5504 | 49 | 43 | $10,598 | $2,644 | $2,969 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 47 | 47 | $28,266 | $7,927 | $8,569 |
| Level 8 Urology and Related ServicesAPC 5378 | 42 | 42 | $58,844 | $15,598 | $17,428 |
| Level 6 Urology and Related ServicesAPC 5376 | 41 | 41 | $40,629 | $6,458 | $7,291 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 38 | 38 | $67,767 | $17,130 | $18,465 |
| Level 4 Endovascular ProceduresAPC 5194 | 36 | 33 | $56,825 | $13,655 | $14,606 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 36 | 36 | $89,765 | $27,752 | $29,375 |
| Level 4 Gynecologic ProceduresAPC 5414 | 36 | 36 | $8,949 | $2,169 | $2,389 |
| Cochlear Implant ProcedureAPC 5166 | 34 | 34 | $81,334 | $28,319 | $29,489 |
| Level 7 Radiation TherapyAPC 5627 | 34 | 31 | $72,596 | $5,558 | $6,121 |
| Level 6 Gynecologic ProceduresAPC 5416 | 33 | 33 | $19,105 | $5,230 | $5,836 |
| Level 3 Neurostimulator and Related ProceduresAPC 5463 | 33 | 33 | $138,383 | $10,554 | $11,550 |
| Level 4 ENT ProceduresAPC 5164 | 32 | 31 | $12,207 | $2,298 | $2,217 |
| Implantation of Drug Infusion DeviceAPC 5471 | 21 | 21 | $49,691 | $13,630 | $14,829 |
| Level 3 ENT ProceduresAPC 5163 | 19 | 17 | $3,992 | $1,088 | $1,106 |
| Level 2 Nerve ProceduresAPC 5432 | 19 | 14 | $30,956 | $4,754 | $4,674 |
| Level 1 Neurostimulator and Related ProceduresAPC 5461 | 16 | 15 | $12,873 | $2,429 | $2,547 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 15 | 15 | $50,469 | $15,785 | $17,052 |
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.