Vassar Brothers Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Vassar Brothers Medical Center, Poughkeepsie, NY in 2024, from traditional Medicare claims. Back to the Vassar Brothers Medical Center profile, with quality ratings, finances and negotiated rates.
5,764
Medicare inpatient discharges
In 141 published DRGs
2.15
Case mix index
IPPS FY 2027
24%
Surgical stays
74%
Stays with complications
In DRGs with a CC or MCC
3,594
Medicare outpatient services
In 39 service groups
Inpatient stays by major diagnostic category
Circulatory system1,698 discharges in 37 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 335 | $38,534 | $12,106 | $13,179 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 105 | $103,110 | $32,102 | $35,263 | 3.24 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 104 | $78,840 | $17,066 | $26,963 | 1.82 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 102 | $153,410 | $49,220 | $52,466 | 4.88 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 94 | $172,082 | $61,942 | $58,852 | 6.25 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 82 | $21,912 | $6,309 | $7,494 | 0.74 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 59 | $51,629 | $14,739 | $17,657 | 1.59 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 59 | $72,314 | $20,095 | $24,732 | 2.16 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 59 | $18,100 | $4,245 | $6,190 | 0.55 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 47 | $37,967 | $10,017 | $12,985 | 1.08 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 47 | $96,296 | $27,046 | $32,933 | 2.87 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 43 | $36,618 | $10,972 | $12,523 | 1.20 |
| Syncope and collapseMS-DRG 312, medical | 40 | $33,676 | $7,968 | $11,517 | 0.86 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 37 | $76,585 | $20,718 | $26,192 | 2.28 |
| Other vascular procedures with CCMS-DRG 253, surgical | 35 | $72,743 | $25,198 | $24,878 | 2.55 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 32 | $175,224 | $74,913 | $59,927 | 7.71 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 30 | $29,519 | $9,765 | $10,095 | 1.07 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 30 | $52,420 | $19,778 | $17,928 | 2.09 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 29 | $122,042 | $35,232 | $41,738 | 3.90 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 27 | $93,725 | $34,431 | $32,054 | 3.35 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 26 | $34,601 | $7,722 | $11,834 | 0.91 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 23 | $113,866 | $34,762 | $38,942 | 3.46 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 23 | $45,738 | $14,403 | $15,642 | 1.58 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 22 | $131,635 | $54,735 | $45,019 | 5.88 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 22 | $106,976 | $32,865 | $36,586 | 3.46 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 21 | $153,798 | $52,136 | $52,599 | 5.06 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 20 | $182,962 | $75,581 | $62,573 | 7.80 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 20 | $122,630 | $41,420 | $41,939 | 4.16 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 19 | $121,620 | $47,125 | $41,594 | 5.24 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 18 | $111,851 | $29,685 | $38,253 | 2.97 |
| Hypertension without MCCMS-DRG 305, medical | 16 | $24,258 | $6,305 | $8,296 | 0.75 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 13 | $61,691 | $17,582 | $21,098 | 1.83 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 12 | $127,912 | $44,614 | $43,746 | 5.20 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 12 | $150,343 | $36,958 | $51,417 | 3.27 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 12 | $32,543 | $8,640 | $11,130 | 0.97 |
| Coronary intravascular lithotripsy with intraluminal device with MCCMS-DRG 323, surgical | 12 | $132,865 | $42,583 | $45,440 | 4.14 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 11 | $26,428 | $5,358 | $9,038 | 0.72 |
Infectious and parasitic diseases1,229 discharges in 5 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 | 905 | $56,347 | $18,649 | $19,271 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 158 | $33,459 | $9,078 | $11,443 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 113 | $137,550 | $47,522 | $47,042 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 37 | $186,478 | $67,555 | $63,776 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 16 | $80,012 | $18,361 | $27,364 | 2.04 |
Respiratory system526 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 | 128 | $50,616 | $15,759 | $17,311 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 89 | $35,978 | $11,716 | $12,304 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 69 | $39,882 | $11,362 | $13,640 | 1.23 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 44 | $50,194 | $13,268 | $17,166 | 1.40 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 33 | $36,586 | $10,218 | $12,513 | 1.10 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 19 | $53,742 | $16,697 | $18,380 | 1.88 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 18 | $30,077 | $8,981 | $10,286 | 0.99 |
| Major chest procedures with CCMS-DRG 164, surgical | 17 | $74,700 | $25,397 | $25,547 | 2.55 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 17 | $51,174 | $15,120 | $17,501 | 1.74 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 16 | $38,853 | $7,243 | $13,288 | 0.82 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 16 | $24,476 | $7,343 | $8,371 | 0.82 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 14 | $86,116 | $27,816 | $29,452 | 2.70 |
| Major chest trauma with CCMS-DRG 184, medical | 12 | $31,875 | $9,418 | $10,901 | 1.05 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 12 | $50,108 | $16,110 | $17,137 | 1.81 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 11 | $41,887 | $17,099 | $14,325 | 1.90 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 11 | $23,650 | $8,375 | $8,088 | 0.96 |
Nervous system510 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 92 | $65,388 | $18,020 | $22,363 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 64 | $39,302 | $8,946 | $13,441 | 1.02 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 34 | $38,386 | $12,622 | $13,128 | 1.36 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 31 | $166,480 | $42,072 | $56,936 | 4.42 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 26 | $42,955 | $9,279 | $14,691 | 1.03 |
| Seizures with MCCMS-DRG 100, medical | 25 | $61,779 | $18,650 | $21,128 | 1.98 |
| Seizures without MCCMS-DRG 101, medical | 24 | $33,532 | $8,127 | $11,468 | 0.91 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 23 | $30,820 | $10,180 | $10,541 | 1.14 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 21 | $73,463 | $22,223 | $25,124 | 2.28 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 20 | $62,486 | $17,380 | $21,370 | 1.47 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 20 | $43,466 | $17,423 | $14,865 | 1.79 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 18 | $53,171 | $21,532 | $18,184 | 2.39 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 18 | $50,141 | $17,332 | $17,148 | 1.79 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 16 | $40,910 | $8,828 | $13,991 | 1.03 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 15 | $28,339 | $9,743 | $9,692 | 1.06 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 13 | $169,329 | $55,705 | $57,911 | 5.67 |
| Extracranial procedures with CCMS-DRG 038, surgical | 13 | $45,848 | $14,403 | $15,680 | 1.60 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 13 | $31,624 | $5,822 | $10,816 | 0.69 |
| Precerebral occlusion without infarction without MCCMS-DRG 068, medical | 13 | $28,606 | $7,530 | $9,783 | 0.87 |
| Headaches without MCCMS-DRG 103, medical | 11 | $32,687 | $7,690 | $11,179 | 0.84 |
Digestive system503 discharges in 14 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 77 | $34,234 | $8,660 | $11,708 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 73 | $53,832 | $17,472 | $18,411 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 70 | $28,788 | $6,824 | $9,845 | 0.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 49 | $79,642 | $21,039 | $27,237 | 2.37 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 35 | $37,223 | $6,656 | $12,730 | 0.80 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 33 | $38,689 | $11,500 | $13,232 | 1.28 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 31 | $115,796 | $39,359 | $39,602 | 4.52 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 30 | $67,639 | $16,033 | $23,133 | 1.62 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 27 | $33,587 | $8,685 | $11,487 | 0.94 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 20 | $52,954 | $16,888 | $18,110 | 1.75 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 18 | $24,554 | $9,631 | $8,397 | 1.04 |
| Digestive malignancy with MCCMS-DRG 374, medical | 16 | $66,501 | $20,232 | $22,743 | 2.10 |
| Digestive malignancy with CCMS-DRG 375, medical | 13 | $36,520 | $11,395 | $12,490 | 1.20 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 11 | $139,271 | $50,040 | $47,631 | 5.08 |
Kidney and urinary tract353 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with MCCMS-DRG 682, medical | 81 | $43,210 | $13,782 | $14,778 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 71 | $30,404 | $8,153 | $10,398 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 59 | $48,503 | $15,677 | $16,588 | 1.65 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 58 | $32,557 | $10,461 | $11,135 | 1.17 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 35 | $29,909 | $9,836 | $10,229 | 1.02 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 33 | $31,159 | $7,119 | $10,656 | 0.81 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 16 | $102,158 | $37,219 | $34,938 | 3.70 |
Musculoskeletal system and connective tissue324 discharges in 14 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 67 | $35,659 | $8,517 | $12,195 | 0.97 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 44 | $67,121 | $20,010 | $22,955 | 2.07 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 28 | $33,148 | $9,952 | $11,337 | 1.09 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 20 | $81,214 | $28,239 | $27,775 | 2.95 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 20 | $88,509 | $18,697 | $30,270 | 1.82 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 19 | $94,212 | $29,275 | $32,220 | 2.99 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 19 | $65,725 | $19,219 | $22,478 | 2.11 |
| Medical back problems with MCCMS-DRG 551, medical | 19 | $41,763 | $16,151 | $14,283 | 1.70 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 17 | $31,712 | $6,594 | $10,846 | 0.79 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 17 | $32,399 | $8,273 | $11,081 | 0.90 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 16 | $67,257 | $18,234 | $23,002 | 1.97 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 13 | $73,470 | $26,544 | $25,127 | 2.96 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 13 | $34,019 | $9,336 | $11,635 | 1.00 |
| Tendonitis, myositis and bursitis with MCCMS-DRG 557, medical | 12 | $46,683 | $14,217 | $15,966 | 1.56 |
Endocrine, nutritional and metabolic193 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 | 72 | $40,372 | $12,342 | $13,807 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 37 | $26,235 | $8,204 | $8,972 | 0.90 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 27 | $26,226 | $6,711 | $8,969 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 26 | $44,631 | $13,806 | $15,264 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 17 | $46,743 | $15,583 | $15,986 | 1.65 |
| Endocrine disorders with CCMS-DRG 644, medical | 14 | $27,495 | $9,262 | $9,403 | 1.06 |
Liver, gallbladder and pancreas129 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 23 | $55,416 | $14,961 | $18,952 | 1.63 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 20 | $37,470 | $9,895 | $12,815 | 1.09 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 19 | $44,986 | $17,873 | $15,385 | 1.83 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 15 | $57,246 | $17,866 | $19,578 | 1.92 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 15 | $32,387 | $7,659 | $11,076 | 0.86 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 13 | $75,749 | $13,899 | $25,906 | 1.76 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 13 | $53,764 | $16,048 | $18,387 | 1.63 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 11 | $83,970 | $17,865 | $28,718 | 2.32 |
Blood and immune system123 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Coagulation disordersMS-DRG 813, medical | 57 | $44,047 | $15,006 | $15,064 | 1.56 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 23 | $39,080 | $13,587 | $13,365 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 20 | $27,091 | $8,672 | $9,265 | 0.90 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 12 | $56,621 | $22,535 | $19,365 | 2.19 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 11 | $51,751 | $11,865 | $17,699 | 1.20 |
Skin, subcutaneous tissue and breast72 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 53 | $25,432 | $7,864 | $8,698 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 19 | $49,086 | $14,077 | $16,787 | 1.49 |
Injuries, poisonings and toxic effects of drugs42 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 16 | $61,022 | $15,775 | $20,870 | 1.60 |
| Complications of treatment with CCMS-DRG 920, medical | 15 | $33,498 | $10,136 | $11,456 | 1.03 |
| Complications of treatment with MCCMS-DRG 919, medical | 11 | $45,709 | $18,324 | $15,632 | 1.82 |
Transplants, ECMO and tracheostomy (pre-MDC)26 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 14 | $317,524 | $145,445 | $108,593 | 14.70 |
| ECMO or tracheostomy with MV >96 hours or principal diagnosis except face, mouth and necMS-DRG 003, surgical | 12 | $551,598 | $202,602 | $188,646 | 21.32 |
Other25 discharges in 1 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 | 25 | $143,492 | $43,227 | $49,074 | 4.74 |
Mental diseases and disorders11 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 | 11 | $59,581 | $15,844 | $20,377 | 1.76 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service (2024 data, released 2026-04-10), traditional Medicare only; CMS omits DRGs with fewer than 11 discharges. Estimated cost is average charges times the hospital's Medicare cost-to-charge ratio from the IPPS Impact File. Weights are the MS-DRG relative weights for the same year.
Outpatient services
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Comprehensive Observation ServicesAPC 8011 | 643 | 594 | $16,603 | $2,311 | $2,090 |
| Level 1 Intraocular ProceduresAPC 5491 | 392 | 256 | $9,222 | $1,971 | $1,752 |
| Level 1 Endovascular ProceduresAPC 5191 | 277 | 277 | $17,838 | $2,530 | $2,208 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 245 | 236 | $7,287 | $1,385 | $1,220 |
| Level 3 Endovascular ProceduresAPC 5193 | 224 | 201 | $54,133 | $10,307 | $8,874 |
| Level 3 Vascular ProceduresAPC 5183 | 175 | 165 | $11,933 | $2,720 | $2,405 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 170 | 166 | $104,780 | $23,989 | $21,117 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 154 | 153 | $20,122 | $4,980 | $4,358 |
| Level 2 Upper GI ProceduresAPC 5302 | 113 | 103 | $6,219 | $1,657 | $1,445 |
| Level 2 Endovascular ProceduresAPC 5192 | 104 | 96 | $22,694 | $4,827 | $4,338 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 96 | 95 | $41,178 | $9,829 | $8,569 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 74 | 70 | $12,125 | $2,472 | $2,141 |
| Level 4 Airway EndoscopyAPC 5154 | 61 | 55 | $14,549 | $3,248 | $2,833 |
| Level 4 Endovascular ProceduresAPC 5194 | 55 | 53 | $88,233 | $17,258 | $14,606 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 54 | 54 | $25,884 | $6,346 | $5,339 |
| Level 2 Vascular ProceduresAPC 5182 | 52 | 51 | $4,224 | $1,375 | $1,204 |
| Level 5 Airway EndoscopyAPC 5155 | 48 | 47 | $19,109 | $5,828 | $5,183 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 48 | 48 | $30,813 | $9,604 | $8,164 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 46 | 41 | $22,610 | $3,254 | $2,930 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 44 | 44 | $8,103 | $1,962 | $1,780 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 41 | 39 | $32,279 | $5,590 | $4,982 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 41 | 41 | $31,716 | $7,549 | $6,514 |
| Level 4 Vascular ProceduresAPC 5184 | 38 | 35 | $27,977 | $4,409 | $3,946 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 37 | 33 | $14,738 | $2,991 | $2,636 |
| Level 3 Urology and Related ServicesAPC 5373 | 37 | 21 | $4,696 | $1,774 | $1,516 |
| Level 3 Lower GI ProceduresAPC 5313 | 36 | 35 | $13,096 | $2,447 | $2,176 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 34 | 34 | $169,207 | $34,638 | $29,375 |
| Level 3 Upper GI ProceduresAPC 5303 | 33 | 29 | $18,995 | $3,288 | $2,888 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 30 | 30 | $118,150 | $19,830 | $17,052 |
| Level 5 ENT ProceduresAPC 5165 | 29 | 29 | $24,634 | $4,925 | $4,436 |
| Level 4 Gynecologic ProceduresAPC 5414 | 29 | 29 | $11,702 | $2,765 | $2,389 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 27 | 27 | $50,259 | $6,370 | $5,682 |
| Level 2 Intraocular ProceduresAPC 5492 | 25 | 21 | $17,686 | $3,551 | $3,116 |
| Complex GI ProceduresAPC 5331 | 20 | 17 | $27,709 | $5,059 | $4,263 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 14 | 13 | $53,451 | $12,400 | $10,772 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 13 | 12 | $14,420 | $2,760 | $2,373 |
| Level 2 Urology and Related ServicesAPC 5372 | 13 | $2,288 | $547 | $502 | |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 11 | 11 | $8,146 | $1,424 | $1,196 |
| Level 4 Urology and Related ServicesAPC 5374 | 11 | 11 | $9,575 | $3,069 | $2,629 |
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.