Wakemed Raleigh Campus And North Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Wakemed Raleigh Campus And North Hospital, Raleigh, NC in 2024, from traditional Medicare claims. Back to the Wakemed Raleigh Campus And North Hospital profile, with quality ratings, finances and negotiated rates.
5,569
Medicare inpatient discharges
In 159 published DRGs
2.05
Case mix index
IPPS FY 2027
27%
Surgical stays
62%
Stays with complications
In DRGs with a CC or MCC
3,572
Medicare outpatient services
In 34 service groups
Inpatient stays by major diagnostic category
Circulatory system1,392 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 | 286 | $34,619 | $9,892 | $9,313 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 102 | $177,114 | $24,906 | $47,644 | 3.24 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 85 | $259,413 | $36,721 | $69,782 | 4.88 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 75 | $100,795 | $12,470 | $27,114 | 1.82 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 70 | $45,652 | $9,207 | $12,280 | 1.20 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 55 | $45,594 | $7,730 | $12,265 | 1.08 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 53 | $72,382 | $15,828 | $19,471 | 2.16 |
| Syncope and collapseMS-DRG 312, medical | 43 | $37,957 | $7,086 | $10,210 | 0.86 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 42 | $155,444 | $27,196 | $41,815 | 4.04 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 39 | $31,218 | $6,345 | $8,398 | 0.74 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 38 | $197,116 | $34,701 | $53,024 | 5.20 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 34 | $278,228 | $37,153 | $74,843 | 5.24 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 32 | $134,382 | $20,678 | $36,149 | 2.87 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 29 | $126,619 | $16,437 | $34,061 | 2.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 29 | $45,405 | $12,307 | $12,214 | 1.59 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 25 | $107,477 | $24,138 | $28,911 | 3.35 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 25 | $22,891 | $4,227 | $6,158 | 0.55 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 24 | $240,395 | $52,176 | $64,666 | 7.71 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 23 | $79,278 | $15,643 | $21,326 | 2.09 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 21 | $340,983 | $53,143 | $91,725 | 6.25 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 21 | $43,251 | $7,022 | $11,635 | 0.91 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 18 | $93,742 | $13,635 | $25,217 | 1.83 |
| Heart failure and shock with CCMS-DRG 292, medical | 18 | $26,086 | $7,230 | $7,017 | 0.86 |
| Hypertension without MCCMS-DRG 305, medical | 18 | $25,164 | $5,867 | $6,769 | 0.75 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 18 | $35,690 | $7,656 | $9,601 | 0.97 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 17 | $132,510 | $25,865 | $35,645 | 3.46 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 16 | $254,051 | $34,320 | $68,340 | 4.16 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 16 | $170,614 | $21,982 | $45,895 | 2.97 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 15 | $235,822 | $30,369 | $63,436 | 3.90 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 15 | $28,993 | $7,659 | $7,799 | 1.07 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 14 | $96,326 | $23,953 | $25,912 | 3.27 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 14 | $40,553 | $5,175 | $10,909 | 0.72 |
| Other vascular procedures with CCMS-DRG 253, surgical | 13 | $105,524 | $19,053 | $28,386 | 2.55 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 13 | $163,781 | $36,828 | $44,057 | 5.06 |
| Chest painMS-DRG 313, medical | 13 | $22,485 | $5,600 | $6,048 | 0.72 |
| Hypertension with MCCMS-DRG 304, medical | 12 | $38,121 | $8,428 | $10,255 | 1.15 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 11 | $191,480 | $35,735 | $51,508 | 5.88 |
Respiratory system739 discharges in 17 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 119 | $42,405 | $12,199 | $11,407 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 119 | $40,349 | $9,804 | $10,854 | 1.33 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 100 | $27,611 | $6,411 | $7,427 | 0.82 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 69 | $40,686 | $8,429 | $10,945 | 1.10 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 52 | $31,891 | $7,733 | $8,579 | 0.99 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 51 | $56,544 | $9,836 | $15,210 | 1.23 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 38 | $32,236 | $6,144 | $8,672 | 0.85 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 32 | $31,810 | $6,442 | $8,557 | 0.82 |
| Simple pneumonia and pleurisy without cc/mccMS-DRG 195, medical | 24 | $20,966 | $4,551 | $5,640 | 0.63 |
| Major chest trauma with CCMS-DRG 184, medical | 22 | $52,203 | $8,044 | $14,043 | 1.05 |
| Major chest procedures with CCMS-DRG 164, surgical | 21 | $120,935 | $18,056 | $32,532 | 2.55 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 20 | $39,709 | $7,589 | $10,682 | 0.96 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 19 | $53,064 | $10,282 | $14,274 | 1.40 |
| Pneumothorax with CCMS-DRG 200, medical | 15 | $51,809 | $8,111 | $13,937 | 1.08 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 14 | $118,241 | $20,476 | $31,807 | 2.70 |
| Major chest trauma with MCCMS-DRG 183, medical | 13 | $71,660 | $12,014 | $19,277 | 1.57 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 11 | $197,380 | $48,640 | $53,095 | 6.91 |
Nervous system607 discharges in 27 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 | 104 | $46,461 | $7,812 | $12,498 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 49 | $78,364 | $14,308 | $21,080 | 2.00 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 35 | $208,465 | $35,171 | $56,077 | 4.42 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 32 | $97,133 | $14,291 | $26,129 | 1.81 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 31 | $70,113 | $10,069 | $18,860 | 1.32 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 30 | $37,422 | $5,158 | $10,066 | 0.69 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 30 | $74,192 | $10,487 | $19,958 | 1.36 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 22 | $39,961 | $7,770 | $10,749 | 1.03 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 19 | $43,244 | $9,396 | $11,633 | 1.36 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 19 | $35,257 | $6,083 | $9,484 | 0.80 |
| Seizures with MCCMS-DRG 100, medical | 18 | $64,098 | $13,982 | $17,242 | 1.98 |
| Traumatic stupor and coma <1 hour without cc/mccMS-DRG 087, medical | 17 | $52,916 | $7,140 | $14,234 | 0.89 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 17 | $62,144 | $12,642 | $16,717 | 1.79 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 16 | $203,973 | $20,419 | $54,869 | 2.43 |
| Traumatic stupor and coma >1 hour without cc/mccMS-DRG 084, medical | 16 | $50,748 | $7,192 | $13,651 | 0.92 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 15 | $177,329 | $22,933 | $47,701 | 2.95 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 15 | $113,075 | $17,899 | $30,417 | 2.30 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 15 | $107,736 | $18,095 | $28,981 | 2.28 |
| Seizures without MCCMS-DRG 101, medical | 15 | $38,336 | $7,374 | $10,312 | 0.91 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 13 | $188,206 | $41,883 | $50,627 | 5.67 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 12 | $67,799 | $7,317 | $18,238 | 1.14 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 12 | $55,887 | $18,565 | $15,034 | 2.39 |
| Extracranial procedures with CCMS-DRG 038, surgical | 11 | $69,297 | $12,237 | $18,641 | 1.60 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 062, medical | 11 | $80,465 | $12,487 | $21,645 | 1.87 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 11 | $55,439 | $8,142 | $14,913 | 1.06 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 11 | $47,019 | $6,516 | $12,648 | 1.03 |
| Headaches without MCCMS-DRG 103, medical | 11 | $34,516 | $5,968 | $9,285 | 0.84 |
Infectious and parasitic diseases586 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 | 385 | $57,444 | $14,363 | $15,452 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 100 | $38,415 | $7,739 | $10,334 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 59 | $185,144 | $39,778 | $49,804 | 5.00 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 23 | $79,545 | $14,893 | $21,398 | 2.04 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 19 | $186,058 | $49,250 | $50,050 | 6.96 |
Kidney and urinary tract536 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 154 | $25,701 | $6,544 | $6,913 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 106 | $37,813 | $9,166 | $10,172 | 1.17 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 77 | $43,176 | $12,482 | $11,614 | 1.65 |
| Renal failure with CCMS-DRG 683, medical | 61 | $29,747 | $7,086 | $8,002 | 0.90 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 30 | $27,110 | $8,058 | $7,293 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 29 | $51,668 | $9,487 | $13,899 | 1.35 |
| Renal failure with MCCMS-DRG 682, medical | 28 | $45,831 | $11,825 | $12,328 | 1.50 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 27 | $46,072 | $7,622 | $12,393 | 1.05 |
| Renal failure without cc/mccMS-DRG 684, medical | 12 | $29,240 | $5,061 | $7,865 | 0.61 |
| Kidney and urinary tract signs and symptoms without MCCMS-DRG 696, medical | 12 | $26,186 | $5,555 | $7,044 | 0.69 |
Musculoskeletal system and connective tissue464 discharges in 19 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 | 80 | $98,782 | $15,495 | $26,572 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 58 | $84,541 | $15,933 | $22,742 | 2.11 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 35 | $307,277 | $50,555 | $82,658 | 6.12 |
| Medical back problems without MCCMS-DRG 552, medical | 31 | $47,728 | $7,263 | $12,839 | 0.97 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 30 | $74,181 | $11,177 | $19,955 | 1.59 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 28 | $185,416 | $26,931 | $49,877 | 3.66 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 23 | $127,391 | $20,586 | $34,268 | 2.95 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 22 | $250,125 | $37,436 | $67,284 | 4.61 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 22 | $113,521 | $18,859 | $30,537 | 2.96 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 21 | $30,821 | $6,110 | $8,291 | 0.79 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 16 | $127,706 | $16,514 | $34,353 | 2.40 |
| Tendonitis, myositis and bursitis without MCCMS-DRG 558, medical | 15 | $33,124 | $6,639 | $8,910 | 0.88 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 13 | $96,145 | $21,563 | $25,863 | 2.99 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 13 | $41,521 | $7,034 | $11,169 | 0.90 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 12 | $96,830 | $13,444 | $26,047 | 1.88 |
| Medical back problems with MCCMS-DRG 551, medical | 12 | $49,016 | $13,051 | $13,185 | 1.70 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 11 | $125,725 | $23,359 | $33,820 | 3.46 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 11 | $78,286 | $13,973 | $21,059 | 1.87 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 11 | $86,056 | $13,841 | $23,149 | 2.04 |
Digestive system434 discharges in 13 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 | 99 | $30,661 | $6,090 | $8,248 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 94 | $41,299 | $7,491 | $11,109 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 30 | $73,942 | $14,081 | $19,890 | 1.79 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 30 | $30,764 | $6,280 | $8,275 | 0.80 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 30 | $37,542 | $10,230 | $10,099 | 1.28 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 26 | $24,738 | $4,334 | $6,655 | 0.56 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 25 | $121,523 | $19,070 | $32,690 | 2.37 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 22 | $166,093 | $34,277 | $44,679 | 4.52 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 19 | $85,828 | $10,670 | $23,088 | 1.67 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 17 | $38,546 | $7,188 | $10,369 | 1.04 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 17 | $35,560 | $6,976 | $9,566 | 0.94 |
| Gastrointestinal hemorrhage without cc/mccMS-DRG 379, medical | 14 | $25,827 | $4,978 | $6,948 | 0.63 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 11 | $47,267 | $10,478 | $12,715 | 1.62 |
Endocrine, nutritional and metabolic278 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 98 | $28,791 | $5,957 | $7,745 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 80 | $40,261 | $10,227 | $10,830 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 31 | $31,103 | $6,810 | $8,367 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 25 | $52,888 | $9,915 | $14,227 | 1.45 |
| Endocrine disorders with CCMS-DRG 644, medical | 19 | $39,277 | $8,418 | $10,566 | 1.06 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 13 | $57,560 | $13,723 | $15,484 | 1.98 |
| Diabetes without cc/mccMS-DRG 639, medical | 12 | $20,835 | $4,574 | $5,605 | 0.62 |
Skin, subcutaneous tissue and breast127 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 93 | $25,817 | $6,718 | $6,945 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 23 | $36,313 | $11,546 | $9,768 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 11 | $44,263 | $7,236 | $11,907 | 0.91 |
Blood and immune system90 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 54 | $33,036 | $7,551 | $8,887 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 36 | $55,138 | $11,156 | $14,832 | 1.40 |
Liver, gallbladder and pancreas89 discharges in 6 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 | 22 | $66,161 | $11,953 | $17,797 | 1.63 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 17 | $37,214 | $6,672 | $10,011 | 0.86 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 14 | $55,743 | $8,535 | $14,995 | 1.09 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 13 | $76,634 | $13,875 | $20,615 | 1.92 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 12 | $39,577 | $7,435 | $10,646 | 1.03 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 11 | $33,226 | $6,727 | $8,938 | 0.95 |
Injuries, poisonings and toxic effects of drugs73 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 | 35 | $57,287 | $11,850 | $15,410 | 1.60 |
| Complications of treatment with MCCMS-DRG 919, medical | 14 | $80,971 | $14,580 | $21,781 | 1.82 |
| Poisoning and toxic effects of drugs without MCCMS-DRG 918, medical | 13 | $30,865 | $6,557 | $8,303 | 0.86 |
| Allergic reactions without MCCMS-DRG 916, medical | 11 | $23,984 | $5,562 | $6,452 | 0.66 |
Other64 discharges in 4 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 | 24 | $193,051 | $34,360 | $51,931 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 15 | $130,598 | $18,907 | $35,131 | 2.49 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 13 | $112,662 | $23,463 | $30,306 | 3.38 |
| Multiple level combined anterior and posterior spinal fusion except cervical without CC/MS-DRG 428 | 12 | $295,797 | $42,981 | $79,570 |
Factors influencing health status42 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 23 | $32,175 | $6,630 | $8,655 | 0.80 |
| Other factors influencing health statusMS-DRG 951, medical | 19 | $16,602 | $4,570 | $4,466 | 0.59 |
Alcohol and drug use20 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 | 20 | $28,084 | $7,277 | $7,555 | 0.86 |
Transplants, ECMO and tracheostomy (pre-MDC)16 discharges in 1 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 | 16 | $641,822 | $160,271 | $172,650 | 21.32 |
Mental diseases and disorders12 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 | 12 | $52,750 | $12,591 | $14,190 | 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 | 1,205 | 1,112 | $22,418 | $1,947 | $2,090 |
| Level 1 Endovascular ProceduresAPC 5191 | 308 | 308 | $23,488 | $2,073 | $2,208 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 204 | 198 | $165,825 | $19,310 | $21,117 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 141 | 139 | $69,572 | $9,910 | $10,772 |
| Level 3 Urology and Related ServicesAPC 5373 | 117 | 94 | $12,014 | $1,430 | $1,516 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 113 | 111 | $36,177 | $4,028 | $4,358 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 109 | 109 | $47,448 | $5,078 | $5,339 |
| Level 3 Endovascular ProceduresAPC 5193 | 109 | 107 | $79,481 | $8,225 | $8,874 |
| Level 4 Urology and Related ServicesAPC 5374 | 106 | 91 | $24,589 | $2,453 | $2,629 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 88 | 87 | $13,668 | $1,130 | $1,196 |
| Level 5 Urology and Related ServicesAPC 5375 | 84 | 80 | $30,825 | $3,712 | $3,918 |
| Level 3 Vascular ProceduresAPC 5183 | 76 | 74 | $23,119 | $2,197 | $2,405 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 70 | 69 | $72,436 | $7,975 | $8,569 |
| Level 4 Endovascular ProceduresAPC 5194 | 69 | 65 | $114,162 | $14,120 | $14,606 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 66 | 63 | $54,814 | $7,508 | $8,164 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 63 | 62 | $116,309 | $14,889 | $15,763 |
| Level 5 Airway EndoscopyAPC 5155 | 63 | 62 | $31,788 | $4,910 | $5,183 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 52 | 49 | $11,142 | $1,106 | $1,220 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 52 | 51 | $45,517 | $5,623 | $6,514 |
| Level 4 Airway EndoscopyAPC 5154 | 51 | 47 | $23,710 | $2,686 | $2,833 |
| Level 2 Upper GI ProceduresAPC 5302 | 49 | 42 | $15,344 | $1,365 | $1,445 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 41 | 41 | $18,110 | $2,034 | $2,141 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 41 | 41 | $29,306 | $2,322 | $2,373 |
| Level 1 Nerve ProceduresAPC 5431 | 39 | 38 | $16,113 | $1,371 | $1,407 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 38 | 38 | $210,552 | $27,897 | $29,375 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 36 | 35 | $23,313 | $2,482 | $2,636 |
| Level 2 Endovascular ProceduresAPC 5192 | 33 | 32 | $50,295 | $4,100 | $4,338 |
| Level 4 Vascular ProceduresAPC 5184 | 26 | 26 | $46,767 | $3,942 | $3,946 |
| Level 4 Gynecologic ProceduresAPC 5414 | 26 | 26 | $21,399 | $2,243 | $2,389 |
| Level 2 Vascular ProceduresAPC 5182 | 25 | 22 | $5,677 | $1,116 | $1,204 |
| Level 5 Gynecologic ProceduresAPC 5415 | 22 | 21 | $34,566 | $3,406 | $3,792 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 21 | 20 | $179,699 | $22,486 | $26,719 |
| Level 3 Airway EndoscopyAPC 5153 | 16 | 16 | $16,630 | $1,217 | $1,264 |
| Level 5 ENT ProceduresAPC 5165 | 13 | 12 | $41,032 | $4,201 | $4,436 |
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.