Wilcox Health Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Wilcox Health, Lihue, HI in 2024, from traditional Medicare claims. Back to the Wilcox Health profile, with quality ratings, finances and negotiated rates.
201
Medicare inpatient discharges
In 9 published DRGs
1.60
Case mix index
IPPS FY 2027
7%
Surgical stays
92%
Stays with complications
In DRGs with a CC or MCC
625
Medicare outpatient services
In 13 service groups
Inpatient stays by major diagnostic category
Respiratory system51 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 27 | $40,573 | $14,978 | $14,038 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 24 | $50,361 | $19,821 | $17,425 | 1.70 |
Infectious and parasitic diseases46 discharges in 1 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 | 46 | $54,739 | $22,751 | $18,940 | 1.98 |
Circulatory system32 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 32 | $30,713 | $12,931 | $10,627 | 1.28 |
Skin, subcutaneous tissue and breast17 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 17 | $29,269 | $9,673 | $10,127 | 0.88 |
Nervous system15 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 15 | $60,021 | $23,415 | $20,767 | 2.00 |
Musculoskeletal system and connective tissue15 discharges in 1 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 | 15 | $64,507 | $22,581 | $22,319 | 2.07 |
Digestive system13 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 13 | $30,027 | $10,190 | $10,389 | 0.98 |
Kidney and urinary tract12 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with MCCMS-DRG 682, medical | 12 | $33,867 | $16,921 | $11,718 | 1.50 |
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 | 167 | 159 | $15,465 | $2,638 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 85 | 83 | $49,057 | $13,862 | $10,772 |
| Level 1 Intraocular ProceduresAPC 5491 | 76 | 60 | $10,168 | $2,286 | $1,752 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 64 | 61 | $7,777 | $1,526 | $1,196 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 55 | 54 | $27,256 | $6,786 | $5,339 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 46 | 45 | $6,011 | $1,468 | $1,220 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 29 | 28 | $12,690 | $3,089 | $2,373 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 23 | 23 | $25,961 | $5,663 | $4,358 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 22 | 20 | $13,468 | $2,541 | $2,141 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 18 | 18 | $73,371 | $20,082 | $15,763 |
| Level 4 Urology and Related ServicesAPC 5374 | 16 | 14 | $13,006 | $3,421 | $2,629 |
| Level 3 Vascular ProceduresAPC 5183 | 13 | 12 | $13,722 | $2,888 | $2,405 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 11 | 11 | $15,838 | $3,395 | $2,636 |
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.