William P. Clements Jr. University Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for William P. Clements Jr. University Hospital, Dallas, TX in 2024, from traditional Medicare claims. Back to the William P. Clements Jr. University Hospital profile, with quality ratings, finances and negotiated rates.
7,202
Medicare inpatient discharges
In 193 published DRGs
2.65
Case mix index
IPPS FY 2027
33%
Surgical stays
76%
Stays with complications
In DRGs with a CC or MCC
9,023
Medicare outpatient services
In 58 service groups
Inpatient stays by major diagnostic category
Circulatory system1,486 discharges in 29 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 230 | $45,694 | $8,620 | $14,348 | 1.28 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 113 | $201,972 | $36,744 | $63,419 | 4.88 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 96 | $125,427 | $17,285 | $39,384 | 2.16 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 92 | $287,677 | $75,019 | $90,331 | 7.71 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 86 | $242,374 | $50,816 | $76,105 | 6.25 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 79 | $117,560 | $23,436 | $36,914 | 3.24 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 74 | $91,236 | $15,708 | $28,648 | 2.09 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 55 | $232,874 | $50,943 | $73,122 | 5.06 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 48 | $175,372 | $37,995 | $55,067 | 5.24 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 48 | $220,471 | $39,940 | $69,228 | 4.16 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 46 | $63,090 | $10,653 | $19,810 | 1.59 |
| Syncope and collapseMS-DRG 312, medical | 43 | $35,352 | $5,962 | $11,100 | 0.86 |
| Other vascular procedures with CCMS-DRG 253, surgical | 39 | $120,682 | $18,438 | $37,894 | 2.55 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 37 | $24,659 | $5,118 | $7,743 | 0.74 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 33 | $138,676 | $25,731 | $43,544 | 3.46 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 33 | $43,115 | $8,778 | $13,538 | 1.20 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 32 | $46,178 | $6,478 | $14,500 | 0.97 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 31 | $40,403 | $6,103 | $12,687 | 1.07 |
| Aortic and heart assist procedures except pulsation balloon with MCCMS-DRG 268, surgical | 30 | $348,172 | $73,571 | $109,326 | 6.85 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 30 | $82,589 | $9,524 | $25,933 | 1.08 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 28 | $44,263 | $9,870 | $13,899 | 1.58 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 27 | $132,449 | $27,968 | $41,589 | 3.35 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 25 | $135,586 | $28,223 | $42,574 | 3.90 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 24 | $135,009 | $20,974 | $42,393 | 2.87 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 23 | $425,621 | $98,984 | $133,645 | 3.27 |
| Heart failure and shock with CCMS-DRG 292, medical | 23 | $37,322 | $6,055 | $11,719 | 0.86 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 23 | $96,853 | $13,077 | $30,412 | 1.82 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 21 | $41,127 | $6,660 | $12,914 | 0.91 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 17 | $196,818 | $39,956 | $61,801 | 5.88 |
Kidney and urinary tract931 discharges in 19 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 | 170 | $55,432 | $12,320 | $17,406 | 1.65 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 115 | $36,231 | $7,275 | $11,376 | 1.02 |
| Renal failure with MCCMS-DRG 682, medical | 94 | $59,870 | $10,749 | $18,799 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 77 | $30,366 | $5,762 | $9,535 | 0.90 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 75 | $28,730 | $5,330 | $9,021 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 52 | $39,069 | $7,845 | $12,268 | 1.17 |
| Major bladder procedures with CCMS-DRG 654, surgical | 48 | $106,735 | $17,415 | $33,515 | 2.74 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 40 | $62,839 | $12,160 | $19,731 | 1.84 |
| Kidney transplantMS-DRG 652, surgical | 35 | $274,389 | $17,015 | $86,158 | 3.00 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 32 | $57,683 | $9,273 | $18,112 | 1.35 |
| Kidney transplant with hemodialysis with MCCMS-DRG 650, surgical | 30 | $294,721 | $31,713 | $92,542 | 4.50 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 28 | $212,587 | $38,043 | $66,752 | 3.70 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 26 | $99,762 | $16,921 | $31,325 | 2.59 |
| Kidney and ureter procedures for neoplasm without cc/mccMS-DRG 658, surgical | 20 | $55,285 | $7,683 | $17,359 | 1.48 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 20 | $47,196 | $6,871 | $14,819 | 1.05 |
| Major bladder procedures with MCCMS-DRG 653, surgical | 19 | $179,892 | $34,876 | $56,486 | 5.41 |
| Kidney and ureter procedures for neoplasm with MCCMS-DRG 656, surgical | 19 | $129,030 | $27,258 | $40,515 | 3.14 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 17 | $87,677 | $17,351 | $27,531 | 2.38 |
| Urinary stones without MCCMS-DRG 694, medical | 14 | $29,954 | $4,421 | $9,406 | 0.78 |
Infectious and parasitic diseases819 discharges in 10 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 | 525 | $80,493 | $14,339 | $25,275 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 90 | $216,883 | $45,925 | $68,101 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 67 | $36,339 | $6,564 | $11,410 | 1.03 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 35 | $65,327 | $13,515 | $20,513 | 1.84 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 23 | $20,167 | $6,668 | $6,332 | 1.01 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 22 | $318,996 | $69,792 | $100,165 | 6.96 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 18 | $121,704 | $30,299 | $38,215 | 4.43 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 14 | $45,995 | $14,968 | $14,442 | 2.14 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 13 | $110,568 | $16,245 | $34,718 | 2.04 |
| Fever and inflammatory conditionsMS-DRG 864, medical | 12 | $32,127 | $6,334 | $10,088 | 0.88 |
Respiratory system768 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 118 | $64,007 | $11,642 | $20,098 | 1.70 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 103 | $139,425 | $25,021 | $43,780 | 1.81 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 88 | $42,200 | $9,199 | $13,251 | 1.33 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 53 | $165,400 | $36,376 | $51,935 | 4.06 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 40 | $40,808 | $5,995 | $12,814 | 0.99 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 39 | $90,158 | $16,485 | $28,310 | 1.90 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 38 | $51,409 | $7,963 | $16,142 | 1.23 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 36 | $29,076 | $5,080 | $9,130 | 0.82 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 36 | $81,826 | $9,035 | $25,693 | 0.91 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 30 | $75,559 | $12,224 | $23,725 | 1.74 |
| Major chest procedures with CCMS-DRG 164, surgical | 29 | $80,137 | $17,098 | $25,163 | 2.55 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 29 | $44,824 | $10,184 | $14,075 | 1.40 |
| Other respiratory system o.r. procedures with CCMS-DRG 167, surgical | 27 | $72,304 | $12,120 | $22,703 | 1.82 |
| Major chest procedures with MCCMS-DRG 163, surgical | 25 | $144,349 | $32,995 | $45,325 | 4.71 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 23 | $42,625 | $7,679 | $13,384 | 1.10 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 17 | $26,674 | $5,542 | $8,376 | 0.85 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 14 | $28,486 | $5,971 | $8,945 | 0.82 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 12 | $28,165 | $6,695 | $8,844 | 0.96 |
| Respiratory signs and symptomsMS-DRG 204, medical | 11 | $30,184 | $6,029 | $9,478 | 0.82 |
Digestive system762 discharges in 21 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 | 102 | $33,720 | $5,227 | $10,588 | 0.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 78 | $52,855 | $10,152 | $16,596 | 1.28 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 64 | $52,563 | $12,767 | $16,505 | 1.62 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 57 | $31,503 | $6,378 | $9,892 | 0.94 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 49 | $99,264 | $16,513 | $31,169 | 2.37 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 49 | $67,378 | $11,949 | $21,157 | 1.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 48 | $38,590 | $6,629 | $12,117 | 0.98 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 37 | $164,355 | $36,272 | $51,607 | 4.52 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 34 | $24,131 | $5,481 | $7,577 | 0.80 |
| Digestive malignancy with MCCMS-DRG 374, medical | 28 | $80,231 | $14,445 | $25,192 | 2.10 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 27 | $40,840 | $10,414 | $12,824 | 1.45 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 26 | $218,908 | $54,312 | $68,737 | 5.08 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 25 | $111,691 | $17,269 | $35,071 | 2.50 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 23 | $58,632 | $11,181 | $18,410 | 1.75 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 23 | $38,257 | $6,259 | $12,013 | 1.04 |
| Hernia procedures except inguinal and femoral with CCMS-DRG 354, surgical | 19 | $83,584 | $11,117 | $26,245 | 1.72 |
| Digestive malignancy with CCMS-DRG 375, medical | 18 | $47,841 | $7,420 | $15,022 | 1.20 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 16 | $61,933 | $10,861 | $19,447 | 1.67 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 16 | $138,350 | $30,044 | $43,442 | 4.28 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 12 | $106,528 | $12,728 | $33,450 | 2.11 |
| Hernia procedures except inguinal and femoral without cc/mccMS-DRG 355, surgical | 11 | $67,313 | $8,335 | $21,136 | 1.36 |
Nervous system634 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 71 | $142,736 | $31,462 | $44,819 | 4.42 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 69 | $46,765 | $9,383 | $14,684 | 1.36 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 58 | $70,797 | $17,362 | $22,230 | 2.43 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 44 | $97,069 | $16,542 | $30,480 | 2.00 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 42 | $48,744 | $8,223 | $15,305 | 1.47 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 42 | $82,824 | $13,048 | $26,007 | 1.79 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 41 | $86,259 | $15,795 | $27,085 | 2.39 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 39 | $86,100 | $18,961 | $27,035 | 2.95 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 38 | $53,097 | $6,840 | $16,673 | 1.02 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 26 | $46,615 | $6,652 | $14,637 | 1.03 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 24 | $171,077 | $35,982 | $53,718 | 5.67 |
| Ventricular shunt procedures without cc/mccMS-DRG 033, surgical | 24 | $43,823 | $11,130 | $13,760 | 1.62 |
| Seizures without MCCMS-DRG 101, medical | 21 | $39,587 | $6,376 | $12,430 | 0.91 |
| Seizures with MCCMS-DRG 100, medical | 20 | $106,928 | $15,476 | $33,575 | 1.98 |
| Ventricular shunt procedures with CCMS-DRG 032, surgical | 19 | $46,990 | $15,089 | $14,755 | 2.15 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 18 | $58,958 | $13,398 | $18,513 | 1.79 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 14 | $43,775 | $5,789 | $13,745 | 1.03 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 13 | $44,649 | $7,932 | $14,020 | 1.06 |
| Headaches without MCCMS-DRG 103, medical | 11 | $29,116 | $5,366 | $9,143 | 0.84 |
Musculoskeletal system and connective tissue322 discharges in 17 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 36 | $32,006 | $6,592 | $10,050 | 0.97 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 30 | $73,717 | $13,205 | $23,147 | 1.88 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 28 | $135,080 | $24,068 | $42,415 | 3.66 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 24 | $72,710 | $12,694 | $22,831 | 2.04 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 21 | $181,426 | $27,661 | $56,968 | 2.95 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 20 | $39,904 | $7,545 | $12,530 | 1.09 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 18 | $70,716 | $11,123 | $22,205 | 1.97 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 18 | $61,988 | $12,528 | $19,464 | 1.82 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 17 | $86,830 | $12,715 | $27,265 | 2.07 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 17 | $31,688 | $5,968 | $9,950 | 0.82 |
| Medical back problems with MCCMS-DRG 551, medical | 15 | $51,742 | $10,766 | $16,247 | 1.70 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 457, surgical | 14 | $271,407 | $57,689 | $85,222 | 6.08 |
| Connective tissue disorders with CCMS-DRG 546, medical | 14 | $51,565 | $8,807 | $16,191 | 1.20 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 13 | $113,525 | $20,569 | $35,647 | 2.48 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 13 | $71,151 | $15,387 | $22,342 | 2.40 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 12 | $159,778 | $21,243 | $50,170 | 3.49 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 12 | $89,074 | $20,865 | $27,969 | 2.96 |
Liver, gallbladder and pancreas289 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 41 | $73,689 | $12,458 | $23,138 | 1.76 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 40 | $82,307 | $15,436 | $25,844 | 1.92 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 35 | $90,277 | $17,100 | $28,347 | 1.83 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 30 | $108,265 | $18,899 | $33,995 | 2.89 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 26 | $36,647 | $7,492 | $11,507 | 0.95 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 25 | $166,802 | $47,201 | $52,376 | 5.51 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 21 | $64,853 | $12,099 | $20,364 | 1.63 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 21 | $42,768 | $7,497 | $13,429 | 1.09 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 19 | $35,145 | $7,229 | $11,035 | 1.03 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 17 | $28,927 | $5,476 | $9,083 | 0.86 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 14 | $74,397 | $13,246 | $23,361 | 1.67 |
Endocrine, nutritional and metabolic288 discharges in 9 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 | 100 | $48,948 | $9,007 | $15,370 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 47 | $29,368 | $5,108 | $9,222 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 31 | $27,775 | $5,527 | $8,721 | 0.90 |
| Adrenal and pituitary procedures with cc/mccMS-DRG 614, surgical | 25 | $62,746 | $15,193 | $19,702 | 2.25 |
| Endocrine disorders with CCMS-DRG 644, medical | 23 | $37,952 | $6,806 | $11,917 | 1.06 |
| Diabetes with MCCMS-DRG 637, medical | 21 | $67,977 | $10,940 | $21,345 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 17 | $48,540 | $10,523 | $15,241 | 1.65 |
| Adrenal and pituitary procedures without cc/mccMS-DRG 615, surgical | 12 | $47,966 | $9,149 | $15,061 | 1.47 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 12 | $75,416 | $11,707 | $23,681 | 1.98 |
Blood and immune system178 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 | 65 | $34,397 | $5,770 | $10,801 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 46 | $59,790 | $10,733 | $18,774 | 1.40 |
| Coagulation disordersMS-DRG 813, medical | 25 | $85,553 | $13,190 | $26,864 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 24 | $43,230 | $8,654 | $13,574 | 1.20 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 18 | $115,070 | $25,607 | $36,132 | 2.19 |
Blood cancers and poorly differentiated neoplasms172 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 47 | $131,720 | $29,110 | $41,360 | 3.13 |
| Chemotherapy without acute leukemia as secondary diagnosis with CCMS-DRG 847, medical | 37 | $39,330 | $9,764 | $12,349 | 1.21 |
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 25 | $110,426 | $18,402 | $34,674 | 2.44 |
| Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy aMS-DRG 837, medical | 23 | $117,366 | $31,834 | $36,853 | 4.84 |
| Acute leukemia with MCCMS-DRG 834, medical | 18 | $260,479 | $67,583 | $81,790 | 5.60 |
| Lymphoma and leukemia with major o.r. procedures with CCMS-DRG 821, surgical | 11 | $66,392 | $15,698 | $20,847 | 2.23 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 11 | $62,207 | $10,157 | $19,533 | 1.57 |
Injuries, poisonings and toxic effects of drugs152 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 | 60 | $71,159 | $14,146 | $22,344 | 1.82 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 31 | $121,229 | $22,974 | $38,066 | 3.72 |
| Complications of treatment with CCMS-DRG 920, medical | 30 | $30,970 | $7,385 | $9,725 | 1.03 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 16 | $62,392 | $12,392 | $19,591 | 2.00 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 15 | $75,831 | $12,873 | $23,811 | 1.60 |
Transplants, ECMO and tracheostomy (pre-MDC)128 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 26 | $1,132,899 | $274,697 | $355,730 | 27.10 |
| Chimeric antigen receptor (car) t-cell and other immunotherapiesMS-DRG 018, medical | 22 | $1,148,750 | $346,811 | $360,708 | 36.84 |
| ECMO or tracheostomy with MV >96 hours or principal diagnosis except face, mouth and necMS-DRG 003, surgical | 19 | $1,239,859 | $274,777 | $389,316 | 21.32 |
| Lung transplantMS-DRG 007, surgical | 18 | $1,011,745 | $162,930 | $317,688 | 12.27 |
| Autologous bone marrow transplant with cc/mccMS-DRG 016, medical | 17 | $122,735 | $39,093 | $38,539 | 6.18 |
| Liver transplant with MCC or intestinal transplantMS-DRG 005, surgical | 15 | $660,209 | $69,431 | $207,306 | 10.35 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 11 | $590,457 | $144,032 | $185,404 | 14.70 |
Skin, subcutaneous tissue and breast77 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 48 | $26,726 | $5,446 | $8,392 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 16 | $40,455 | $8,539 | $12,703 | 1.49 |
| Minor skin disorders without MCCMS-DRG 607, medical | 13 | $40,442 | $5,556 | $12,699 | 0.89 |
Other61 discharges in 3 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 | 30 | $171,605 | $40,797 | $53,884 | 4.74 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 18 | $187,497 | $39,220 | $58,874 | 3.38 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 13 | $71,756 | $15,137 | $22,531 | 2.49 |
Mental diseases and disorders38 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 25 | $47,714 | $12,517 | $14,982 | 1.76 |
| Acute adjustment reaction and psychosocial dysfunctionMS-DRG 880, medical | 13 | $33,434 | $4,287 | $10,498 | 0.95 |
Male reproductive system29 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major male pelvic procedures with cc/mccMS-DRG 707, surgical | 18 | $67,725 | $13,072 | $21,266 | 1.96 |
| Transurethral prostatectomy with cc/mccMS-DRG 713, surgical | 11 | $36,037 | $7,398 | $11,316 | 1.45 |
Factors influencing health status28 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms with MCCMS-DRG 947, medical | 16 | $84,196 | $12,463 | $26,437 | 1.25 |
| Signs and symptoms without MCCMS-DRG 948, medical | 12 | $26,787 | $4,833 | $8,411 | 0.80 |
Female reproductive system15 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Female reproductive system reconstructive proceduresMS-DRG 748, surgical | 15 | $78,230 | $12,061 | $24,564 | 1.40 |
Ear, nose, mouth and throat14 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 | 14 | $113,826 | $19,057 | $35,741 | 2.07 |
HIV infections11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| HIV with major related condition with MCCMS-DRG 974, medical | 11 | $154,712 | $25,305 | $48,580 | 2.92 |
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 | 701 | 446 | $8,088 | $1,643 | $1,752 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 578 | 452 | $28,289 | $2,010 | $2,141 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 551 | 508 | $10,009 | $1,127 | $1,220 |
| Level 1 Endovascular ProceduresAPC 5191 | 419 | 405 | $22,087 | $2,035 | $2,208 |
| Comprehensive Observation ServicesAPC 8011 | 401 | 384 | $16,094 | $1,865 | $2,090 |
| Level 3 Vascular ProceduresAPC 5183 | 374 | 341 | $21,268 | $2,217 | $2,405 |
| Level 1 Nerve ProceduresAPC 5431 | 361 | 257 | $5,510 | $1,363 | $1,407 |
| Level 4 Urology and Related ServicesAPC 5374 | 354 | 304 | $12,887 | $2,433 | $2,629 |
| Level 5 Urology and Related ServicesAPC 5375 | 351 | 322 | $26,950 | $3,665 | $3,918 |
| Level 2 Upper GI ProceduresAPC 5302 | 334 | 287 | $11,425 | $1,346 | $1,445 |
| Level 3 Urology and Related ServicesAPC 5373 | 308 | 253 | $9,083 | $1,427 | $1,516 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 298 | 298 | $46,514 | $7,575 | $8,164 |
| Level 4 Airway EndoscopyAPC 5154 | 270 | 211 | $17,991 | $2,623 | $2,833 |
| Level 5 ENT ProceduresAPC 5165 | 208 | 206 | $32,168 | $4,056 | $4,436 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 206 | 198 | $8,426 | $1,650 | $1,780 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 196 | 193 | $30,803 | $4,074 | $4,358 |
| Level 3 Endovascular ProceduresAPC 5193 | 188 | 172 | $60,273 | $8,127 | $8,874 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 183 | 177 | $57,364 | $9,805 | $10,772 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 168 | 164 | $29,649 | $5,067 | $5,339 |
| Level 5 Airway EndoscopyAPC 5155 | 164 | 159 | $37,319 | $4,848 | $5,183 |
| Level 2 Intraocular ProceduresAPC 5492 | 153 | 125 | $15,130 | $2,896 | $3,116 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 145 | 139 | $116,346 | $19,550 | $21,117 |
| Level 2 Vascular ProceduresAPC 5182 | 136 | 135 | $9,388 | $1,107 | $1,204 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 131 | 128 | $33,674 | $4,569 | $4,982 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 110 | 101 | $20,894 | $2,456 | $2,636 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 105 | 103 | $77,573 | $15,103 | $15,763 |
| Level 3 Airway EndoscopyAPC 5153 | 105 | 82 | $13,420 | $1,203 | $1,264 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 103 | 101 | $17,588 | $2,255 | $2,373 |
| Level 4 Endovascular ProceduresAPC 5194 | 101 | 93 | $79,678 | $13,692 | $14,606 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 85 | 77 | $18,891 | $2,717 | $2,930 |
| Level 2 Endovascular ProceduresAPC 5192 | 85 | 83 | $35,945 | $4,049 | $4,338 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 84 | 81 | $5,758 | $1,097 | $1,196 |
| Level 4 Vascular ProceduresAPC 5184 | 75 | 63 | $32,403 | $3,257 | $3,946 |
| Level 6 Urology and Related ServicesAPC 5376 | 73 | 71 | $34,445 | $6,563 | $7,291 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 70 | 69 | $102,013 | $25,107 | $26,719 |
| Level 4 Gynecologic ProceduresAPC 5414 | 63 | 63 | $13,781 | $2,133 | $2,389 |
| Level 8 Urology and Related ServicesAPC 5378 | 60 | 59 | $69,726 | $16,198 | $17,428 |
| Level 3 Neurostimulator and Related ProceduresAPC 5463 | 58 | 56 | $105,195 | $10,606 | $11,550 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 56 | 52 | $19,938 | $4,900 | $4,524 |
| Level 3 Lower GI ProceduresAPC 5313 | 53 | 50 | $11,233 | $2,023 | $2,176 |
| Level 7 Radiation TherapyAPC 5627 | 48 | 48 | $55,086 | $5,351 | $6,121 |
| Complex GI ProceduresAPC 5331 | 47 | 36 | $31,704 | $3,999 | $4,263 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 43 | 43 | $51,958 | $7,591 | $8,569 |
| Level 3 Upper GI ProceduresAPC 5303 | 43 | 43 | $21,725 | $2,743 | $2,888 |
| Level 5 Gynecologic ProceduresAPC 5415 | 43 | 41 | $21,911 | $3,483 | $3,792 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 43 | 43 | $83,744 | $18,007 | $18,465 |
| Level 2 Urology and Related ServicesAPC 5372 | 34 | 30 | $4,779 | $490 | $502 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 32 | 32 | $163,210 | $27,887 | $29,375 |
| Level 6 Gynecologic ProceduresAPC 5416 | 32 | 30 | $34,084 | $5,243 | $5,836 |
| Level 4 Extraocular, Repair, and Plastic Eye ProceduresAPC 5504 | 31 | 29 | $15,738 | $2,772 | $2,969 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 29 | 29 | $35,460 | $6,087 | $6,514 |
| Cochlear Implant ProcedureAPC 5166 | 28 | 28 | $142,244 | $28,456 | $29,489 |
| Level 4 ENT ProceduresAPC 5164 | 26 | 26 | $16,292 | $2,308 | $2,217 |
| Level 3 Intraocular ProceduresAPC 5493 | 21 | 13 | $18,001 | $3,747 | $4,004 |
| Level 3 Breast/Lymphatic Surgery and Related ProceduresAPC 5093 | 16 | 16 | $39,455 | $6,849 | $7,546 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 15 | 14 | $84,495 | $15,864 | $17,052 |
| Level 4 Breast/Lymphatic Surgery and Related ProceduresAPC 5094 | 14 | 13 | $94,294 | $14,194 | $15,549 |
| Level 2 Nerve ProceduresAPC 5432 | 14 | 14 | $33,203 | $4,776 | $4,674 |
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.