Medical Hospital Stay Costs

367 Diagnosis-Related Groups with average charges, Medicare payments, and length of stay

All DRGs Surgical Medical

DRG

Description

Type

Avg Medicare Payment

Avg Length of Stay

Discharges

SEPTIC ARTHRITIS WITH CC

SEPTIC ARTHRITIS WITHOUT CC/MCC

MEDICAL BACK PROBLEMS WITH MCC

MEDICAL BACK PROBLEMS WITHOUT MCC

BONE DISEASES AND ARTHROPATHIES WITH MCC

BONE DISEASES AND ARTHROPATHIES WITHOUT MCC

SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC

SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC

TENDONITIS, MYOSITIS AND BURSITIS WITH MCC

TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC

AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC

AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC

AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC

FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC

FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC

SKIN ULCERS WITH MCC

SKIN ULCERS WITH CC

SKIN ULCERS WITHOUT CC/MCC

MAJOR SKIN DISORDERS WITH MCC

MAJOR SKIN DISORDERS WITHOUT MCC

MALIGNANT BREAST DISORDERS WITH MCC

MALIGNANT BREAST DISORDERS WITH CC

MALIGNANT BREAST DISORDERS WITHOUT CC/MCC

NON-MALIGNANT BREAST DISORDERS WITH CC/MCC

NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC

CELLULITIS WITH MCC

CELLULITIS WITHOUT MCC

TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC

TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC

MINOR SKIN DISORDERS WITH MCC

MINOR SKIN DISORDERS WITHOUT MCC

DIABETES WITH MCC

DIABETES WITH CC

DIABETES WITHOUT CC/MCC

MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC

MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC

INBORN AND OTHER DISORDERS OF METABOLISM

ENDOCRINE DISORDERS WITH MCC

ENDOCRINE DISORDERS WITH CC

ENDOCRINE DISORDERS WITHOUT CC/MCC

RENAL FAILURE WITH MCC

RENAL FAILURE WITH CC

RENAL FAILURE WITHOUT CC/MCC

KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC

KIDNEY AND URINARY TRACT NEOPLASMS WITH CC

KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC

KIDNEY AND URINARY TRACT INFECTIONS WITH MCC

KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC

URINARY STONES WITH MCC

URINARY STONES WITHOUT MCC

KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC

KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC

URETHRAL STRICTURE

OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC

OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC

OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC

MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC

MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC

MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

BENIGN PROSTATIC HYPERTROPHY WITH MCC

BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC

INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC

INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC

OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC

OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC

INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC

INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC

MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC

POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES

ABORTION WITHOUT D&C

NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY

EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE

PREMATURITY WITH MAJOR PROBLEMS

PREMATURITY WITHOUT MAJOR PROBLEMS

FULL TERM NEONATE WITH MAJOR PROBLEMS

NEONATE WITH OTHER SIGNIFICANT PROBLEMS

VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC

VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC

VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC

MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC

MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC

MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC

RED BLOOD CELL DISORDERS WITH MCC

RED BLOOD CELL DISORDERS WITHOUT MCC

COAGULATION DISORDERS

RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC

RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC

RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC

OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC

OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC

OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC

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What is a DRG?

A Diagnosis-Related Group (DRG) is how Medicare classifies hospital inpatient stays for payment purposes. Each DRG groups patients with similar diagnoses and treatments, establishing a standard payment amount regardless of the actual costs incurred by the hospital.

Average Medicare Payment

The amount Medicare pays the hospital for this DRG. This is a national average — actual payments vary by hospital wage index, teaching status, and case mix.

Average Length of Stay

The typical number of days patients spend in the hospital for this DRG. Hospitals receive the same DRG payment whether the stay is shorter or longer than average.

Surgical vs. Medical

Surgical DRGs involve operating room procedures. Medical DRGs are for non-surgical hospital stays. Surgical DRGs generally have higher payments due to greater resource use.

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