Hospital Stay Costs by DRG
770 Diagnosis-Related Groups with average charges, Medicare payments, and length of stay
Surgical DRGs 50 procedures
DRG
Description
Avg Medicare Payment
Avg Length of Stay
Discharges
489
KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC
$7,259
1.2 days
—
492
LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC
$23,865
6.6 days
—
493
LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC
$16,485
4.2 days
—
494
LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC
$13,042
2.8 days
—
495
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC
$23,567
7.2 days
—
496
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC
$11,725
2.8 days
—
497
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC
$7,854
1.4 days
—
498
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC
$19,609
4.4 days
—
499
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC
$13,096
1.8 days
—
500
SOFT TISSUE PROCEDURES WITH MCC
$20,571
7.6 days
—
501
SOFT TISSUE PROCEDURES WITH CC
$11,363
4 days
—
502
SOFT TISSUE PROCEDURES WITHOUT CC/MCC
$8,748
2.4 days
—
503
FOOT PROCEDURES WITH MCC
$18,142
7.1 days
—
504
FOOT PROCEDURES WITH CC
$12,150
4.5 days
—
505
FOOT PROCEDURES WITHOUT CC/MCC
$11,653
2.7 days
—
506
MAJOR THUMB OR JOINT PROCEDURES
$8,770
3.7 days
—
507
MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC
$11,742
5.1 days
—
508
MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC
$9,844
3.2 days
—
510
SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC
$19,633
5.3 days
—
511
SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC
$13,516
3.5 days
—
512
SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC
$10,760
2.3 days
—
513
HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC
$10,233
3.9 days
—
514
HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC
$6,645
2.1 days
—
515
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC
$20,715
6.7 days
—
516
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC
$13,508
4 days
—
Medical DRGs 50 diagnoses
DRG
Description
Avg Medicare Payment
Avg Length of Stay
Discharges
533
FRACTURES OF FEMUR WITH MCC
$10,190
4.3 days
—
534
FRACTURES OF FEMUR WITHOUT MCC
$5,240
2.9 days
—
535
FRACTURES OF HIP AND PELVIS WITH MCC
$8,333
3.9 days
—
536
FRACTURES OF HIP AND PELVIS WITHOUT MCC
$5,249
2.9 days
—
537
SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC
$6,203
3.3 days
—
538
SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC
$4,682
2.4 days
—
539
OSTEOMYELITIS WITH MCC
$12,803
6.2 days
—
540
OSTEOMYELITIS WITH CC
$8,426
4.3 days
—
541
OSTEOMYELITIS WITHOUT CC/MCC
$5,118
2.9 days
—
542
PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC
$11,482
5 days
—
543
PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC
$6,682
3.5 days
—
544
PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC
$4,905
2.7 days
—
545
CONNECTIVE TISSUE DISORDERS WITH MCC
$16,131
5.5 days
—
546
CONNECTIVE TISSUE DISORDERS WITH CC
$7,497
3.4 days
—
547
CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
$5,435
2.5 days
—
548
SEPTIC ARTHRITIS WITH MCC
$12,551
5.9 days
—
549
SEPTIC ARTHRITIS WITH CC
$7,847
3.9 days
—
550
SEPTIC ARTHRITIS WITHOUT CC/MCC
$5,682
3.1 days
—
551
MEDICAL BACK PROBLEMS WITH MCC
$10,895
4.5 days
—
552
MEDICAL BACK PROBLEMS WITHOUT MCC
$6,248
2.9 days
—
553
BONE DISEASES AND ARTHROPATHIES WITH MCC
$8,426
4 days
—
554
BONE DISEASES AND ARTHROPATHIES WITHOUT MCC
$5,396
2.8 days
—
555
SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
$8,592
3.8 days
—
556
SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC
$5,399
2.7 days
—
557
TENDONITIS, MYOSITIS AND BURSITIS WITH MCC
$9,665
4.7 days
—
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.