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HCHospitalCostData

Updated April 2026

Nutritional and Misc Metabolic Disorders with MCC in Puerto Rico

37 Puerto Rico hospitals report Medicare totals for this DRG, averaging $7,777 (well below the $11,374 national mean), with a 3× spread from $4,377 to $11,121. 0 carry an A grade, 0 carry an F.

The Metabolic procedure Nutritional and Misc Metabolic Disorders with MCC carries DRG code 641 in the CMS classification system. 2,704 hospitals in Puerto Rico report payment data, averaging $11,374 per procedure — median $11,065, ranging from $3,981 to $24,023. A $24,023 maximum and $3,981 minimum on the same DRG procedure is normal for the Medicare payment system — DRG codes bundle cases that may differ in complexity, and hospital wage-index adjustments alone can move payments by 30% across regions.

Within Puerto Rico, the 2,704 hospitals reporting this procedure span the full range of ownership types and hospital sizes. The state-specific average ($11,374) is shaped by which hospitals in the state see enough volume to report the DRG code at all. For patients with elective scheduling on Nutritional and Misc Metabolic Disorders with MCC, the cost-comparison logic is straightforward: the per-procedure payment range is meaningfully wide, so the hospital chosen affects total cost. For patients in an emergency, the choice is functionally fixed — but the listed prices still matter for insurance-coverage and out-of-pocket planning.

About This Procedure

This procedure category groups related Medicare DRGs. Cost spread across hospitals is driven by length of stay, case complexity, regional wage indexes, and whether the facility is an academic referral center.

Nutritional and Misc Metabolic Disorders with MCC is Medicare DRG 641 in the Metabolic category. National Medicare average for this DRG is $11,374 across 2,704 reporting hospitals. The state-level view here filters that universe down to Puerto Rico only.

Cost Picture in Puerto Rico

Puerto Rico's average for this DRG sits well below the national Medicare mean. State-level differences are explained primarily by the regional Medicare wage index — the multiplier CMS applies to standardize DRG payments to local labor costs — alongside hospital case mix and the concentration of academic referral centers in the state's larger metros.

Within the state, the 3× spread between the lowest- and highest-reporting facility usually reflects length-of-stay differences, complication adjustments for sicker patients, teaching-status add-ons, and outlier payments for unusually long stays. Two hospitals reporting the same DRG can post meaningfully different totals without anything “wrong” happening at either site. For non-Medicare patients, the more relevant figure is the negotiated commercial rate published in each hospital's machine-readable file under the CMS Hospital Price Transparency Rule.

Quality Alongside Price

For a planned admission, the most useful complement to the cost view is the hospital-specific quality data on CMS Care Compare. The site publishes risk-adjusted measures of mortality, readmission, complication, infection, and patient experience for every Medicare-participating hospital. The Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators feed many of these CMS measures.

For complex procedures, hospital-level case volume correlates with outcomes in published research, even after risk adjustment. CMS publishes case counts on Care Compare alongside outcome measures.

Hospitals in Puerto Rico Reporting Nutritional and Misc Metabolic Disorders with MCC

Sorted lowest to highest Medicare total payment. Pricing is informational and should be considered alongside CMS quality measures.

#HospitalPaymentGrade
1Hospital Universitario Dr Ruiz Arnau
Bayamon
$4,377B
2Ryder Memorial Hospital Inc
Humacao
$5,352B
3Centro Cardiovascular De Puerto Rico Y El Caribe
San Juan
$5,415B
4Professional Hospital Guaynabo Inc
Guaynabo
$5,559B
5University Pediatric Hospital
San Juan
$6,047B
6Hospital Metropolitano Dr Pila
Ponce
$6,179B
7Bayamon Medical Center
Bayamon
$6,228C
8Hospital Oncologico Dr Isaac Gonzalez Martinez
San Juan
$6,355B
9San Juan Municipality Hospital
Rio Piedras
$6,409B
10Auxilio Mutuo Hospital
San Juan
$6,452B
11Hospital San Carlos Borromeo
Moca
$6,594C
12Hospital Metropolitano De La Montana
Bda Nueva
$6,862B
13Hospital Metropolitano Psiquiatrico De Cabo Rojo
Cabo Rojo
$7,059C
14Manati Medical Center Dr Otero Lopez
Manati
$7,194B
15Hospital Metropolitano Dr Susoni
Arecibo
$7,214B
16Doctors Center Hospital Carolina Llc
Carolina
$7,474B
17Hospital De La Concepcion
San German
$7,668B
18Hospital San Antonio Inc
Mayaguez
$7,811B
19Hospital Upr, Dr Federico Trilla
Carolina
$7,836C
20Doctors' Center Bayamon
Bayamon
$8,191C
21Hospital Damas Inc
Ponce
$8,411C
22Centro Medico Wilma N Vazquez
Vega Baja
$8,426C
23Hospital San Francisco
San Juan
$8,466B
24Hospital Pavia Caguas
Caguas
$8,475C
25Hospital Menonita Caguas Inc
Caguas
$8,499B
26San Juan Va Medical Center
San Juan
$8,502C
27Bella Vista Hospital
Mayaguez
$8,627B
28Doctor's Center De San Juan
Santurce
$8,904C
29Hospital Menonita Guayama
Guayama
$9,046B
30Hospital Pavia Yauco
Yauco
$9,132B
31Hospital Pavia Santurce
San Juan
$9,253C
32Hospital Menonita Ponce
Ponce
$9,263B
33Doctors' Center Hospital, Inc
Manati
$9,351C
34Doctors Center Hospital Orlando Health Dorado
Dorado
$9,854B
35Hospital Comunitario Buen Samaritano Inc
Aguadilla
$9,932B
36San Juan Capestrano Hospital Inc
Rio Piedras
$10,225B
37The San Jorge Hospital Inc
San Juan
$11,121C

Frequently Asked Questions

How much does nutritional and misc metabolic disorders with mcc cost in Puerto Rico?

Nutritional and Misc Metabolic Disorders with MCC (DRG 641) averages $7,777 in total Medicare payment across 37 Puerto Rico hospitals reporting this code. Within the state, payments span $4,377 to $11,121 — about 3× from cheapest to most expensive.

Is Nutritional and Misc Metabolic Disorders with MCC more or less expensive in Puerto Rico than nationally?

Puerto Rico's state-level average of $7,777 sits well below the national Medicare average of $11,374 for this DRG. State differences are driven primarily by the regional Medicare wage index, case mix, and the share of high-acuity referral hospitals.

Why is the spread between hospitals so wide?

Variation within a state runs 3× because the same DRG can come with different lengths of stay, complication adjustments, teaching-status add-ons, and outlier payments. The CMS Hospital Price Transparency Rule publishes machine-readable rate files that allow direct comparisons against negotiated commercial rates, which often differ from Medicare totals.

Are these the prices a privately insured patient would pay?

No. Figures here are Medicare DRG payments. Privately insured patients are billed under their plan's negotiated network rate, published in each hospital's price-transparency file. Uninsured patients should ask the hospital for the cash-pay rate, also disclosed under federal price-transparency rules.

Should I choose a hospital based only on price?

No. HospitalCostData is informational. Surgeon experience, hospital volume for the procedure, complication rates, and your specific clinical situation matter at least as much as price. Always discuss options with your physician and review CMS Care Compare quality data alongside any pricing benchmark.

See the methodology page for DRG sourcing and Medicare wage-index context.

Sources & Citations

  • CMS Medicare Inpatient Hospital Payments (IPPS). DRG-level average covered charges, total payments, and Medicare payments per facility. data.cms.gov
  • CMS Hospital Compare (Care Compare). Star ratings, mortality, readmission, safety-of-care, and patient-experience measures. medicare.gov/care-compare
  • CMS Hospital Price Transparency Rule. Standard charge files required from every Medicare-participating hospital. cms.gov/hospital-price-transparency
  • Agency for Healthcare Research and Quality (AHRQ). National benchmarks, quality indicators, and clinical context for hospital outcome measures. ahrq.gov

Dataset last refreshed: April 2026. Underlying CMS files are public domain. Suggested citation: “HospitalCostData, hospitalcostdata.com, accessed May 24, 2026.”

This page is informational only and does not constitute medical, legal, or financial advice. Care decisions should be made with a licensed physician.

Source: CMS Hospital Price Transparency, 2026.