Medicare payment by MS‑DRG, 2024
What Medicare paid hospitals per discharge in 2024 for every MS‑DRG with at least 1,000 discharges at 30 or more hospitals (260 MS‑DRGs, 98.6% of all discharges). Each links to its state-by-state page.
Most-priced MS‑DRGs
The 12 MS‑DRGs with the most Medicare discharges in 2024, the most common inpatient claims.
871Septicemia or Severe Sepsis without MV >96 Hours with MCC · 577,119291Heart Failure and Shock with MCC · 304,694177Respiratory Infections and Inflammations with MCC · 141,351193Simple Pneumonia and Pleurisy with MCC · 136,649872Septicemia or Severe Sepsis without MV >96 Hours without MCC · 103,998690Kidney and Urinary Tract Infections without MCC · 91,493189Pulmonary Edema and Respiratory Failure · 89,991392Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders without MCC · 85,970280Acute Myocardial Infarction, Discharged Alive with MCC · 83,841689Kidney and Urinary Tract Infections with MCC · 79,740853Infectious and Parasitic Diseases with O.R. Procedures with MCC · 79,560683Renal Failure with CC · 78,178
Pre-MDC: transplants, ECMO and tracheostomy
Nervous system
Ear, nose, mouth and throat
| MS‑DRG | Discharges | Paid per case |
|---|---|---|
141Major Head and Neck Procedures with CC | 1,174 | $19,833 |
149Dysequilibrium | 7,721 | $5,179 |
Respiratory system
Circulatory system
Digestive system
Hepatobiliary system and pancreas
| MS‑DRG | Discharges | Paid per case |
|---|---|---|
405Pancreas, Liver and Shunt Procedures with MCC | 1,759 | $55,775 |
406Pancreas, Liver and Shunt Procedures with CC | 3,016 | $26,175 |
417Laparoscopic Cholecystectomy without CDE with MCC | 4,116 | $17,873 |
418Laparoscopic Cholecystectomy without CDE with CC | 11,142 | $11,906 |
419Laparoscopic Cholecystectomy without CDE without CC/MCC | 2,460 | $9,012 |
432Cirrhosis and Alcoholic Hepatitis with MCC | 10,422 | $16,645 |
433Cirrhosis and Alcoholic Hepatitis with CC | 2,658 | $8,296 |
435Malignancy of Hepatobiliary System or Pancreas with MCC | 7,905 | $15,237 |
438Disorders of Pancreas except Malignancy with MCC | 2,641 | $13,710 |
439Disorders of Pancreas except Malignancy with CC | 6,261 | $6,221 |
441Disorders of Liver except Malignancy, Cirrhosis or Alcoholic Hepatitis with MCC | 7,597 | $16,564 |
442Disorders of Liver except Malignancy, Cirrhosis or Alcoholic Hepatitis with CC | 4,126 | $8,007 |
444Disorders of the Biliary Tract with MCC | 6,191 | $13,672 |
445Disorders of the Biliary Tract with CC | 9,692 | $8,459 |
Musculoskeletal system and connective tissue
Skin, subcutaneous tissue and breast
| MS‑DRG | Discharges | Paid per case |
|---|---|---|
580Other Skin, Subcutaneous Tissue and Breast Procedures with CC | 1,201 | $13,552 |
602Cellulitis with MCC | 10,980 | $11,351 |
603Cellulitis without MCC | 54,310 | $6,446 |
605Trauma to the Skin, Subcutaneous Tissue and Breast without MCC | 5,045 | $7,200 |
Endocrine, nutritional and metabolic
| MS‑DRG | Discharges | Paid per case |
|---|---|---|
617Amputation of Lower Limb for Endocrine, Nutritional and Metabolic Disorders with CC | 4,466 | $14,568 |
621O.R. Procedures for Obesity without CC/MCC | 1,084 | $10,118 |
637Diabetes with MCC | 20,859 | $11,464 |
638Diabetes with CC | 26,317 | $6,926 |
640Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes with MCC | 73,514 | $10,642 |
641Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes without MCC | 61,771 | $5,830 |
643Endocrine Disorders with MCC | 6,565 | $13,230 |
644Endocrine Disorders with CC | 6,026 | $8,107 |
Kidney and urinary tract
| MS‑DRG | Discharges | Paid per case |
|---|---|---|
650Kidney Transplant with Hemodialysis with MCC | 2,130 | $45,823 |
652Kidney Transplant | 6,202 | $26,484 |
654Major Bladder Procedures with CC | 1,511 | $24,909 |
657Kidney and Ureter Procedures for Neoplasm with CC | 2,505 | $15,146 |
658Kidney and Ureter Procedures for Neoplasm without CC/MCC | 1,248 | $11,165 |
659Kidney and Ureter Procedures for Non-Neoplasm with MCC | 4,378 | $21,075 |
660Kidney and Ureter Procedures for Non-Neoplasm with CC | 12,733 | $9,722 |
661Kidney and Ureter Procedures for Non-Neoplasm without CC/MCC | 3,619 | $6,873 |
673Other Kidney and Urinary Tract Procedures with MCC | 6,418 | $33,289 |
674Other Kidney and Urinary Tract Procedures with CC | 1,454 | $19,714 |
682Renal Failure with MCC | 73,354 | $11,457 |
683Renal Failure with CC | 78,178 | $6,630 |
689Kidney and Urinary Tract Infections with MCC | 79,740 | $8,838 |
690Kidney and Urinary Tract Infections without MCC | 91,493 | $5,986 |
698Other Kidney and Urinary Tract Diagnoses with MCC | 74,188 | $13,077 |
699Other Kidney and Urinary Tract Diagnoses with CC | 31,564 | $8,251 |
Blood and immunological disorders
| MS‑DRG | Discharges | Paid per case |
|---|---|---|
808Major Hematological and Immunological Diagnoses except Sickle Cell Crisis and Coagulation Disorders with MCC | 2,337 | $22,237 |
809Major Hematological and Immunological Diagnoses except Sickle Cell Crisis and Coagulation Disorders with CC | 3,674 | $11,264 |
811Red Blood Cell Disorders with MCC | 21,895 | $11,546 |
812Red Blood Cell Disorders without MCC | 27,448 | $7,178 |
813Coagulation Disorders | 10,079 | $14,793 |
Myeloproliferative disorders and neoplasms
| MS‑DRG | Discharges | Paid per case |
|---|---|---|
834Acute Leukemia with MCC | 2,220 | $63,232 |
837Chemotherapy with Acute Leukemia as Secondary Diagnosis or with High Dose Chemotherapy Agent with MCC | 1,063 | $50,344 |
840Lymphoma and Non-Acute Leukemia with MCC | 3,774 | $33,609 |
841Lymphoma and Non-Acute Leukemia with CC | 1,686 | $15,179 |
846Chemotherapy without Acute Leukemia as Secondary Diagnosis with MCC | 2,074 | $27,886 |
847Chemotherapy without Acute Leukemia as Secondary Diagnosis with CC | 6,635 | $12,159 |
Infectious and parasitic diseases
| MS‑DRG | Discharges | Paid per case |
|---|---|---|
853Infectious and Parasitic Diseases with O.R. Procedures with MCC | 79,560 | $40,557 |
854Infectious and Parasitic Diseases with O.R. Procedures with CC | 13,459 | $15,086 |
856Postoperative or Post-Traumatic Infections with O.R. Procedures with MCC | 2,662 | $39,860 |
857Postoperative or Post-Traumatic Infections with O.R. Procedures with CC | 2,444 | $18,673 |
862Postoperative and Post-Traumatic Infections with MCC | 5,074 | $16,013 |
863Postoperative and Post-Traumatic Infections without MCC | 2,343 | $8,197 |
870Septicemia or Severe Sepsis with MV >96 Hours | 20,906 | $58,778 |
871Septicemia or Severe Sepsis without MV >96 Hours with MCC | 577,119 | $15,524 |
872Septicemia or Severe Sepsis without MV >96 Hours without MCC | 103,998 | $7,681 |
Mental diseases and disorders
| MS‑DRG | Discharges | Paid per case |
|---|---|---|
880Acute Adjustment Reaction and Psychosocial Dysfunction | 1,036 | $7,565 |
884Organic Disturbances and Intellectual Disability | 16,642 | $13,593 |
885Psychoses | 38,035 | $11,869 |
Alcohol and drug use
| MS‑DRG | Discharges | Paid per case |
|---|---|---|
895Alcohol, Drug Abuse or Dependence with Rehabilitation Therapy | 3,333 | $12,280 |
896Alcohol, Drug Abuse or Dependence without Rehabilitation Therapy with MCC | 2,956 | $15,247 |
897Alcohol, Drug Abuse or Dependence without Rehabilitation Therapy without MCC | 11,716 | $7,306 |
Injuries, poisonings and toxic effects
| MS‑DRG | Discharges | Paid per case |
|---|---|---|
907Other O.R. Procedures for Injuries with MCC | 3,322 | $34,788 |
908Other O.R. Procedures for Injuries with CC | 2,346 | $17,382 |
917Poisoning and Toxic Effects of Drugs with MCC | 9,015 | $13,880 |
919Complications of Treatment with MCC | 8,121 | $16,740 |
920Complications of Treatment with CC | 5,288 | $8,567 |
Factors influencing health status
| MS‑DRG | Discharges | Paid per case |
|---|---|---|
945Rehabilitation with CC/MCC | 1,400 | $18,552 |
947Signs and Symptoms with MCC | 1,417 | $11,395 |
948Signs and Symptoms without MCC | 11,326 | $6,097 |
951Other Factors Influencing Health Status | 3,008 | $4,596 |
Multiple significant trauma
| MS‑DRG | Discharges | Paid per case |
|---|---|---|
956Limb Reattachment, Hip and Femur Procedures for Multiple Significant Trauma | 1,978 | $32,828 |
964Other Multiple Significant Trauma with CC | 1,052 | $13,599 |
Operating room procedures unrelated to the principal diagnosis
| MS‑DRG | Discharges | Paid per case |
|---|---|---|
981Extensive O.R. Procedures Unrelated to Principal Diagnosis with MCC | 14,959 | $40,277 |
982Extensive O.R. Procedures Unrelated to Principal Diagnosis with CC | 4,289 | $20,080 |
987Non-Extensive O.R. Procedures Unrelated to Principal Diagnosis with MCC | 1,872 | $32,476 |