MS‑DRG 001: Heart Transplant or Implant of Heart Assist System with MCC
What Medicare paid hospitals for MS‑DRG 001 in 2024: nationally, state by state and across hospitals.
In 2024 Medicare paid hospitals an average of $295,327 per discharge for MS‑DRG 001, across 1,814 fee-for-service discharges at 87 hospitals: 0.04% of all Medicare inpatient discharges and $535.7M in total, the 36th largest MS‑DRG by Medicare spending.
By state, the average ran from $144,650 in Louisiana to $423,489 in California. Across hospitals, half were paid between $232,263 and $319,622 per case, and the median hospital $274,697; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.
Hospitals charged $1,604,490 on average for these stays, 5.4 times what Medicare paid: charges are list prices, while Medicare pays a fixed amount per MS‑DRG.
What changed in FY2027
The rates for discharges from October 1, 2026 (MS‑DRG version 44) against FY2026.
| FY2026 | FY2027 | Change | |
|---|---|---|---|
| Relative weight | 28.0239 | 28.0947 | +0.3% |
| Geometric mean stay (days) | 25.8 | 24.5 | −1.3 |
| Average stay (days) | 36.2 | 35.5 | −0.7 |
- Not capped: the +0.3% is CMS’s yearly recalibration of every weight from recent claims and cost data.
- Name, MDC and transfer status are unchanged.
FY2027 national base payment (illustration)
$207,562.24
The FY2027 weight times the operating standardized amount and the capital rate ($6,848.00 + $539.95) at a wage index of 1.0. No IME, DSH, outlier or other hospital-specific adjustment, so it is not what any hospital is paid; price it at a hospital for that.
| MS‑DRG | Severity | Payment ($) | Step ($) |
|---|---|---|---|
| 001 | with MCC | 207,562.24 | — |
| 002 | without MCC | 81,332.46 | −126,229.78 |
FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 001 at a hospital
Paid per case, by state
| State | Paid per case | Discharges | Hospitals | Charges ÷ paid |
|---|---|---|---|---|
| Maryland* | $512,608 | 24 | 1 | 1.2× |
| California | $423,489 | 218 | 10 | 6.0× |
| New York | $420,457 | 112 | 5 | 6.2× |
| Washington | $331,533 | 24 | 1 | 4.0× |
| Massachusetts | $321,352 | 68 | 3 | 4.2× |
| Utah | $319,197 | 18 | 1 | 3.2× |
| Pennsylvania | $316,329 | 70 | 4 | 6.2× |
| Colorado | $306,289 | 16 | 1 | 6.5× |
| Illinois | $302,949 | 97 | 3 | 5.1× |
| Virginia | $298,082 | 41 | 3 | 4.8× |
| Minnesota | $296,298 | 59 | 3 | 4.3× |
| Oklahoma | $287,995 | 21 | 1 | 7.8× |
| District of Columbia | $282,646 | 51 | 1 | 4.9× |
| Ohio | $276,391 | 69 | 3 | 4.6× |
| Kentucky | $268,566 | 25 | 2 | 4.9× |
| Missouri | $264,659 | 66 | 2 | 4.4× |
| South Carolina | $261,822 | 28 | 1 | 4.4× |
| New Jersey | $253,121 | 47 | 3 | 5.2× |
| Connecticut | $251,112 | 14 | 1 | 5.4× |
| Arizona | $248,860 | 16 | 1 | 3.9× |
| North Carolina | $243,135 | 115 | 6 | 4.4× |
| Alabama | $242,985 | 11 | 1 | 5.5× |
| Florida | $242,075 | 145 | 7 | 6.3× |
| Georgia | $240,953 | 54 | 2 | 5.9× |
| Indiana | $239,543 | 34 | 2 | 5.1× |
| Nebraska | $237,940 | 22 | 1 | 5.0× |
| Texas | $237,546 | 154 | 7 | 7.3× |
| Michigan | $234,256 | 28 | 2 | 3.9× |
| Oregon | $228,261 | 18 | 1 | 2.7× |
| Arkansas | $226,376 | 38 | 2 | 5.2× |
| Tennessee | $226,169 | 79 | 4 | 7.4× |
| Kansas | $211,672 | 21 | 1 | 6.1× |
| Louisiana | $144,650 | 11 | 1 | 2.7× |
| United States | $295,327 | 1,814 | 87 | 5.4× |
* Maryland hospitals are paid under the state’s all-payer model, not the IPPS, so Maryland is left out of the state range above.
How much hospitals vary
Each hospital’s own average Medicare payment for MS‑DRG 001.
| 10th percentile | $196,436 |
|---|---|
| 25th percentile | $232,263 |
| Median hospital | $274,697 |
| 75th percentile | $319,622 |
| 90th percentile | $388,869 |
Related analysis
- DRG validation and the single-MCC claim: when one code moves the payment · Payment integrity
More in Pre-MDC: transplants, ECMO and tracheostomy
003ECMO or Tracheostomy with MV >96 Hours or Principal Diagnosis except Face, Mouth and Neck with Major O.R. Procedures004Tracheostomy with MV >96 Hours or Principal Diagnosis except Face, Mouth and Neck without Major O.R. Procedures018Chimeric Antigen Receptor (CAR) T-Cell and Other Immunotherapies016Autologous Bone Marrow Transplant with CC/MCC005Liver Transplant with MCC or Intestinal Transplant
Questions
What did Medicare pay for MS‑DRG 001 in 2024?
An average of $295,327 per discharge across 1,814 fee-for-service discharges at 87 hospitals, $535.7M in total.
Which state paid the most for MS‑DRG 001?
California, at $423,489 per case; Louisiana paid the least, $144,650.
Where do these figures come from?
From the Medicare Inpatient Hospitals - by Provider and Service (data year 2024): the published hospital-by-DRG averages of Medicare fee-for-service inpatient discharges in 2024. Cells with fewer than 11 discharges are not published, so a hospital with a handful of cases is not counted. Average Medicare payment excludes the patient’s deductible and coinsurance.