MS‑DRG 003: ECMO or Tracheostomy with MV >96 Hours or Principal Diagnosis except Face, Mouth and Neck with Major O.R. Procedures
What Medicare paid hospitals for MS‑DRG 003 in 2024: nationally, state by state and across hospitals.
In 2024 Medicare paid hospitals an average of $209,580 per discharge for MS‑DRG 003, across 6,749 fee-for-service discharges at 272 hospitals: 0.14% of all Medicare inpatient discharges and $1.4B in total, the 7th largest MS‑DRG by Medicare spending.
By state, the average ran from $126,921 in Arkansas to $326,145 in California. Across hospitals, half were paid between $142,956 and $225,249 per case, and the median hospital $176,186; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.
Hospitals charged $1,160,394 on average for these stays, 5.5 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 | 21.2252 | 21.2763 | +0.2% |
| Geometric mean stay (days) | 22.9 | 22.0 | −0.9 |
| Average stay (days) | 33.0 | 32.0 | −1.0 |
- Not capped: the +0.2% 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)
$157,188.24
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.
FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 003 at a hospital
Paid per case, by state
| State | Paid per case | Discharges | Hospitals | Charges ÷ paid |
|---|---|---|---|---|
| California | $326,145 | 668 | 24 | 6.5× |
| Massachusetts | $274,375 | 274 | 8 | 3.5× |
| New York | $264,560 | 614 | 22 | 6.1× |
| New Hampshire | $252,688 | 11 | 1 | 3.4× |
| Maryland* | $244,829 | 84 | 2 | 1.1× |
| Maine | $235,545 | 17 | 1 | 4.6× |
| Rhode Island | $235,324 | 20 | 1 | 3.0× |
| Pennsylvania | $231,692 | 350 | 13 | 7.4× |
| Minnesota | $223,210 | 207 | 5 | 4.0× |
| Virginia | $220,719 | 162 | 6 | 5.1× |
| District of Columbia | $218,440 | 91 | 3 | 4.8× |
| Oregon | $215,540 | 40 | 2 | 2.7× |
| Michigan | $214,512 | 130 | 6 | 3.9× |
| Illinois | $213,571 | 296 | 11 | 4.7× |
| Washington | $208,526 | 77 | 5 | 4.0× |
| Colorado | $208,446 | 41 | 2 | 8.7× |
| Utah | $204,669 | 40 | 2 | 3.2× |
| New Mexico | $198,693 | 22 | 1 | 1.9× |
| Connecticut | $194,449 | 79 | 3 | 4.8× |
| Georgia | $189,311 | 194 | 8 | 5.5× |
| North Carolina | $188,525 | 229 | 9 | 4.1× |
| Arizona | $187,758 | 77 | 4 | 4.6× |
| Delaware | $187,035 | 29 | 1 | 2.9× |
| Ohio | $184,153 | 355 | 11 | 4.9× |
| South Dakota | $182,276 | 12 | 1 | 2.3× |
| Texas | $182,260 | 510 | 21 | 6.8× |
| Wisconsin | $181,042 | 73 | 3 | 4.8× |
| New Jersey | $180,986 | 197 | 9 | 5.8× |
| Missouri | $178,755 | 144 | 5 | 4.3× |
| Alabama | $163,978 | 78 | 3 | 7.0× |
| Mississippi | $162,259 | 31 | 1 | 4.1× |
| Nevada | $160,856 | 61 | 3 | 8.5× |
| Florida | $155,934 | 594 | 28 | 7.0× |
| Oklahoma | $155,201 | 136 | 5 | 6.8× |
| South Carolina | $154,419 | 129 | 6 | 5.1× |
| Louisiana | $153,958 | 87 | 6 | 4.1× |
| Vermont | $152,814 | 12 | 1 | 4.3× |
| Indiana | $151,386 | 83 | 5 | 5.0× |
| Nebraska | $150,692 | 59 | 3 | 4.0× |
| Iowa | $147,968 | 30 | 2 | 4.0× |
| North Dakota | $143,885 | 14 | 1 | 3.0× |
| West Virginia | $141,984 | 42 | 2 | 4.6× |
| Kansas | $139,118 | 29 | 1 | 5.3× |
| Idaho | $135,136 | 14 | 1 | 3.0× |
| Tennessee | $134,095 | 180 | 8 | 6.9× |
| Kentucky | $130,654 | 70 | 3 | 4.7× |
| Arkansas | $126,921 | 57 | 3 | 3.7× |
| United States | $209,580 | 6,749 | 272 | 5.5× |
* 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 003.
| 10th percentile | $120,744 |
|---|---|
| 25th percentile | $142,956 |
| Median hospital | $176,186 |
| 75th percentile | $225,249 |
| 90th percentile | $276,280 |
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Questions
What did Medicare pay for MS‑DRG 003 in 2024?
An average of $209,580 per discharge across 6,749 fee-for-service discharges at 272 hospitals, $1.4B in total.
Which state paid the most for MS‑DRG 003?
California, at $326,145 per case; Arkansas paid the least, $126,921.
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.