MS‑DRG 016: Autologous Bone Marrow Transplant with CC/MCC
What Medicare paid hospitals for MS‑DRG 016 in 2024: nationally, state by state and across hospitals.
In 2024 Medicare paid hospitals an average of $55,916 per discharge for MS‑DRG 016, across 1,153 fee-for-service discharges at 54 hospitals: 0.02% of all Medicare inpatient discharges and $64.5M in total, the 176th largest MS‑DRG by Medicare spending.
By state, the average ran from $39,587 in Alabama to $85,616 in California. Across hospitals, half were paid between $49,715 and $59,479 per case, and the median hospital $54,347; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.
Hospitals charged $281,844 on average for these stays, 5.0 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 | 5.9297 | 6.0162 | +1.5% |
| Geometric mean stay (days) | 16.1 | 15.6 | −0.5 |
| Average stay (days) | 17.2 | 17.1 | −0.1 |
- Not capped: the +1.5% 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)
$44,447.38
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 ($) |
|---|---|---|---|
| 016 | with CC/MCC | 44,447.38 | — |
| 017 | without CC/MCC | 36,120.43 | −8,326.95 |
FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 016 at a hospital
Paid per case, by state
| State | Paid per case | Discharges | Hospitals | Charges ÷ paid |
|---|---|---|---|---|
| California | $85,616 | 74 | 4 | 5.3× |
| Oregon | $82,169 | 16 | 1 | 3.7× |
| District of Columbia | $79,466 | 13 | 1 | 4.9× |
| New York | $68,797 | 44 | 2 | 3.6× |
| Pennsylvania | $64,207 | 89 | 4 | 6.0× |
| Minnesota | $60,673 | 15 | 1 | 1.5× |
| Maryland* | $59,549 | 23 | 1 | 1.1× |
| Arkansas | $59,269 | 28 | 1 | 3.4× |
| New Jersey | $57,057 | 54 | 2 | 3.7× |
| Virginia | $56,501 | 36 | 2 | 5.8× |
| Missouri | $56,347 | 46 | 1 | 4.6× |
| Wisconsin | $56,123 | 42 | 2 | 3.7× |
| Kansas | $55,890 | 35 | 1 | 5.1× |
| Illinois | $55,588 | 75 | 3 | 3.8× |
| Massachusetts | $54,354 | 17 | 1 | 3.8× |
| Arizona | $54,339 | 11 | 1 | 2.7× |
| Utah | $53,838 | 16 | 1 | 2.6× |
| Nebraska | $53,361 | 21 | 1 | 4.0× |
| Georgia | $52,573 | 48 | 1 | 3.5× |
| Ohio | $52,494 | 26 | 2 | 4.5× |
| Iowa | $52,227 | 11 | 1 | 4.3× |
| Michigan | $52,039 | 41 | 2 | 4.6× |
| North Carolina | $51,639 | 36 | 2 | 2.9× |
| Connecticut | $51,484 | 12 | 1 | 2.7× |
| Tennessee | $50,443 | 21 | 1 | 15.1× |
| Indiana | $48,948 | 36 | 2 | 4.3× |
| Oklahoma | $48,515 | 15 | 1 | 7.4× |
| Florida | $46,427 | 34 | 1 | 2.3× |
| Colorado | $44,859 | 41 | 1 | 13.5× |
| South Dakota | $43,473 | 15 | 1 | 3.1× |
| Texas | $42,067 | 115 | 6 | 9.3× |
| North Dakota | $41,764 | 11 | 1 | 1.9× |
| Alabama | $39,587 | 36 | 1 | 4.7× |
| United States | $55,916 | 1,153 | 54 | 5.0× |
* 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 016.
| 10th percentile | $41,089 |
|---|---|
| 25th percentile | $49,715 |
| Median hospital | $54,347 |
| 75th percentile | $59,479 |
| 90th percentile | $75,019 |
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Questions
What did Medicare pay for MS‑DRG 016 in 2024?
An average of $55,916 per discharge across 1,153 fee-for-service discharges at 54 hospitals, $64.5M in total.
Which state paid the most for MS‑DRG 016?
California, at $85,616 per case; Alabama paid the least, $39,587.
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.