MS‑DRG 018: Chimeric Antigen Receptor (CAR) T-Cell and Other Immunotherapies
What Medicare paid hospitals for MS‑DRG 018 in 2024: nationally, state by state and across hospitals.
In 2024 Medicare paid hospitals an average of $434,771 per discharge for MS‑DRG 018, across 1,360 fee-for-service discharges at 49 hospitals: 0.03% of all Medicare inpatient discharges and $591.3M in total, the 31st largest MS‑DRG by Medicare spending.
By state, the average ran from $246,044 in Wisconsin to $624,699 in District of Columbia. Across hospitals, half were paid between $381,473 and $495,728 per case, and the median hospital $442,988; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.
Hospitals charged $2,187,781 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 | 43.1828 | 45.1464 | +4.5% |
| Geometric mean stay (days) | 12.4 | 11.4 | −1.0 |
| Average stay (days) | 14.7 | 13.3 | −1.4 |
- Not capped: the +4.5% 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)
$333,539.35
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 018 at a hospital
Paid per case, by state
| State | Paid per case | Discharges | Hospitals | Charges ÷ paid |
|---|---|---|---|---|
| District of Columbia | $624,699 | 15 | 1 | 4.6× |
| Arizona | $538,656 | 39 | 1 | 3.4× |
| Arkansas | $522,439 | 23 | 1 | 3.8× |
| Nebraska | $520,023 | 24 | 1 | 4.3× |
| Georgia | $508,736 | 37 | 1 | 3.7× |
| Illinois | $507,739 | 84 | 3 | 5.9× |
| Indiana | $495,728 | 11 | 1 | 6.0× |
| Minnesota | $489,912 | 40 | 2 | 4.1× |
| Connecticut | $489,460 | 18 | 1 | 4.2× |
| Oregon | $484,477 | 24 | 1 | 2.7× |
| North Carolina | $476,728 | 41 | 2 | 4.7× |
| Michigan | $460,814 | 23 | 1 | 3.8× |
| Florida | $459,233 | 31 | 1 | 4.5× |
| Alabama | $458,298 | 45 | 1 | 5.3× |
| Utah | $457,220 | 29 | 1 | 2.4× |
| Pennsylvania | $455,767 | 94 | 3 | 9.8× |
| California | $446,891 | 182 | 6 | 4.9× |
| Iowa | $442,988 | 50 | 1 | 4.7× |
| Virginia | $428,548 | 26 | 2 | 4.6× |
| Massachusetts | $425,245 | 102 | 2 | 4.0× |
| Ohio | $400,642 | 39 | 1 | 4.5× |
| Missouri | $399,444 | 45 | 1 | 4.3× |
| New York | $386,528 | 76 | 4 | 4.7× |
| New Jersey | $380,610 | 44 | 1 | 5.0× |
| Texas | $366,404 | 49 | 3 | 6.9× |
| Kansas | $351,774 | 75 | 1 | 6.3× |
| Maryland* | $310,138 | 23 | 1 | 1.2× |
| Colorado | $302,192 | 30 | 2 | 8.4× |
| Wisconsin | $246,044 | 41 | 2 | 3.4× |
| United States | $434,771 | 1,360 | 49 | 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 018.
| 10th percentile | $316,227 |
|---|---|
| 25th percentile | $381,473 |
| Median hospital | $442,988 |
| 75th percentile | $495,728 |
| 90th percentile | $541,339 |
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Questions
What did Medicare pay for MS‑DRG 018 in 2024?
An average of $434,771 per discharge across 1,360 fee-for-service discharges at 49 hospitals, $591.3M in total.
Which state paid the most for MS‑DRG 018?
District of Columbia, at $624,699 per case; Wisconsin paid the least, $246,044.
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.