MS‑DRG 023: Craniotomy with Major Device Implant or Acute Complex CNS Principal Diagnosis with MCC or Antineoplastic Implant or Epilepsy with Neurostimulator

What Medicare paid hospitals for MS‑DRG 023 in 2024: nationally, state by state and across hospitals.

Paid per case$47,9783.2× the all-DRG average

Discharges11,8050.24% of all Medicare discharges

Total paid$566.4M33rd largest MS‑DRG by spending

Hospitals432in 49 states and DC

Charges ÷ paid5.9×$281,418 average charge

Relative weight5.7444FY2027, 7.2-day geometric mean stay; FY2026 5.7303 (+0.2%)

In 2024 Medicare paid hospitals an average of $47,978 per discharge for MS‑DRG 023, across 11,805 fee-for-service discharges at 432 hospitals: 0.24% of all Medicare inpatient discharges and $566.4M in total, the 33rd largest MS‑DRG by Medicare spending.

By state, the average ran from $30,413 in Vermont to $63,991 in California. Across hospitals, half were paid between $38,463 and $53,114 per case, and the median hospital $43,982; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.

Hospitals charged $281,418 on average for these stays, 5.9 times what Medicare paid: charges are list prices, while Medicare pays a fixed amount per MS‑DRG.

See MS‑DRG 023 on the interactive map Price an MS‑DRG 023 claim at any hospital Every MS‑DRG

What changed in FY2027

The rates for discharges from October 1, 2026 (MS‑DRG version 44) against FY2026.

MS‑DRG 023, FY2026 and FY2027
	FY2026	FY2027	Change
Relative weight	5.7303	5.7444	+0.2%
Geometric mean stay (days)	7.1	7.2	+0.1
Average stay (days)	10.0	10.1	+0.1

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)

$42,439.34

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 national base payment across the severity levels of MS‑DRG 023
MS‑DRG	Severity	Payment ($)	Step ($)
023	with MCC	42,439.34	—
024	without MCC	29,336.07	−13,103.27

FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 023 at a hospital

Paid per case, by state

MS‑DRG 023 by state, 2024
State	Paid per case	Discharges	Hospitals	Charges ÷ paid
Maryland*	$69,591	191	7	1.2×
California	$63,991	1,279	54	7.2×
Massachusetts	$62,337	323	8	2.8×
New Mexico	$61,581	55	1	2.5×
New York	$61,161	705	25	5.6×
New Hampshire	$57,582	56	2	4.8×
Connecticut	$56,118	122	4	3.9×
District of Columbia	$55,680	79	3	6.2×
Hawaii	$55,272	57	1	5.0×
Oregon	$51,556	101	5	3.6×
Maine	$51,403	45	1	4.1×
New Jersey	$49,874	379	14	6.9×
Washington	$48,833	279	8	4.6×
Rhode Island	$48,556	98	1	2.2×
Minnesota	$48,063	213	8	3.2×
Alaska	$47,502	38	2	9.7×
Illinois	$47,190	533	20	5.2×
Georgia	$46,698	297	9	6.7×
Pennsylvania	$46,478	568	21	6.9×
South Dakota	$45,665	103	3	5.1×
Wisconsin	$45,188	170	5	5.1×
Michigan	$45,185	248	14	3.8×
Delaware	$45,138	74	1	3.9×
Arizona	$44,393	294	9	6.3×
Iowa	$44,263	90	2	4.6×
Nevada	$44,078	99	4	9.8×
Virginia	$43,389	377	11	4.8×
Utah	$43,373	89	5	3.5×
Missouri	$42,866	256	10	5.2×
Oklahoma	$42,642	157	6	7.7×
North Carolina	$42,383	372	12	4.4×
Nebraska	$42,054	73	3	4.2×
Montana	$41,932	77	3	2.7×
Colorado	$41,822	150	6	9.8×
Indiana	$41,436	199	7	5.2×
Texas	$41,429	713	34	9.0×
Kentucky	$41,021	184	6	6.8×
South Carolina	$41,019	214	5	6.8×
Ohio	$41,012	380	13	5.0×
Louisiana	$40,254	175	6	4.8×
Kansas	$40,241	128	3	7.5×
Mississippi	$40,151	81	4	5.1×
Florida	$39,782	882	37	7.9×
West Virginia	$39,225	61	2	4.9×
Idaho	$38,942	61	3	5.2×
Tennessee	$38,551	323	11	5.2×
Alabama	$37,056	192	7	6.1×
Arkansas	$34,790	119	4	4.5×
North Dakota	$32,723	23	1	4.2×
Vermont	$30,413	23	1	6.1×
United States	$47,978	11,805	432	5.9×

* 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 023.

10th percentile	$35,107
25th percentile	$38,463
Median hospital	$43,982
75th percentile	$53,114
90th percentile	$61,839

Related analysis

Transfers and the per-diem rule: when a short stay pays less than the full DRG · Inpatient DRG
DRG validation and the single-MCC claim: when one code moves the payment · Payment integrity

The same condition at other severities

024Craniotomy with Major Device Implant or Acute Complex CNS Principal Diagnosis without MCC · $30,973

Nearby MS‑DRG numbers

Questions

What did Medicare pay for MS‑DRG 023 in 2024?

An average of $47,978 per discharge across 11,805 fee-for-service discharges at 432 hospitals, $566.4M in total.

Which state paid the most for MS‑DRG 023?

California, at $63,991 per case; Vermont paid the least, $30,413.

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.