MS‑DRG 038: Extracranial Procedures with CC
What Medicare paid hospitals for MS‑DRG 038 in 2024: nationally, state by state and across hospitals.
In 2024 Medicare paid hospitals an average of $12,004 per discharge for MS‑DRG 038, across 3,458 fee-for-service discharges at 210 hospitals: 0.07% of all Medicare inpatient discharges and $41.5M in total, the 205th largest MS‑DRG by Medicare spending.
By state, the average ran from $8,556 in Vermont to $16,418 in California. Across hospitals, half were paid between $10,093 and $13,280 per case, and the median hospital $11,289; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.
Hospitals charged $80,586 on average for these stays, 6.7 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 | 1.6226 | 1.6296 | +0.4% |
| Geometric mean stay (days) | 1.9 | 1.8 | −0.1 |
| Average stay (days) | 2.7 | 2.6 | −0.1 |
- Not capped: the +0.4% 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)
$12,039.40
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 ($) |
|---|---|---|---|
| 037 | with MCC | 25,292.65 | +13,253.25 |
| 038 | with CC | 12,039.40 | — |
| 039 | without CC/MCC | 8,754.72 | −3,284.68 |
FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 038 at a hospital
Paid per case, by state
| State | Paid per case | Discharges | Hospitals | Charges ÷ paid |
|---|---|---|---|---|
| Maryland* | $17,475 | 105 | 7 | 1.2× |
| California | $16,418 | 195 | 12 | 8.3× |
| New York | $15,949 | 185 | 10 | 6.4× |
| Massachusetts | $15,662 | 155 | 8 | 4.9× |
| New Hampshire | $13,994 | 25 | 2 | 7.0× |
| Connecticut | $13,857 | 11 | 1 | 5.4× |
| Nevada | $13,525 | 12 | 1 | 4.5× |
| New Jersey | $13,306 | 101 | 5 | 6.2× |
| Delaware | $13,284 | 24 | 1 | 4.8× |
| Minnesota | $12,925 | 118 | 7 | 4.4× |
| Pennsylvania | $12,762 | 84 | 5 | 9.4× |
| Maine | $12,583 | 17 | 1 | 4.3× |
| South Dakota | $12,404 | 25 | 2 | 6.3× |
| Virginia | $11,956 | 89 | 5 | 4.7× |
| Arizona | $11,831 | 48 | 4 | 6.7× |
| North Dakota | $11,792 | 30 | 2 | 5.1× |
| Washington | $11,715 | 55 | 4 | 7.4× |
| North Carolina | $11,657 | 87 | 6 | 5.3× |
| South Carolina | $11,622 | 54 | 4 | 8.7× |
| Utah | $11,562 | 12 | 1 | 4.1× |
| Colorado | $11,474 | 26 | 2 | 9.0× |
| Georgia | $11,159 | 152 | 8 | 8.7× |
| Missouri | $11,130 | 125 | 9 | 7.2× |
| Michigan | $11,101 | 66 | 4 | 4.8× |
| Oregon | $10,955 | 11 | 1 | 5.0× |
| Texas | $10,949 | 202 | 12 | 8.7× |
| Wisconsin | $10,935 | 128 | 8 | 4.6× |
| Kansas | $10,920 | 80 | 5 | 5.7× |
| Illinois | $10,617 | 126 | 10 | 7.8× |
| Florida | $10,597 | 263 | 13 | 9.1× |
| Indiana | $10,528 | 94 | 6 | 6.1× |
| Montana | $10,304 | 15 | 1 | 5.6× |
| Ohio | $10,282 | 150 | 9 | 8.2× |
| Oklahoma | $10,163 | 110 | 6 | 6.4× |
| Mississippi | $10,145 | 74 | 4 | 4.9× |
| Nebraska | $10,078 | 64 | 3 | 4.1× |
| Idaho | $9,871 | 11 | 1 | 5.1× |
| Arkansas | $9,811 | 24 | 2 | 7.6× |
| Tennessee | $9,686 | 44 | 3 | 7.9× |
| Alabama | $9,475 | 77 | 4 | 12.6× |
| West Virginia | $9,434 | 24 | 2 | 8.7× |
| Louisiana | $9,263 | 70 | 4 | 8.8× |
| Kentucky | $9,159 | 55 | 3 | 6.7× |
| Iowa | $9,006 | 21 | 1 | 5.7× |
| Vermont | $8,556 | 14 | 1 | 5.8× |
| United States | $12,004 | 3,458 | 210 | 6.7× |
* 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 038.
| 10th percentile | $9,089 |
|---|---|
| 25th percentile | $10,093 |
| Median hospital | $11,289 |
| 75th percentile | $13,280 |
| 90th percentile | $15,799 |
Related analysis
- DRG validation and the single-MCC claim: when one code moves the payment · Payment integrity
The same condition at other severities
More in Nervous system
065Intracranial Hemorrhage or Cerebral Infarction with CC or tPA in 24 Hours064Intracranial Hemorrhage or Cerebral Infarction with MCC101Seizures without MCC057Degenerative Nervous System Disorders without MCC025Craniotomy and Endovascular Intracranial Procedures with MCC069Transient Ischemia without Thrombolytic100Seizures with MCC092Other Disorders of Nervous System with CC
Questions
What did Medicare pay for MS‑DRG 038 in 2024?
An average of $12,004 per discharge across 3,458 fee-for-service discharges at 210 hospitals, $41.5M in total.
Which state paid the most for MS‑DRG 038?
California, at $16,418 per case; Vermont paid the least, $8,556.
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.