MS‑DRG 086: Traumatic Stupor and Coma <1 Hour with CC
What Medicare paid hospitals for MS‑DRG 086 in 2024: nationally, state by state and across hospitals.
In 2024 Medicare paid hospitals an average of $10,198 per discharge for MS‑DRG 086, across 8,306 fee-for-service discharges at 406 hospitals: 0.17% of all Medicare inpatient discharges and $84.7M in total, the 147th largest MS‑DRG by Medicare spending.
By state, the average ran from $7,849 in Iowa to $13,372 in Oregon. Across hospitals, half were paid between $8,457 and $11,321 per case, and the median hospital $9,533; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.
Hospitals charged $73,080 on average for these stays, 7.2 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 | 1.3027 | 1.3067 | +0.3% |
| Geometric mean stay (days) | 2.9 | 2.9 | 0.0 |
| Average stay (days) | 3.6 | 3.6 | 0.0 |
- Not capped: the +0.3% 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)
$9,653.83
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 086 at a hospital
Paid per case, by state
| State | Paid per case | Discharges | Hospitals | Charges ÷ paid |
|---|---|---|---|---|
| Oregon | $13,372 | 24 | 2 | 5.0× |
| California | $13,282 | 911 | 48 | 9.5× |
| Hawaii | $12,745 | 23 | 1 | 6.7× |
| Maryland* | $12,703 | 138 | 8 | 1.2× |
| Georgia | $12,525 | 215 | 9 | 6.4× |
| New York | $12,275 | 337 | 18 | 7.1× |
| Massachusetts | $11,979 | 225 | 11 | 2.6× |
| Rhode Island | $11,898 | 24 | 1 | 2.7× |
| Connecticut | $11,600 | 56 | 4 | 4.7× |
| District of Columbia | $11,581 | 13 | 1 | 4.4× |
| New Hampshire | $10,845 | 24 | 1 | 8.6× |
| New Jersey | $10,808 | 286 | 14 | 9.9× |
| Texas | $10,401 | 628 | 28 | 7.3× |
| Nevada | $10,313 | 70 | 3 | 9.1× |
| Tennessee | $10,189 | 307 | 11 | 6.0× |
| Washington | $10,146 | 56 | 4 | 5.8× |
| Nebraska | $9,861 | 84 | 4 | 3.6× |
| Missouri | $9,682 | 199 | 11 | 6.1× |
| Idaho | $9,558 | 12 | 1 | 4.7× |
| South Dakota | $9,482 | 19 | 1 | 4.2× |
| North Carolina | $9,466 | 227 | 7 | 5.2× |
| Delaware | $9,465 | 70 | 2 | 3.7× |
| Arizona | $9,373 | 205 | 9 | 8.5× |
| Illinois | $9,372 | 379 | 22 | 5.7× |
| Florida | $9,332 | 1,025 | 45 | 10.1× |
| Maine | $9,310 | 28 | 1 | 4.0× |
| Pennsylvania | $9,273 | 489 | 24 | 7.3× |
| Ohio | $9,259 | 357 | 16 | 4.9× |
| Minnesota | $9,217 | 115 | 8 | 4.3× |
| North Dakota | $9,206 | 30 | 2 | 5.1× |
| Wisconsin | $9,156 | 99 | 6 | 5.2× |
| Indiana | $8,964 | 148 | 6 | 4.2× |
| South Carolina | $8,959 | 104 | 5 | 9.7× |
| Michigan | $8,944 | 139 | 9 | 4.3× |
| Arkansas | $8,869 | 46 | 3 | 4.6× |
| Utah | $8,836 | 38 | 3 | 5.3× |
| Colorado | $8,833 | 116 | 6 | 11.2× |
| Oklahoma | $8,756 | 127 | 6 | 6.3× |
| Virginia | $8,683 | 278 | 14 | 6.7× |
| Kansas | $8,678 | 167 | 5 | 10.2× |
| Montana | $8,616 | 11 | 1 | 2.6× |
| West Virginia | $8,363 | 47 | 3 | 4.9× |
| Kentucky | $8,356 | 54 | 3 | 5.4× |
| Louisiana | $8,292 | 139 | 7 | 7.2× |
| Alabama | $8,185 | 108 | 6 | 5.4× |
| Vermont | $8,172 | 21 | 1 | 7.6× |
| Mississippi | $7,889 | 54 | 3 | 4.8× |
| Iowa | $7,849 | 34 | 2 | 5.6× |
| United States | $10,198 | 8,306 | 406 | 7.2× |
* 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 086.
| 10th percentile | $7,871 |
|---|---|
| 25th percentile | $8,457 |
| Median hospital | $9,533 |
| 75th percentile | $11,321 |
| 90th percentile | $13,305 |
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Questions
What did Medicare pay for MS‑DRG 086 in 2024?
An average of $10,198 per discharge across 8,306 fee-for-service discharges at 406 hospitals, $84.7M in total.
Which state paid the most for MS‑DRG 086?
Oregon, at $13,372 per case; Iowa paid the least, $7,849.
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.