MS‑DRG 091: Other Disorders of Nervous System with MCC

What Medicare paid hospitals for MS‑DRG 091 in 2024: nationally, state by state and across hospitals.

Paid per case$15,1611.0× the all-DRG average

Discharges9,7900.20% of all Medicare discharges

Total paid$148.4M103rd largest MS‑DRG by spending

Hospitals497in 49 states and DC

Charges ÷ paid5.9×$89,350 average charge

Relative weight1.7046FY2027, 4.3-day geometric mean stay; FY2026 1.7562 (−2.9%)

In 2024 Medicare paid hospitals an average of $15,161 per discharge for MS‑DRG 091, across 9,790 fee-for-service discharges at 497 hospitals: 0.20% of all Medicare inpatient discharges and $148.4M in total, the 103rd largest MS‑DRG by Medicare spending.

By state, the average ran from $10,358 in North Dakota to $22,518 in Hawaii. Across hospitals, half were paid between $11,760 and $16,260 per case, and the median hospital $13,452; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.

Hospitals charged $89,350 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 091 on the interactive map Price an MS‑DRG 091 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 091, FY2026 and FY2027
	FY2026	FY2027	Change
Relative weight	1.7562	1.7046	−2.9%
Geometric mean stay (days)	4.4	4.3	−0.1
Average stay (days)	6.3	6.1	−0.2

Not capped: the −2.9% 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)

$12,593.50

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 091
MS‑DRG	Severity	Payment ($)	Step ($)
091	with MCC	12,593.50	—
092	with CC	7,564.52	−5,028.98
093	without CC/MCC	5,750.04	−6,843.46

FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 091 at a hospital

Paid per case, by state

MS‑DRG 091 by state, 2024
State	Paid per case	Discharges	Hospitals	Charges ÷ paid
Maryland*	$30,821	225	12	1.2×
Hawaii	$22,518	11	1	8.4×
New York	$20,107	770	30	6.7×
California	$19,757	1,028	54	6.9×
Connecticut	$16,834	112	6	5.1×
Oregon	$16,605	101	7	3.6×
Minnesota	$16,491	183	11	4.1×
Washington	$16,364	140	9	4.8×
Massachusetts	$16,342	530	23	3.2×
Pennsylvania	$15,691	408	19	8.3×
Alaska	$15,360	14	1	8.8×
New Jersey	$15,210	293	17	7.6×
District of Columbia	$14,989	56	3	5.5×
Wisconsin	$14,465	159	5	5.0×
Arizona	$14,364	131	8	5.6×
Illinois	$14,327	472	26	5.3×
Rhode Island	$14,254	28	2	4.0×
Georgia	$14,115	277	16	5.9×
Colorado	$14,068	65	4	10.9×
Nevada	$13,931	117	7	8.6×
New Hampshire	$13,818	57	4	4.5×
Idaho	$13,798	42	3	4.8×
Utah	$13,772	81	4	4.3×
Vermont	$13,727	22	1	5.9×
North Carolina	$13,638	285	15	4.3×
Missouri	$13,481	123	7	4.4×
Maine	$13,481	32	1	3.2×
South Dakota	$13,162	63	3	5.7×
Ohio	$13,147	170	10	4.6×
Delaware	$13,140	66	1	3.7×
Montana	$12,947	28	2	3.0×
Michigan	$12,864	297	17	4.0×
Virginia	$12,825	262	17	4.4×
South Carolina	$12,703	183	10	6.6×
Oklahoma	$12,672	130	6	5.2×
Florida	$12,500	836	37	8.2×
Texas	$12,410	670	31	8.1×
Indiana	$12,370	203	13	4.7×
Nebraska	$12,209	53	3	5.2×
Louisiana	$11,884	90	6	5.7×
Tennessee	$11,731	323	14	5.3×
Kentucky	$11,494	91	4	5.5×
New Mexico	$11,480	31	1	5.1×
Iowa	$11,449	67	3	6.1×
Kansas	$11,446	143	5	9.7×
West Virginia	$10,819	12	1	4.6×
Alabama	$10,710	108	6	7.7×
Mississippi	$10,551	152	7	4.1×
Arkansas	$10,534	34	3	4.2×
North Dakota	$10,358	16	1	4.8×
United States	$15,161	9,790	497	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 091.

10th percentile	$10,693
25th percentile	$11,760
Median hospital	$13,452
75th percentile	$16,260
90th percentile	$19,358

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

092Other Disorders of Nervous System with CC · $8,252

Nearby MS‑DRG numbers

Questions

What did Medicare pay for MS‑DRG 091 in 2024?

An average of $15,161 per discharge across 9,790 fee-for-service discharges at 497 hospitals, $148.4M in total.

Which state paid the most for MS‑DRG 091?

Hawaii, at $22,518 per case; North Dakota paid the least, $10,358.

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.