MS‑DRG 149: Dysequilibrium
What Medicare paid hospitals for MS‑DRG 149 in 2024: nationally, state by state and across hospitals.
In 2024 Medicare paid hospitals an average of $5,179 per discharge for MS‑DRG 149, across 7,721 fee-for-service discharges at 405 hospitals: 0.16% of all Medicare inpatient discharges and $40.0M in total, the 212th largest MS‑DRG by Medicare spending.
By state, the average ran from $3,101 in Alabama to $6,995 in Connecticut. Across hospitals, half were paid between $4,294 and $5,579 per case, and the median hospital $4,819; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.
Hospitals charged $47,453 on average for these stays, 9.2 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 | 0.7516 | 0.7527 | +0.1% |
| Geometric mean stay (days) | 1.9 | 1.9 | 0.0 |
| Average stay (days) | 2.4 | 2.4 | 0.0 |
- Not capped: the +0.1% 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)
$5,560.91
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 149 at a hospital
Paid per case, by state
| State | Paid per case | Discharges | Hospitals | Charges ÷ paid |
|---|---|---|---|---|
| Maryland* | $8,380 | 223 | 13 | 1.3× |
| Connecticut | $6,995 | 12 | 1 | 7.4× |
| California | $6,868 | 474 | 28 | 11.2× |
| New York | $6,647 | 858 | 31 | 9.4× |
| Rhode Island | $6,640 | 16 | 1 | 4.5× |
| Oregon | $5,686 | 12 | 1 | 3.0× |
| Nevada | $5,602 | 143 | 6 | 17.3× |
| New Jersey | $5,407 | 396 | 25 | 10.5× |
| Maine | $5,335 | 15 | 1 | 4.8× |
| Delaware | $5,223 | 53 | 3 | 5.4× |
| Massachusetts | $5,219 | 414 | 19 | 3.5× |
| Georgia | $5,160 | 163 | 10 | 7.5× |
| Minnesota | $5,063 | 88 | 6 | 5.8× |
| New Hampshire | $4,974 | 35 | 2 | 8.9× |
| Washington | $4,877 | 71 | 5 | 6.8× |
| Nebraska | $4,856 | 19 | 1 | 5.3× |
| South Dakota | $4,832 | 47 | 3 | 6.9× |
| Texas | $4,794 | 420 | 22 | 13.3× |
| Kansas | $4,790 | 76 | 5 | 14.8× |
| Michigan | $4,765 | 287 | 16 | 5.8× |
| North Carolina | $4,744 | 126 | 7 | 7.0× |
| Illinois | $4,740 | 376 | 21 | 7.0× |
| Colorado | $4,724 | 54 | 4 | 17.7× |
| South Carolina | $4,639 | 150 | 8 | 9.5× |
| Florida | $4,621 | 1,344 | 60 | 12.5× |
| Arizona | $4,581 | 135 | 7 | 10.3× |
| Oklahoma | $4,581 | 42 | 3 | 7.1× |
| Pennsylvania | $4,543 | 521 | 26 | 8.7× |
| Tennessee | $4,527 | 94 | 5 | 8.1× |
| Wisconsin | $4,518 | 51 | 3 | 7.6× |
| North Dakota | $4,424 | 12 | 1 | 4.5× |
| Indiana | $4,399 | 79 | 6 | 6.7× |
| Ohio | $4,397 | 217 | 14 | 6.9× |
| Mississippi | $4,290 | 12 | 1 | 5.2× |
| Missouri | $4,216 | 164 | 10 | 7.3× |
| Virginia | $4,133 | 344 | 18 | 9.0× |
| West Virginia | $3,992 | 49 | 3 | 5.6× |
| Kentucky | $3,956 | 64 | 4 | 8.7× |
| New Mexico | $3,665 | 15 | 1 | 13.1× |
| Iowa | $3,632 | 27 | 2 | 6.4× |
| Louisiana | $3,485 | 11 | 1 | 7.1× |
| Alabama | $3,101 | 12 | 1 | 21.4× |
| United States | $5,179 | 7,721 | 405 | 9.2× |
* 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 149.
| 10th percentile | $3,871 |
|---|---|
| 25th percentile | $4,294 |
| Median hospital | $4,819 |
| 75th percentile | $5,579 |
| 90th percentile | $6,853 |
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Questions
What did Medicare pay for MS‑DRG 149 in 2024?
An average of $5,179 per discharge across 7,721 fee-for-service discharges at 405 hospitals, $40.0M in total.
Which state paid the most for MS‑DRG 149?
Connecticut, at $6,995 per case; Alabama paid the least, $3,101.
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.