MS‑DRG 164: Major Chest Procedures with CC

What Medicare paid hospitals for MS‑DRG 164 in 2024: nationally, state by state and across hospitals.

Paid per case$20,4361.3× the all-DRG average

Discharges11,9190.24% of all Medicare discharges

Total paid$243.6M72nd largest MS‑DRG by spending

Hospitals433in 49 states and DC

Charges ÷ paid6.1×$123,756 average charge

Relative weight2.5157FY2027, 3.2-day geometric mean stay; FY2026 2.5240 (−0.3%)

In 2024 Medicare paid hospitals an average of $20,436 per discharge for MS‑DRG 164, across 11,919 fee-for-service discharges at 433 hospitals: 0.24% of all Medicare inpatient discharges and $243.6M in total, the 72nd largest MS‑DRG by Medicare spending.

By state, the average ran from $11,203 in Vermont to $28,810 in California. Across hospitals, half were paid between $16,332 and $21,496 per case, and the median hospital $18,364; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.

Hospitals charged $123,756 on average for these stays, 6.1 times what Medicare paid: charges are list prices, while Medicare pays a fixed amount per MS‑DRG.

See MS‑DRG 164 on the interactive map Price an MS‑DRG 164 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 164, FY2026 and FY2027
	FY2026	FY2027	Change
Relative weight	2.5240	2.5157	−0.3%
Geometric mean stay (days)	3.4	3.2	−0.2
Average stay (days)	4.3	4.0	−0.3

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)

$18,585.87

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 164
MS‑DRG	Severity	Payment ($)	Step ($)
163	with MCC	33,165.99	+14,580.12
164	with CC	18,585.87	—
165	without CC/MCC	14,254.31	−4,331.56

FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 164 at a hospital

Paid per case, by state

MS‑DRG 164 by state, 2024
State	Paid per case	Discharges	Hospitals	Charges ÷ paid
Maryland*	$30,919	304	11	1.2×
California	$28,810	872	33	7.3×
New York	$25,383	917	24	5.8×
Massachusetts	$24,061	680	16	3.5×
Rhode Island	$23,765	39	1	1.9×
Connecticut	$23,751	122	5	3.5×
District of Columbia	$23,306	97	4	6.0×
Oregon	$22,277	159	6	3.9×
Alaska	$22,194	13	1	9.7×
New Hampshire	$22,191	82	3	4.9×
Idaho	$21,522	48	3	6.3×
New Jersey	$21,142	495	13	5.3×
Hawaii	$20,709	23	1	5.7×
Minnesota	$20,491	306	11	3.9×
Washington	$19,915	296	10	5.6×
Pennsylvania	$19,831	594	22	7.8×
Illinois	$19,808	505	16	6.3×
Arizona	$19,651	277	11	6.9×
Colorado	$19,586	209	6	6.8×
Delaware	$19,338	79	3	3.6×
Utah	$19,158	61	3	4.5×
Michigan	$18,670	269	12	4.5×
Wisconsin	$18,440	171	7	5.0×
Nebraska	$18,440	167	4	5.4×
Georgia	$18,326	310	15	7.2×
North Carolina	$18,272	487	17	5.4×
Nevada	$18,028	27	2	11.0×
South Carolina	$17,885	265	9	7.9×
Virginia	$17,837	435	13	6.1×
Montana	$17,788	53	3	3.6×
Iowa	$17,727	69	4	4.8×
Missouri	$17,583	256	11	5.4×
Ohio	$17,529	343	12	5.9×
Kansas	$17,443	135	5	7.0×
South Dakota	$17,438	61	3	5.6×
Indiana	$17,368	190	11	7.6×
Florida	$17,243	780	30	9.1×
Mississippi	$17,171	70	4	4.7×
Arkansas	$16,855	93	4	4.9×
Texas	$16,788	509	24	9.6×
Maine	$16,689	54	2	4.9×
Tennessee	$16,200	299	11	6.1×
West Virginia	$16,068	83	3	6.1×
Oklahoma	$15,945	105	4	8.3×
North Dakota	$15,911	30	2	4.8×
Kentucky	$15,592	228	8	8.2×
Louisiana	$15,442	92	4	7.2×
Alabama	$15,166	126	4	6.1×
New Mexico	$14,648	13	1	15.5×
Vermont	$11,203	21	1	6.0×
United States	$20,436	11,919	433	6.1×

* 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 164.

10th percentile	$15,038
25th percentile	$16,332
Median hospital	$18,364
75th percentile	$21,496
90th percentile	$25,335

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

163Major Chest Procedures with MCC · $37,586
165Major Chest Procedures without CC/MCC · $14,964

Nearby MS‑DRG numbers

Questions

What did Medicare pay for MS‑DRG 164 in 2024?

An average of $20,436 per discharge across 11,919 fee-for-service discharges at 433 hospitals, $243.6M in total.

Which state paid the most for MS‑DRG 164?

California, at $28,810 per case; Vermont paid the least, $11,203.

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.