MS‑DRG 178: Respiratory Infections and Inflammations with CC

What Medicare paid hospitals for MS‑DRG 178 in 2024: nationally, state by state and across hospitals.

Paid per case$7,2790.5× the all-DRG average

Discharges26,4470.53% of all Medicare discharges

Total paid$192.5M87th largest MS‑DRG by spending

Hospitals1,020in 50 states and DC

Charges ÷ paid6.3×$45,703 average charge

Relative weight0.9744FY2027, 3.1-day geometric mean stay; FY2026 0.9760 (−0.2%)

In 2024 Medicare paid hospitals an average of $7,279 per discharge for MS‑DRG 178, across 26,447 fee-for-service discharges at 1,020 hospitals: 0.53% of all Medicare inpatient discharges and $192.5M in total, the 87th largest MS‑DRG by Medicare spending.

By state, the average ran from $5,500 in Vermont to $9,662 in Wyoming. Across hospitals, half were paid between $5,934 and $7,867 per case, and the median hospital $6,740; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.

Hospitals charged $45,703 on average for these stays, 6.3 times what Medicare paid: charges are list prices, while Medicare pays a fixed amount per MS‑DRG.

See MS‑DRG 178 on the interactive map Price an MS‑DRG 178 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 178, FY2026 and FY2027
	FY2026	FY2027	Change
Relative weight	0.9760	0.9744	−0.2%
Geometric mean stay (days)	3.1	3.1	0.0
Average stay (days)	3.9	3.9	0.0

Not capped: the −0.2% 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)

$7,198.82

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 178
MS‑DRG	Severity	Payment ($)	Step ($)
177	with MCC	11,888.69	+4,689.87
178	with CC	7,198.82	—
179	without CC/MCC	5,426.45	−1,772.37

FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 178 at a hospital

Paid per case, by state

MS‑DRG 178 by state, 2024
State	Paid per case	Discharges	Hospitals	Charges ÷ paid
Maryland*	$11,956	1,028	33	1.3×
Wyoming	$9,662	61	3	3.2×
California	$9,580	1,717	66	8.9×
Utah	$9,048	37	2	4.8×
New York	$8,741	2,088	70	7.3×
Hawaii	$8,663	34	1	5.7×
Connecticut	$8,590	350	15	4.4×
Alaska	$8,017	11	1	7.7×
Nevada	$8,009	59	5	8.9×
Oregon	$7,893	131	8	4.4×
Massachusetts	$7,705	1,682	41	3.3×
New Jersey	$7,372	1,267	41	10.5×
District of Columbia	$7,341	56	3	6.4×
Maine	$7,269	74	4	6.3×
New Mexico	$7,265	39	2	3.4×
Delaware	$7,235	213	4	5.4×
Rhode Island	$7,215	137	5	4.4×
Georgia	$7,213	509	23	5.9×
Washington	$7,078	277	13	5.6×
Minnesota	$7,066	468	20	4.5×
South Dakota	$7,054	66	3	6.2×
Texas	$6,905	1,059	50	7.1×
North Carolina	$6,846	1,082	37	4.9×
Colorado	$6,725	163	7	12.5×
Florida	$6,695	2,496	83	8.1×
Illinois	$6,675	1,592	53	5.9×
Michigan	$6,615	662	26	4.4×
New Hampshire	$6,611	162	9	5.1×
Virginia	$6,564	609	27	5.2×
Nebraska	$6,558	199	6	6.0×
South Carolina	$6,557	501	22	5.8×
Pennsylvania	$6,515	1,603	64	7.8×
Arizona	$6,495	413	17	7.4×
North Dakota	$6,484	94	3	4.5×
Indiana	$6,404	530	24	5.4×
Oklahoma	$6,323	373	16	6.6×
Wisconsin	$6,306	313	15	6.1×
Montana	$6,232	42	3	3.3×
Missouri	$6,210	705	25	6.5×
Ohio	$6,183	1,002	51	5.8×
Idaho	$6,170	62	4	4.7×
West Virginia	$5,949	210	11	5.4×
Tennessee	$5,946	331	15	5.3×
Mississippi	$5,938	204	11	5.1×
Alabama	$5,871	386	18	6.1×
Kansas	$5,835	187	7	10.1×
Arkansas	$5,791	234	11	4.5×
Iowa	$5,663	223	11	4.7×
Louisiana	$5,608	298	14	6.8×
Kentucky	$5,605	364	14	6.6×
Vermont	$5,500	44	3	7.0×
United States	$7,279	26,447	1,020	6.3×

* 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 178.

10th percentile	$5,422
25th percentile	$5,934
Median hospital	$6,740
75th percentile	$7,867
90th percentile	$9,442

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

177Respiratory Infections and Inflammations with MCC · $12,668

Nearby MS‑DRG numbers

Questions

What did Medicare pay for MS‑DRG 178 in 2024?

An average of $7,279 per discharge across 26,447 fee-for-service discharges at 1,020 hospitals, $192.5M in total.

Which state paid the most for MS‑DRG 178?

Wyoming, at $9,662 per case; Vermont paid the least, $5,500.

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.