MS‑DRG 186: Pleural Effusion with MCC

What Medicare paid hospitals for MS‑DRG 186 in 2024: nationally, state by state and across hospitals.

Paid per case$12,1390.8× the all-DRG average

Discharges1,7510.04% of all Medicare discharges

Total paid$21.3M257th largest MS‑DRG by spending

Hospitals123in 36 states

Charges ÷ paid6.8×$81,946 average charge

Relative weight1.5835FY2027, 4.2-day geometric mean stay; FY2026 1.5585 (+1.6%)

In 2024 Medicare paid hospitals an average of $12,139 per discharge for MS‑DRG 186, across 1,751 fee-for-service discharges at 123 hospitals: 0.04% of all Medicare inpatient discharges and $21.3M in total, the 257th largest MS‑DRG by Medicare spending.

By state, the average ran from $9,242 in Mississippi to $16,253 in California. Across hospitals, half were paid between $10,184 and $12,885 per case, and the median hospital $11,215; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.

Hospitals charged $81,946 on average for these stays, 6.8 times what Medicare paid: charges are list prices, while Medicare pays a fixed amount per MS‑DRG.

See MS‑DRG 186 on the interactive map Price an MS‑DRG 186 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 186, FY2026 and FY2027
	FY2026	FY2027	Change
Relative weight	1.5585	1.5835	+1.6%
Geometric mean stay (days)	4.2	4.2	0.0
Average stay (days)	5.6	5.6	0.0

Not capped: the +1.6% 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)

$11,698.82

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 186
MS‑DRG	Severity	Payment ($)	Step ($)
186	with MCC	11,698.82	—
187	with CC	7,388.69	−4,310.13
188	without CC/MCC	4,915.94	−6,782.88

FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 186 at a hospital

Paid per case, by state

MS‑DRG 186 by state, 2024
State	Paid per case	Discharges	Hospitals	Charges ÷ paid
California	$16,253	173	13	7.6×
New York	$16,198	171	9	8.6×
Connecticut	$16,189	26	2	4.5×
Massachusetts	$13,988	40	3	3.0×
West Virginia	$13,186	14	1	7.4×
Utah	$13,134	12	1	4.3×
Pennsylvania	$12,878	61	4	8.8×
New Jersey	$12,760	64	5	7.2×
Delaware	$12,390	19	1	3.6×
Nevada	$12,320	20	1	4.1×
Hawaii	$12,074	14	1	8.0×
Kansas	$11,741	35	3	9.8×
North Carolina	$11,586	64	4	4.0×
Arizona	$11,525	86	6	5.9×
Georgia	$11,469	45	4	8.2×
Maryland*	$11,403	35	3	1.2×
Ohio	$11,331	14	1	4.0×
Montana	$11,319	12	1	3.2×
Texas	$11,118	80	6	9.5×
Missouri	$10,917	25	2	3.4×
Oklahoma	$10,911	43	3	6.1×
South Carolina	$10,827	24	2	6.2×
Alabama	$10,710	15	1	7.3×
Virginia	$10,575	38	3	7.3×
Florida	$10,293	306	19	7.0×
Kentucky	$10,243	19	1	5.3×
Colorado	$10,203	11	1	7.4×
Illinois	$10,143	77	6	5.6×
Michigan	$10,133	11	1	5.2×
Tennessee	$10,128	72	6	5.8×
Iowa	$9,874	37	2	6.8×
Nebraska	$9,733	27	2	4.7×
Louisiana	$9,730	23	2	5.6×
Arkansas	$9,615	11	1	9.0×
New Mexico	$9,604	15	1	4.6×
Mississippi	$9,242	12	1	5.2×
United States	$12,139	1,751	123	6.8×

* 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 186.

10th percentile	$9,308
25th percentile	$10,184
Median hospital	$11,215
75th percentile	$12,885
90th percentile	$15,624

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

Nearby MS‑DRG numbers

Questions

What did Medicare pay for MS‑DRG 186 in 2024?

An average of $12,139 per discharge across 1,751 fee-for-service discharges at 123 hospitals, $21.3M in total.

Which state paid the most for MS‑DRG 186?

California, at $16,253 per case; Mississippi paid the least, $9,242.

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.