MS‑DRG 191: Chronic Obstructive Pulmonary Disease with CC

What Medicare paid hospitals for MS‑DRG 191 in 2024: nationally, state by state and across hospitals.

Paid per case$6,3740.4× the all-DRG average

Discharges11,4850.23% of all Medicare discharges

Total paid$73.2M162nd largest MS‑DRG by spending

Hospitals583in 41 states and DC

Charges ÷ paid6.3×$39,874 average charge

Relative weight0.8261FY2027, 2.6-day geometric mean stay; FY2026 0.8430 (−2.0%)

In 2024 Medicare paid hospitals an average of $6,374 per discharge for MS‑DRG 191, across 11,485 fee-for-service discharges at 583 hospitals: 0.23% of all Medicare inpatient discharges and $73.2M in total, the 162nd largest MS‑DRG by Medicare spending.

By state, the average ran from $4,083 in Kansas to $9,844 in District of Columbia. Across hospitals, half were paid between $5,212 and $6,948 per case, and the median hospital $5,915; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.

Hospitals charged $39,874 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 191 on the interactive map Price an MS‑DRG 191 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 191, FY2026 and FY2027
	FY2026	FY2027	Change
Relative weight	0.8430	0.8261	−2.0%
Geometric mean stay (days)	2.6	2.6	0.0
Average stay (days)	3.3	3.2	−0.1

Not capped: the −2.0% 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)

$6,103.19

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 191
MS‑DRG	Severity	Payment ($)	Step ($)
190	with MCC	7,940.57	+1,837.38
191	with CC	6,103.19	—
192	without CC/MCC	4,645.54	−1,457.65

FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 191 at a hospital

Paid per case, by state

MS‑DRG 191 by state, 2024
State	Paid per case	Discharges	Hospitals	Charges ÷ paid
Maryland*	$10,340	527	24	1.3×
District of Columbia	$9,844	13	1	3.1×
California	$8,554	600	37	9.0×
New York	$8,013	868	41	6.5×
Connecticut	$7,338	106	7	4.7×
Nevada	$7,078	30	2	16.6×
Massachusetts	$6,747	868	36	3.0×
Maine	$6,720	14	1	3.2×
Oregon	$6,686	13	1	2.7×
New Jersey	$6,491	696	34	9.7×
Minnesota	$6,385	98	5	4.3×
Texas	$6,198	317	20	7.8×
Georgia	$6,150	163	10	6.2×
Rhode Island	$6,141	31	2	4.0×
North Carolina	$5,991	624	30	4.7×
Florida	$5,973	1,304	64	9.1×
Pennsylvania	$5,922	708	36	7.9×
Washington	$5,915	20	1	7.2×
Delaware	$5,859	115	4	4.8×
Illinois	$5,827	711	34	6.1×
North Dakota	$5,808	16	1	3.0×
South Dakota	$5,790	18	1	6.6×
Michigan	$5,772	537	24	4.6×
South Carolina	$5,651	209	10	5.8×
New Hampshire	$5,646	78	4	4.1×
Missouri	$5,604	395	21	6.1×
Tennessee	$5,535	110	7	5.9×
Arizona	$5,490	134	9	8.0×
Virginia	$5,488	260	15	5.2×
Oklahoma	$5,389	88	5	8.6×
Alabama	$5,377	207	9	6.0×
Indiana	$5,298	282	15	5.6×
Wisconsin	$5,237	62	4	5.4×
Nebraska	$5,202	51	3	5.2×
Ohio	$5,186	415	24	6.2×
Mississippi	$4,995	95	4	7.7×
Iowa	$4,909	52	4	4.1×
Arkansas	$4,908	116	7	4.9×
Kentucky	$4,771	286	11	6.4×
Louisiana	$4,766	117	7	7.4×
West Virginia	$4,761	117	7	5.7×
Kansas	$4,083	14	1	8.9×
United States	$6,374	11,485	583	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 191.

10th percentile	$4,694
25th percentile	$5,212
Median hospital	$5,915
75th percentile	$6,948
90th percentile	$8,409

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

190Chronic Obstructive Pulmonary Disease with MCC · $8,467

Questions

What did Medicare pay for MS‑DRG 191 in 2024?

An average of $6,374 per discharge across 11,485 fee-for-service discharges at 583 hospitals, $73.2M in total.

Which state paid the most for MS‑DRG 191?

District of Columbia, at $9,844 per case; Kansas paid the least, $4,083.

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.