MS‑DRG 216: Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with MCC

What Medicare paid hospitals for MS‑DRG 216 in 2024: nationally, state by state and across hospitals.

Paid per case$90,3136.0× the all-DRG average

Discharges2,5770.05% of all Medicare discharges

Total paid$232.7M76th largest MS‑DRG by spending

Hospitals124in 38 states and DC

Charges ÷ paid5.5×$501,084 average charge

Relative weight9.8832FY2027, 10.5-day geometric mean stay; FY2026 9.7828 (+1.0%)

In 2024 Medicare paid hospitals an average of $90,313 per discharge for MS‑DRG 216, across 2,577 fee-for-service discharges at 124 hospitals: 0.05% of all Medicare inpatient discharges and $232.7M in total, the 76th largest MS‑DRG by Medicare spending.

By state, the average ran from $51,973 in Iowa to $138,685 in California. Across hospitals, half were paid between $68,912 and $98,149 per case, and the median hospital $81,676; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.

Hospitals charged $501,084 on average for these stays, 5.5 times what Medicare paid: charges are list prices, while Medicare pays a fixed amount per MS‑DRG.

See MS‑DRG 216 on the interactive map Price an MS‑DRG 216 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 216, FY2026 and FY2027
	FY2026	FY2027	Change
Relative weight	9.7828	9.8832	+1.0%
Geometric mean stay (days)	10.6	10.5	−0.1
Average stay (days)	13.6	13.4	−0.2

Not capped: the +1.0% 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)

$73,016.59

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 216
MS‑DRG	Severity	Payment ($)	Step ($)
216	with MCC	73,016.59	—
217	with CC	50,283.13	−22,733.46
218	without CC/MCC	50,283.13	−22,733.46

FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 216 at a hospital

Paid per case, by state

MS‑DRG 216 by state, 2024
State	Paid per case	Discharges	Hospitals	Charges ÷ paid
California	$138,685	159	9	6.5×
Maryland*	$138,682	60	4	1.3×
New York	$107,555	360	8	4.9×
Massachusetts	$104,677	109	4	3.1×
Oregon	$101,756	30	2	3.3×
Pennsylvania	$100,532	88	5	8.2×
District of Columbia	$93,260	50	1	4.1×
Minnesota	$92,772	104	3	3.6×
Michigan	$92,285	66	4	4.2×
Connecticut	$91,100	28	2	3.7×
Washington	$89,221	34	2	5.3×
Illinois	$88,366	54	4	5.0×
Wyoming	$87,667	20	1	4.5×
Nevada	$87,093	26	2	14.6×
New Hampshire	$83,000	17	1	3.2×
New Jersey	$82,853	109	5	6.3×
Arizona	$82,678	79	5	6.6×
Ohio	$82,244	222	4	4.5×
Nebraska	$80,946	14	1	4.4×
Virginia	$79,389	76	3	6.0×
South Carolina	$78,180	27	2	5.8×
Wisconsin	$77,808	41	2	5.2×
Kansas	$77,502	23	2	8.7×
Texas	$77,288	171	10	8.6×
Vermont	$74,665	14	1	4.8×
Georgia	$74,403	43	3	7.0×
Florida	$74,299	113	7	8.2×
Missouri	$73,456	47	3	5.4×
West Virginia	$72,758	14	1	4.6×
North Carolina	$72,453	77	4	5.2×
Maine	$71,573	26	2	4.5×
Indiana	$70,990	25	1	5.7×
Kentucky	$69,959	35	2	6.0×
Tennessee	$69,942	80	4	7.3×
Alabama	$69,299	35	2	5.7×
New Mexico	$62,372	38	3	6.6×
Arkansas	$61,525	37	3	5.2×
Oklahoma	$56,459	15	1	5.5×
Iowa	$51,973	11	1	6.3×
United States	$90,313	2,577	124	5.5×

* 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 216.

10th percentile	$61,740
25th percentile	$68,912
Median hospital	$81,676
75th percentile	$98,149
90th percentile	$112,150

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

219Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization with MCC · $69,387

Nearby MS‑DRG numbers

Questions

What did Medicare pay for MS‑DRG 216 in 2024?

An average of $90,313 per discharge across 2,577 fee-for-service discharges at 124 hospitals, $232.7M in total.

Which state paid the most for MS‑DRG 216?

California, at $138,685 per case; Iowa paid the least, $51,973.

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.