MS‑DRG 239: Amputation for Circulatory System Disorders except Upper Limb and Toe with MCC
What Medicare paid hospitals for MS‑DRG 239 in 2024: nationally, state by state and across hospitals.
In 2024 Medicare paid hospitals an average of $40,809 per discharge for MS‑DRG 239, across 1,489 fee-for-service discharges at 96 hospitals: 0.03% of all Medicare inpatient discharges and $60.8M in total, the 181st largest MS‑DRG by Medicare spending.
By state, the average ran from $23,178 in Nebraska to $72,995 in Oregon. Across hospitals, half were paid between $29,979 and $48,195 per case, and the median hospital $39,215; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.
Hospitals charged $241,346 on average for these stays, 5.9 times what Medicare paid: charges are list prices, while Medicare pays a fixed amount per MS‑DRG.
What changed in FY2027
The rates for discharges from October 1, 2026 (MS‑DRG version 44) against FY2026.
| FY2026 | FY2027 | Change | |
|---|---|---|---|
| Relative weight | 4.9217 | 5.0019 | +1.6% |
| Geometric mean stay (days) | 11.1 | 11.0 | −0.1 |
| Average stay (days) | 13.8 | 13.7 | −0.1 |
- 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)
$36,953.79
The FY2027 weight times the operating standardized amount and the capital rate ($6,848.00 + $539.95) at a wage index of 1.0. No IME, DSH, outlier or other hospital-specific adjustment, so it is not what any hospital is paid; price it at a hospital for that.
| MS‑DRG | Severity | Payment ($) | Step ($) |
|---|---|---|---|
| 239 | with MCC | 36,953.79 | — |
| 240 | with CC | 21,754.56 | −15,199.23 |
| 241 | without CC/MCC | 10,955.59 | −25,998.20 |
FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 239 at a hospital
Paid per case, by state
| State | Paid per case | Discharges | Hospitals | Charges ÷ paid |
|---|---|---|---|---|
| Oregon | $72,995 | 11 | 1 | 4.5× |
| Massachusetts | $61,614 | 65 | 5 | 3.7× |
| District of Columbia | $58,251 | 37 | 2 | 6.5× |
| Minnesota | $53,249 | 33 | 2 | 3.4× |
| California | $52,254 | 129 | 9 | 6.2× |
| New Hampshire | $51,425 | 11 | 1 | 4.5× |
| New York | $50,869 | 215 | 11 | 6.3× |
| Connecticut | $50,115 | 22 | 2 | 5.3× |
| Pennsylvania | $45,737 | 64 | 4 | 8.8× |
| Hawaii | $44,876 | 13 | 1 | 5.7× |
| Michigan | $43,099 | 22 | 2 | 3.2× |
| New Jersey | $40,872 | 37 | 2 | 6.6× |
| Delaware | $39,232 | 21 | 1 | 4.7× |
| Virginia | $38,688 | 51 | 4 | 4.8× |
| Illinois | $37,564 | 71 | 4 | 5.5× |
| Ohio | $36,578 | 44 | 3 | 5.0× |
| Indiana | $32,403 | 36 | 3 | 4.3× |
| Oklahoma | $32,016 | 20 | 1 | 5.2× |
| Missouri | $31,838 | 36 | 2 | 5.3× |
| Louisiana | $31,803 | 25 | 2 | 4.4× |
| Tennessee | $31,472 | 59 | 4 | 4.5× |
| Florida | $31,394 | 41 | 2 | 8.9× |
| Texas | $31,120 | 168 | 9 | 9.4× |
| South Carolina | $30,776 | 84 | 6 | 5.1× |
| North Carolina | $30,748 | 69 | 5 | 3.6× |
| Kentucky | $29,756 | 28 | 2 | 5.4× |
| South Dakota | $29,739 | 11 | 1 | 4.9× |
| Washington | $28,650 | 11 | 1 | 7.6× |
| Arkansas | $27,439 | 15 | 1 | 6.4× |
| Mississippi | $23,679 | 26 | 2 | 4.5× |
| Nebraska | $23,178 | 14 | 1 | 4.8× |
| United States | $40,809 | 1,489 | 96 | 5.9× |
How much hospitals vary
Each hospital’s own average Medicare payment for MS‑DRG 239.
| 10th percentile | $26,870 |
|---|---|
| 25th percentile | $29,979 |
| Median hospital | $39,215 |
| 75th percentile | $48,195 |
| 90th percentile | $56,480 |
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Questions
What did Medicare pay for MS‑DRG 239 in 2024?
An average of $40,809 per discharge across 1,489 fee-for-service discharges at 96 hospitals, $60.8M in total.
Which state paid the most for MS‑DRG 239?
Oregon, at $72,995 per case; Nebraska paid the least, $23,178.
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.