MS‑DRG 243: Permanent Cardiac Pacemaker Implant with CC

What Medicare paid hospitals for MS‑DRG 243 in 2024: nationally, state by state and across hospitals.

Paid per case$17,3151.1× the all-DRG average

Discharges14,8760.30% of all Medicare discharges

Total paid$257.6M66th largest MS‑DRG by spending

Hospitals681in 50 states and DC

Charges ÷ paid6.3×$109,447 average charge

Relative weight2.1079FY2027, 2.8-day geometric mean stay; FY2026 2.1309 (−1.1%)

In 2024 Medicare paid hospitals an average of $17,315 per discharge for MS‑DRG 243, across 14,876 fee-for-service discharges at 681 hospitals: 0.30% of all Medicare inpatient discharges and $257.6M in total, the 66th largest MS‑DRG by Medicare spending.

By state, the average ran from $9,531 in Vermont to $23,089 in California. Across hospitals, half were paid between $14,710 and $18,734 per case, and the median hospital $16,149; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.

Hospitals charged $109,447 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 243 on the interactive map Price an MS‑DRG 243 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 243, FY2026 and FY2027
	FY2026	FY2027	Change
Relative weight	2.1309	2.1079	−1.1%
Geometric mean stay (days)	2.8	2.8	0.0
Average stay (days)	3.5	3.4	−0.1

Not capped: the −1.1% 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)

$15,573.06

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 243
MS‑DRG	Severity	Payment ($)	Step ($)
242	with MCC	23,077.00	+7,503.94
243	with CC	15,573.06	—
244	without CC/MCC	13,030.87	−2,542.19

FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 243 at a hospital

Paid per case, by state

MS‑DRG 243 by state, 2024
State	Paid per case	Discharges	Hospitals	Charges ÷ paid
Maryland*	$25,675	363	16	1.2×
California	$23,089	941	50	7.6×
Massachusetts	$21,951	511	18	3.0×
District of Columbia	$21,876	43	1	4.9×
Connecticut	$21,683	164	7	3.5×
New York	$21,610	817	32	6.0×
Wyoming	$19,739	17	1	4.4×
Rhode Island	$19,672	61	3	3.6×
Oregon	$19,349	152	7	4.1×
Hawaii	$19,316	36	2	4.1×
Nevada	$18,935	99	6	11.8×
New Jersey	$18,921	472	20	7.0×
New Hampshire	$18,625	99	6	5.4×
Alaska	$18,624	33	1	5.4×
Washington	$17,895	293	15	4.8×
Arizona	$17,622	267	16	6.2×
Minnesota	$17,376	430	13	4.9×
Delaware	$17,005	117	3	4.7×
Colorado	$16,980	84	6	7.9×
Maine	$16,962	75	2	5.4×
Pennsylvania	$16,832	820	34	7.2×
Illinois	$16,340	558	28	5.7×
Utah	$16,332	134	6	5.4×
Idaho	$16,323	96	5	4.9×
South Dakota	$16,284	113	3	5.3×
North Dakota	$16,173	43	2	4.3×
North Carolina	$16,124	571	19	5.6×
Michigan	$16,009	388	20	4.6×
Wisconsin	$15,985	217	10	4.6×
Georgia	$15,965	367	19	6.8×
Virginia	$15,891	626	23	6.4×
Missouri	$15,614	276	15	6.0×
Indiana	$15,590	312	16	6.6×
Florida	$15,544	1,364	60	9.3×
Texas	$15,480	953	51	9.5×
South Carolina	$15,414	367	15	8.2×
Montana	$15,400	92	5	4.1×
Ohio	$15,396	592	28	5.6×
Nebraska	$15,126	114	5	4.4×
Tennessee	$15,002	340	15	7.4×
Kansas	$14,899	157	8	7.0×
West Virginia	$14,815	133	7	5.8×
Iowa	$14,623	167	9	4.7×
Kentucky	$14,303	168	9	9.0×
Louisiana	$14,299	129	9	7.3×
New Mexico	$14,072	18	1	9.4×
Oklahoma	$13,926	179	8	5.8×
Alabama	$13,888	138	7	6.7×
Arkansas	$13,887	191	10	4.2×
Mississippi	$13,683	132	8	6.2×
Vermont	$9,531	47	1	8.6×
United States	$17,315	14,876	681	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 243.

10th percentile	$13,827
25th percentile	$14,710
Median hospital	$16,149
75th percentile	$18,734
90th percentile	$22,044

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

242Permanent Cardiac Pacemaker Implant with MCC · $26,961
244Permanent Cardiac Pacemaker Implant without CC/MCC · $13,216

Nearby MS‑DRG numbers

Questions

What did Medicare pay for MS‑DRG 243 in 2024?

An average of $17,315 per discharge across 14,876 fee-for-service discharges at 681 hospitals, $257.6M in total.

Which state paid the most for MS‑DRG 243?

California, at $23,089 per case; Vermont paid the least, $9,531.

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.