MS‑DRG 266: Endovascular Cardiac Valve Replacement and Supplement Procedures with MCC

What Medicare paid hospitals for MS‑DRG 266 in 2024: nationally, state by state and across hospitals.

Paid per case$52,9953.5× the all-DRG average

Discharges23,6300.48% of all Medicare discharges

Total paid$1.3B9th largest MS‑DRG by spending

Hospitals533in 49 states and DC

Charges ÷ paid5.4×$285,418 average charge

Relative weight5.9309FY2027, 2.3-day geometric mean stay; FY2026 6.1284 (−3.2%)

In 2024 Medicare paid hospitals an average of $52,995 per discharge for MS‑DRG 266, across 23,630 fee-for-service discharges at 533 hospitals: 0.48% of all Medicare inpatient discharges and $1.3B in total, the 9th largest MS‑DRG by Medicare spending.

By state, the average ran from $39,745 in Mississippi to $70,954 in California. Across hospitals, half were paid between $43,455 and $57,469 per case, and the median hospital $48,562; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.

Hospitals charged $285,418 on average for these stays, 5.4 times what Medicare paid: charges are list prices, while Medicare pays a fixed amount per MS‑DRG.

See MS‑DRG 266 on the interactive map Price an MS‑DRG 266 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 266, FY2026 and FY2027
	FY2026	FY2027	Change
Relative weight	6.1284	5.9309	−3.2%
Geometric mean stay (days)	2.5	2.3	−0.2
Average stay (days)	4.5	4.2	−0.3

Not capped: the −3.2% 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)

$43,817.19

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 266
MS‑DRG	Severity	Payment ($)	Step ($)
266	with MCC	43,817.19	—
267	without MCC	34,891.07	−8,926.12

FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 266 at a hospital

Paid per case, by state

MS‑DRG 266 by state, 2024
State	Paid per case	Discharges	Hospitals	Charges ÷ paid
Maryland*	$94,532	259	8	1.1×
California	$70,954	2,347	52	5.9×
Massachusetts	$69,139	683	10	3.0×
New York	$67,082	1,629	23	5.0×
Delaware	$66,050	95	2	4.3×
District of Columbia	$62,576	106	2	4.7×
Connecticut	$62,173	253	6	3.0×
Rhode Island	$59,940	56	1	2.6×
Hawaii	$59,553	46	2	3.5×
New Hampshire	$57,112	116	3	4.2×
Oregon	$56,863	346	7	3.3×
New Jersey	$56,806	723	13	6.5×
Minnesota	$55,765	533	10	3.5×
Alaska	$54,024	40	1	5.0×
Maine	$53,171	89	2	5.1×
Washington	$52,906	905	13	4.4×
Michigan	$52,636	359	13	4.0×
Pennsylvania	$52,498	999	30	5.9×
Nevada	$52,129	274	8	7.7×
Illinois	$51,857	640	19	5.5×
Arizona	$51,680	414	15	6.5×
Kentucky	$49,742	146	6	7.0×
Ohio	$49,034	683	13	4.2×
West Virginia	$49,006	107	3	5.4×
Colorado	$48,955	453	10	6.5×
North Carolina	$48,658	443	13	4.8×
Virginia	$48,546	802	13	4.6×
Wisconsin	$47,721	497	11	4.2×
North Dakota	$46,911	68	3	3.9×
South Dakota	$46,267	74	3	5.3×
Utah	$46,085	181	6	4.1×
Texas	$46,009	1,869	38	8.1×
Montana	$45,887	202	4	2.7×
Georgia	$45,747	768	14	6.0×
Nebraska	$45,478	145	4	3.5×
South Carolina	$45,477	570	12	5.7×
Idaho	$45,448	62	2	3.2×
Florida	$44,904	2,221	51	7.0×
Kansas	$44,862	268	4	6.5×
Iowa	$44,695	225	6	4.4×
Missouri	$44,460	475	13	5.2×
Indiana	$43,922	444	13	5.0×
New Mexico	$42,277	80	3	6.4×
Tennessee	$42,120	616	12	6.5×
Vermont	$42,007	58	1	5.3×
Oklahoma	$41,649	138	5	5.6×
Louisiana	$40,649	263	9	4.6×
Arkansas	$39,929	208	5	3.5×
Alabama	$39,836	356	10	6.6×
Mississippi	$39,745	296	6	4.0×
United States	$52,995	23,630	533	5.4×

* 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 266.

10th percentile	$40,292
25th percentile	$43,455
Median hospital	$48,562
75th percentile	$57,469
90th percentile	$67,020

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

267Endovascular Cardiac Valve Replacement and Supplement Procedures without MCC · $40,567

Nearby MS‑DRG numbers

Questions

What did Medicare pay for MS‑DRG 266 in 2024?

An average of $52,995 per discharge across 23,630 fee-for-service discharges at 533 hospitals, $1.3B in total.

Which state paid the most for MS‑DRG 266?

California, at $70,954 per case; Mississippi paid the least, $39,745.

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.