MS‑DRG 394: Other Digestive System Diagnoses with CC
What Medicare paid hospitals for MS‑DRG 394 in 2024: nationally, state by state and across hospitals.
In 2024 Medicare paid hospitals an average of $7,241 per discharge for MS‑DRG 394, across 23,654 fee-for-service discharges at 1,004 hospitals: 0.48% of all Medicare inpatient discharges and $171.3M in total, the 98th largest MS‑DRG by Medicare spending.
By state, the average ran from $4,406 in Vermont to $9,522 in California. Across hospitals, half were paid between $5,906 and $7,868 per case, and the median hospital $6,603; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.
Hospitals charged $48,649 on average for these stays, 6.7 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 | 0.9357 | 0.9228 | −1.4% |
| Geometric mean stay (days) | 2.9 | 2.9 | 0.0 |
| Average stay (days) | 3.7 | 3.7 | 0.0 |
- Not capped: the −1.4% 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)
$6,817.60
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 ($) |
|---|---|---|---|
| 393 | with MCC | 11,732.80 | +4,915.20 |
| 394 | with CC | 6,817.60 | — |
| 395 | without CC/MCC | 4,714.99 | −2,102.61 |
FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 394 at a hospital
Paid per case, by state
| State | Paid per case | Discharges | Hospitals | Charges ÷ paid |
|---|---|---|---|---|
| Maryland* | $11,812 | 653 | 27 | 1.2× |
| California | $9,522 | 2,259 | 103 | 8.6× |
| New York | $8,982 | 1,677 | 55 | 7.1× |
| Connecticut | $8,427 | 271 | 12 | 4.9× |
| District of Columbia | $8,157 | 41 | 3 | 8.0× |
| Oregon | $7,959 | 131 | 7 | 4.2× |
| Hawaii | $7,947 | 28 | 1 | 5.5× |
| Georgia | $7,939 | 514 | 28 | 5.7× |
| Massachusetts | $7,893 | 1,128 | 34 | 3.3× |
| Alaska | $7,448 | 29 | 2 | 10.5× |
| Rhode Island | $7,346 | 92 | 5 | 3.8× |
| New Jersey | $7,287 | 1,004 | 38 | 9.3× |
| Nevada | $7,236 | 280 | 14 | 13.6× |
| Washington | $7,153 | 329 | 17 | 5.8× |
| Wyoming | $6,968 | 14 | 1 | 3.2× |
| New Hampshire | $6,917 | 144 | 6 | 4.9× |
| North Carolina | $6,914 | 623 | 24 | 4.7× |
| Colorado | $6,853 | 170 | 9 | 10.4× |
| South Dakota | $6,803 | 102 | 3 | 6.1× |
| Utah | $6,728 | 94 | 5 | 4.8× |
| Texas | $6,709 | 1,469 | 69 | 8.3× |
| Michigan | $6,691 | 731 | 31 | 4.4× |
| Pennsylvania | $6,618 | 1,185 | 45 | 7.9× |
| Minnesota | $6,608 | 404 | 15 | 4.5× |
| Indiana | $6,571 | 579 | 26 | 5.7× |
| Illinois | $6,560 | 1,171 | 45 | 5.9× |
| Florida | $6,543 | 2,479 | 95 | 9.4× |
| Arizona | $6,526 | 433 | 19 | 6.8× |
| Maine | $6,512 | 57 | 3 | 5.0× |
| Wisconsin | $6,449 | 371 | 17 | 5.3× |
| South Carolina | $6,398 | 372 | 18 | 6.4× |
| Delaware | $6,374 | 107 | 3 | 4.9× |
| North Dakota | $6,367 | 62 | 3 | 3.7× |
| Nebraska | $6,345 | 131 | 5 | 4.9× |
| Oklahoma | $6,340 | 163 | 7 | 5.9× |
| Missouri | $6,191 | 372 | 17 | 6.1× |
| Mississippi | $6,184 | 206 | 10 | 5.3× |
| Tennessee | $6,105 | 507 | 21 | 6.0× |
| Virginia | $6,061 | 728 | 31 | 6.2× |
| Idaho | $6,058 | 67 | 3 | 4.1× |
| Montana | $6,033 | 59 | 4 | 3.8× |
| Alabama | $5,930 | 259 | 15 | 7.0× |
| Kansas | $5,920 | 212 | 10 | 9.1× |
| Ohio | $5,905 | 836 | 41 | 5.9× |
| Iowa | $5,841 | 183 | 9 | 4.8× |
| Kentucky | $5,737 | 294 | 13 | 6.2× |
| Louisiana | $5,604 | 251 | 12 | 6.6× |
| Arkansas | $5,444 | 153 | 9 | 5.5× |
| West Virginia | $5,420 | 156 | 9 | 5.8× |
| New Mexico | $5,382 | 39 | 3 | 8.0× |
| Vermont | $4,406 | 35 | 2 | 8.1× |
| United States | $7,241 | 23,654 | 1,004 | 6.7× |
* 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 394.
| 10th percentile | $5,281 |
|---|---|
| 25th percentile | $5,906 |
| Median hospital | $6,603 |
| 75th percentile | $7,868 |
| 90th percentile | $9,383 |
Related analysis
- DRG validation and the single-MCC claim: when one code moves the payment · Payment integrity
The same condition at other severities
More in Digestive system
392Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders without MCC378Gastrointestinal Hemorrhage with CC377Gastrointestinal Hemorrhage with MCC330Major Small and Large Bowel Procedures with CC389Gastrointestinal Obstruction with CC391Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders with MCC329Major Small and Large Bowel Procedures with MCC331Major Small and Large Bowel Procedures without CC/MCC
Questions
What did Medicare pay for MS‑DRG 394 in 2024?
An average of $7,241 per discharge across 23,654 fee-for-service discharges at 1,004 hospitals, $171.3M in total.
Which state paid the most for MS‑DRG 394?
California, at $9,522 per case; Vermont paid the least, $4,406.
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.