MS‑DRG 432: Cirrhosis and Alcoholic Hepatitis with MCC
What Medicare paid hospitals for MS‑DRG 432 in 2024: nationally, state by state and across hospitals.
In 2024 Medicare paid hospitals an average of $16,645 per discharge for MS‑DRG 432, across 10,422 fee-for-service discharges at 544 hospitals: 0.21% of all Medicare inpatient discharges and $173.5M in total, the 96th largest MS‑DRG by Medicare spending.
By state, the average ran from $11,979 in West Virginia to $23,979 in California. Across hospitals, half were paid between $12,971 and $17,907 per case, and the median hospital $14,662; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.
Hospitals charged $104,714 on average for these stays, 6.3 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 | 1.9682 | 1.9828 | +0.7% |
| Geometric mean stay (days) | 4.9 | 4.9 | 0.0 |
| Average stay (days) | 6.7 | 6.7 | 0.0 |
- Not capped: the +0.7% 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)
$14,648.83
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 ($) |
|---|---|---|---|
| 432 | with MCC | 14,648.83 | — |
| 433 | with CC | 7,681.25 | −6,967.58 |
| 434 | without CC/MCC | 4,737.89 | −9,910.94 |
FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 432 at a hospital
Paid per case, by state
| State | Paid per case | Discharges | Hospitals | Charges ÷ paid |
|---|---|---|---|---|
| Maryland* | $25,891 | 116 | 8 | 1.2× |
| California | $23,979 | 1,139 | 62 | 6.7× |
| New York | $23,757 | 439 | 20 | 8.5× |
| District of Columbia | $22,795 | 58 | 3 | 7.5× |
| Oregon | $19,082 | 50 | 4 | 4.2× |
| Massachusetts | $19,028 | 398 | 19 | 3.3× |
| Connecticut | $18,784 | 88 | 5 | 4.3× |
| Delaware | $18,182 | 46 | 2 | 4.4× |
| Rhode Island | $17,703 | 29 | 2 | 3.2× |
| New Jersey | $17,378 | 265 | 17 | 8.6× |
| Hawaii | $17,010 | 14 | 1 | 5.4× |
| Vermont | $16,839 | 16 | 1 | 4.1× |
| Minnesota | $16,832 | 190 | 11 | 3.8× |
| Wyoming | $16,690 | 27 | 2 | 2.9× |
| Nevada | $16,228 | 143 | 8 | 9.7× |
| South Dakota | $16,005 | 65 | 3 | 5.2× |
| Alaska | $15,817 | 28 | 2 | 9.9× |
| North Dakota | $15,756 | 22 | 2 | 4.6× |
| Texas | $15,692 | 1,391 | 60 | 7.8× |
| New Hampshire | $15,667 | 79 | 6 | 4.2× |
| Illinois | $15,571 | 398 | 21 | 5.3× |
| Pennsylvania | $15,394 | 331 | 18 | 7.9× |
| Arizona | $15,241 | 229 | 15 | 5.4× |
| Florida | $15,177 | 886 | 42 | 8.1× |
| North Carolina | $15,161 | 262 | 13 | 4.3× |
| Michigan | $14,971 | 198 | 12 | 4.2× |
| Georgia | $14,912 | 209 | 12 | 6.3× |
| Wisconsin | $14,874 | 123 | 6 | 5.5× |
| Missouri | $14,803 | 237 | 14 | 4.8× |
| Washington | $14,725 | 153 | 10 | 5.3× |
| Utah | $14,636 | 32 | 2 | 2.8× |
| Ohio | $14,577 | 340 | 17 | 5.0× |
| New Mexico | $14,551 | 88 | 4 | 3.9× |
| Louisiana | $14,405 | 103 | 6 | 5.5× |
| Colorado | $14,390 | 94 | 5 | 9.0× |
| Indiana | $14,268 | 216 | 10 | 4.8× |
| Oklahoma | $14,250 | 191 | 9 | 6.7× |
| Kansas | $14,215 | 116 | 4 | 8.3× |
| Idaho | $13,962 | 32 | 2 | 4.8× |
| Montana | $13,956 | 13 | 1 | 4.3× |
| Virginia | $13,620 | 343 | 18 | 5.5× |
| South Carolina | $13,439 | 166 | 9 | 7.0× |
| Nebraska | $13,406 | 82 | 5 | 4.5× |
| Mississippi | $13,009 | 153 | 8 | 4.2× |
| Tennessee | $12,986 | 280 | 14 | 5.3× |
| Iowa | $12,984 | 43 | 3 | 4.6× |
| Maine | $12,678 | 36 | 2 | 7.8× |
| Arkansas | $12,607 | 78 | 5 | 4.5× |
| Kentucky | $12,457 | 216 | 9 | 5.6× |
| Alabama | $12,395 | 92 | 4 | 7.7× |
| West Virginia | $11,979 | 79 | 6 | 3.9× |
| United States | $16,645 | 10,422 | 544 | 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 432.
| 10th percentile | $11,693 |
|---|---|
| 25th percentile | $12,971 |
| Median hospital | $14,662 |
| 75th percentile | $17,907 |
| 90th percentile | $21,162 |
Related analysis
- DRG validation and the single-MCC claim: when one code moves the payment · Payment integrity
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Questions
What did Medicare pay for MS‑DRG 432 in 2024?
An average of $16,645 per discharge across 10,422 fee-for-service discharges at 544 hospitals, $173.5M in total.
Which state paid the most for MS‑DRG 432?
California, at $23,979 per case; West Virginia paid the least, $11,979.
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.