MS‑DRG 445: Disorders of the Biliary Tract with CC
What Medicare paid hospitals for MS‑DRG 445 in 2024: nationally, state by state and across hospitals.
In 2024 Medicare paid hospitals an average of $8,459 per discharge for MS‑DRG 445, across 9,692 fee-for-service discharges at 504 hospitals: 0.20% of all Medicare inpatient discharges and $82.0M in total, the 152nd largest MS‑DRG by Medicare spending.
By state, the average ran from $4,324 in Vermont to $11,384 in California. Across hospitals, half were paid between $6,907 and $9,410 per case, and the median hospital $7,757; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.
Hospitals charged $60,708 on average for these stays, 7.2 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 | 1.0944 | 1.0872 | −0.7% |
| Geometric mean stay (days) | 3.0 | 2.9 | −0.1 |
| Average stay (days) | 3.7 | 3.6 | −0.1 |
- 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)
$8,032.18
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 ($) |
|---|---|---|---|
| 444 | with MCC | 12,312.02 | +4,279.84 |
| 445 | with CC | 8,032.18 | — |
| 446 | without CC/MCC | 6,001.97 | −2,030.21 |
FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 445 at a hospital
Paid per case, by state
| State | Paid per case | Discharges | Hospitals | Charges ÷ paid |
|---|---|---|---|---|
| Maryland* | $12,943 | 312 | 16 | 1.2× |
| California | $11,384 | 885 | 50 | 8.5× |
| Connecticut | $10,534 | 113 | 6 | 4.8× |
| New York | $10,037 | 747 | 36 | 7.7× |
| Hawaii | $9,661 | 27 | 2 | 5.1× |
| Massachusetts | $9,614 | 479 | 18 | 3.8× |
| Utah | $9,191 | 38 | 2 | 4.0× |
| Oregon | $9,029 | 63 | 5 | 5.0× |
| Nevada | $8,758 | 119 | 7 | 13.1× |
| Wyoming | $8,713 | 16 | 1 | 4.0× |
| Rhode Island | $8,578 | 30 | 2 | 4.2× |
| New Jersey | $8,538 | 383 | 20 | 9.8× |
| Colorado | $8,233 | 79 | 4 | 9.4× |
| Washington | $8,228 | 183 | 10 | 6.3× |
| District of Columbia | $8,159 | 33 | 2 | 6.1× |
| Minnesota | $8,127 | 147 | 8 | 4.3× |
| North Carolina | $8,115 | 356 | 17 | 5.6× |
| Idaho | $8,020 | 27 | 2 | 5.2× |
| Georgia | $7,974 | 104 | 6 | 8.6× |
| Michigan | $7,969 | 224 | 10 | 5.1× |
| Texas | $7,934 | 490 | 26 | 8.8× |
| Maine | $7,916 | 46 | 3 | 5.2× |
| Delaware | $7,902 | 73 | 3 | 5.5× |
| Pennsylvania | $7,871 | 566 | 28 | 9.1× |
| New Hampshire | $7,830 | 68 | 5 | 6.8× |
| South Carolina | $7,807 | 152 | 6 | 5.8× |
| Alaska | $7,803 | 15 | 1 | 7.4× |
| Wisconsin | $7,716 | 105 | 6 | 6.5× |
| Indiana | $7,579 | 219 | 11 | 6.1× |
| Kansas | $7,533 | 85 | 4 | 9.8× |
| North Dakota | $7,482 | 48 | 2 | 5.4× |
| Oklahoma | $7,434 | 144 | 6 | 7.3× |
| Illinois | $7,425 | 445 | 24 | 6.9× |
| Arizona | $7,425 | 236 | 14 | 7.9× |
| Florida | $7,380 | 874 | 44 | 10.2× |
| Virginia | $7,357 | 249 | 14 | 6.9× |
| Ohio | $7,225 | 283 | 16 | 6.3× |
| South Dakota | $7,210 | 66 | 2 | 6.5× |
| Missouri | $7,155 | 222 | 12 | 6.5× |
| Nebraska | $7,093 | 62 | 3 | 5.9× |
| Kentucky | $6,918 | 97 | 4 | 7.8× |
| Tennessee | $6,835 | 163 | 10 | 7.2× |
| Iowa | $6,802 | 125 | 7 | 6.6× |
| Montana | $6,724 | 47 | 3 | 3.7× |
| Louisiana | $6,696 | 120 | 7 | 7.8× |
| New Mexico | $6,517 | 30 | 2 | 9.0× |
| West Virginia | $6,488 | 83 | 4 | 6.4× |
| Alabama | $6,461 | 73 | 5 | 9.6× |
| Arkansas | $6,235 | 81 | 4 | 5.8× |
| Mississippi | $6,172 | 42 | 3 | 6.5× |
| Vermont | $4,324 | 18 | 1 | 9.6× |
| United States | $8,459 | 9,692 | 504 | 7.2× |
* 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 445.
| 10th percentile | $6,274 |
|---|---|
| 25th percentile | $6,907 |
| Median hospital | $7,757 |
| 75th percentile | $9,410 |
| 90th percentile | $11,079 |
Related analysis
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Questions
What did Medicare pay for MS‑DRG 445 in 2024?
An average of $8,459 per discharge across 9,692 fee-for-service discharges at 504 hospitals, $82.0M in total.
Which state paid the most for MS‑DRG 445?
California, at $11,384 per case; Vermont paid the least, $4,324.
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.