MS‑DRG 467: Revision of Hip or Knee Replacement with CC
What Medicare paid hospitals for MS‑DRG 467 in 2024: nationally, state by state and across hospitals.
In 2024 Medicare paid hospitals an average of $26,100 per discharge for MS‑DRG 467, across 14,134 fee-for-service discharges at 561 hospitals: 0.29% of all Medicare inpatient discharges and $368.9M in total, the 52nd largest MS‑DRG by Medicare spending.
By state, the average ran from $15,767 in Vermont to $43,363 in Wyoming. Across hospitals, half were paid between $21,615 and $27,419 per case, and the median hospital $23,966; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.
Hospitals charged $160,618 on average for these stays, 6.2 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.
- Deleted in MS‑DRG version 44. Its FY2026 weight was 3.5266; from October 1, 2026 its stays group to other MS‑DRGs.
Paid per case, by state
| State | Paid per case | Discharges | Hospitals | Charges ÷ paid |
|---|---|---|---|---|
| Wyoming | $43,363 | 16 | 1 | 1.9× |
| Maryland* | $40,964 | 261 | 11 | 1.2× |
| California | $36,674 | 991 | 39 | 6.8× |
| Hawaii | $34,730 | 12 | 1 | 4.3× |
| New York | $32,981 | 818 | 27 | 5.1× |
| Oregon | $31,007 | 131 | 7 | 3.2× |
| New Hampshire | $29,832 | 107 | 3 | 3.1× |
| Connecticut | $29,629 | 149 | 7 | 3.5× |
| Massachusetts | $29,315 | 411 | 13 | 3.0× |
| Alaska | $28,720 | 52 | 2 | 9.6× |
| Minnesota | $27,808 | 508 | 15 | 3.3× |
| New Jersey | $27,728 | 300 | 12 | 5.0× |
| District of Columbia | $27,189 | 51 | 2 | 4.0× |
| Washington | $26,518 | 258 | 12 | 5.1× |
| Illinois | $25,389 | 544 | 24 | 5.5× |
| Montana | $25,330 | 49 | 3 | 3.9× |
| Delaware | $25,240 | 43 | 1 | 3.8× |
| Pennsylvania | $25,109 | 704 | 26 | 6.0× |
| Utah | $24,981 | 170 | 6 | 4.0× |
| Maine | $24,815 | 21 | 1 | 5.5× |
| Idaho | $24,676 | 70 | 3 | 4.5× |
| Texas | $24,654 | 1,114 | 42 | 11.6× |
| North Carolina | $24,474 | 478 | 19 | 5.1× |
| Nevada | $24,464 | 85 | 4 | 10.9× |
| Indiana | $24,373 | 312 | 15 | 5.5× |
| Arizona | $24,101 | 344 | 17 | 6.8× |
| Louisiana | $24,079 | 144 | 9 | 5.9× |
| Colorado | $24,071 | 325 | 15 | 9.4× |
| New Mexico | $24,006 | 27 | 2 | 6.6× |
| Kentucky | $23,905 | 177 | 7 | 8.0× |
| Wisconsin | $23,901 | 255 | 11 | 4.4× |
| North Dakota | $23,870 | 99 | 3 | 3.6× |
| Missouri | $23,840 | 298 | 12 | 4.9× |
| Michigan | $23,800 | 295 | 14 | 4.4× |
| Georgia | $23,795 | 203 | 12 | 7.7× |
| Virginia | $23,459 | 440 | 21 | 7.1× |
| South Dakota | $23,435 | 138 | 4 | 4.2× |
| Rhode Island | $23,199 | 43 | 2 | 3.0× |
| West Virginia | $23,197 | 66 | 2 | 6.1× |
| South Carolina | $23,051 | 215 | 12 | 6.5× |
| Iowa | $23,040 | 145 | 6 | 4.8× |
| Florida | $22,704 | 1,161 | 42 | 9.1× |
| Ohio | $22,622 | 556 | 19 | 5.5× |
| Kansas | $22,126 | 216 | 8 | 7.2× |
| Tennessee | $22,073 | 382 | 14 | 6.7× |
| Mississippi | $22,022 | 112 | 5 | 6.4× |
| Arkansas | $22,013 | 161 | 4 | 3.6× |
| Oklahoma | $21,950 | 272 | 10 | 6.1× |
| Nebraska | $21,187 | 167 | 6 | 5.1× |
| Alabama | $20,642 | 217 | 7 | 7.4× |
| Vermont | $15,767 | 21 | 1 | 6.8× |
| United States | $26,100 | 14,134 | 561 | 6.2× |
* 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 467.
| 10th percentile | $19,885 |
|---|---|
| 25th percentile | $21,615 |
| Median hospital | $23,966 |
| 75th percentile | $27,419 |
| 90th percentile | $32,773 |
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 Musculoskeletal system and connective tissue
481Hip and Femur Procedures except Major Joint with CC470Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC552Medical Back Problems without MCC522Hip Replacement with Principal Diagnosis of Hip Fracture without MCC480Hip and Femur Procedures except Major Joint with MCC460Spinal Fusion except Cervical without MCC563Fracture, Sprain, Strain and Dislocation except Femur, Hip, Pelvis and Thigh without MCC454Combined Anterior and Posterior Spinal Fusion with CC
Questions
What did Medicare pay for MS‑DRG 467 in 2024?
An average of $26,100 per discharge across 14,134 fee-for-service discharges at 561 hospitals, $368.9M in total.
Which state paid the most for MS‑DRG 467?
Wyoming, at $43,363 per case; Vermont paid the least, $15,767.
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.