MS‑DRG 468: Revision of Hip or Knee Replacement without CC/MCC

What Medicare paid hospitals for MS‑DRG 468 in 2024: nationally, state by state and across hospitals.

Paid per case$19,7221.3× the all-DRG average
Discharges9,1150.18% of all Medicare discharges
Total paid$179.8M91st largest MS‑DRG by spending
Hospitals420in 47 states and DC
Charges ÷ paid6.5×$128,705 average charge
Relative weight2.7480FY2026; not an MS‑DRG in FY2027

In 2024 Medicare paid hospitals an average of $19,722 per discharge for MS‑DRG 468, across 9,115 fee-for-service discharges at 420 hospitals: 0.18% of all Medicare inpatient discharges and $179.8M in total, the 91st largest MS‑DRG by Medicare spending.

By state, the average ran from $15,418 in Mississippi to $30,734 in Wyoming. Across hospitals, half were paid between $16,643 and $21,004 per case, and the median hospital $18,371; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.

Hospitals charged $128,705 on average for these stays, 6.5 times what Medicare paid: charges are list prices, while Medicare pays a fixed amount per MS‑DRG.

See MS‑DRG 468 on the interactive mapPrice an MS‑DRG 468 claim at any hospitalEvery MS‑DRG

What changed in FY2027

The rates for discharges from October 1, 2026 (MS‑DRG version 44) against FY2026.

FY2027 inpatient rates: what else changed on October 1

Paid per case, by state

MS‑DRG 468 by state, 2024
StatePaid per caseDischargesHospitalsCharges ÷ paid
Maryland*$32,239217101.2×
Wyoming$30,7342623.0×
California$26,947520256.6×
New York$24,361529165.3×
Maine$23,5573024.8×
Massachusetts$22,48017192.5×
Kentucky$22,374140511.1×
Connecticut$22,2474332.7×
New Jersey$22,200192105.7×
New Hampshire$22,1335745.8×
Alaska$21,29050111.1×
District of Columbia$20,8707624.2×
Washington$20,62616495.6×
Colorado$20,528194118.6×
Minnesota$20,40610353.1×
Delaware$20,1948633.6×
Nevada$20,1289848.6×
Oregon$19,9567354.6×
Pennsylvania$19,933401195.8×
Illinois$19,810270145.7×
Texas$19,4206033111.6×
North Dakota$19,4083413.2×
Rhode Island$19,3724822.8×
Utah$19,26213865.7×
Wisconsin$19,0494834.7×
North Carolina$18,489427186.1×
Georgia$18,47916086.9×
Virginia$18,452399167.8×
Montana$18,27710054.6×
Arizona$18,213331177.4×
Idaho$18,0425334.9×
Florida$17,741743338.7×
Indiana$17,737210116.4×
Michigan$17,45514485.2×
Missouri$17,396192105.2×
South Dakota$17,2269234.5×
South Carolina$17,202239147.5×
Nebraska$16,99910744.7×
Arkansas$16,83117644.2×
Tennessee$16,768283126.9×
New Mexico$16,7224438.5×
Iowa$16,6919945.9×
Ohio$16,495294126.1×
Louisiana$16,19810467.9×
Oklahoma$15,719242105.3×
Kansas$15,70513975.7×
Alabama$15,460168710.9×
Mississippi$15,41858312.8×
United States$19,7229,1154206.5×

* 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 468.

10th percentile$15,444
25th percentile$16,643
Median hospital$18,371
75th percentile$21,004
90th percentile$25,156

The same condition at other severities

More in Musculoskeletal system and connective tissue

Nearby MS‑DRG numbers

Questions

What did Medicare pay for MS‑DRG 468 in 2024?

An average of $19,722 per discharge across 9,115 fee-for-service discharges at 420 hospitals, $179.8M in total.

Which state paid the most for MS‑DRG 468?

Wyoming, at $30,734 per case; Mississippi paid the least, $15,418.

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.