MS‑DRG 478: Biopsies of Musculoskeletal System and Connective Tissue with CC

What Medicare paid hospitals for MS‑DRG 478 in 2024: nationally, state by state and across hospitals.

Paid per case$18,9281.2× the all-DRG average

Discharges1,4800.03% of all Medicare discharges

Total paid$28.0M237th largest MS‑DRG by spending

Hospitals93in 28 states and DC

Charges ÷ paid7.2×$137,262 average charge

Relative weight2.4337FY2027, 5.3-day geometric mean stay; FY2026 2.4592 (−1.0%)

In 2024 Medicare paid hospitals an average of $18,928 per discharge for MS‑DRG 478, across 1,480 fee-for-service discharges at 93 hospitals: 0.03% of all Medicare inpatient discharges and $28.0M in total, the 237th largest MS‑DRG by Medicare spending.

By state, the average ran from $14,413 in Kentucky to $25,496 in Connecticut. Across hospitals, half were paid between $15,910 and $21,016 per case, and the median hospital $17,486; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.

Hospitals charged $137,262 on average for these stays, 7.2 times what Medicare paid: charges are list prices, while Medicare pays a fixed amount per MS‑DRG.

See MS‑DRG 478 on the interactive map Price an MS‑DRG 478 claim at any hospital Every MS‑DRG

What changed in FY2027

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

MS‑DRG 478, FY2026 and FY2027
	FY2026	FY2027	Change
Relative weight	2.4592	2.4337	−1.0%
Geometric mean stay (days)	5.4	5.3	−0.1
Average stay (days)	6.7	6.5	−0.2

Not capped: the −1.0% 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)

$17,980.05

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.

FY2027 national base payment across the severity levels of MS‑DRG 478
MS‑DRG	Severity	Payment ($)	Step ($)
477	with MCC	25,148.58	+7,168.53
478	with CC	17,980.05	—
479	without CC/MCC	13,698.74	−4,281.31

FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 478 at a hospital

Paid per case, by state

MS‑DRG 478 by state, 2024
State	Paid per case	Discharges	Hospitals	Charges ÷ paid
Connecticut	$25,496	15	1	4.5×
New York	$25,378	89	5	7.0×
California	$24,483	204	12	9.1×
Minnesota	$24,001	16	1	2.9×
Massachusetts	$21,674	51	4	3.5×
Mississippi	$20,590	11	1	4.1×
New Jersey	$19,892	75	5	7.3×
South Carolina	$19,111	17	1	4.6×
Colorado	$19,039	26	2	8.9×
Kansas	$19,032	15	1	7.5×
Missouri	$18,931	52	3	4.5×
Washington	$18,767	11	1	5.8×
District of Columbia	$18,563	11	1	6.3×
Delaware	$18,305	21	1	4.9×
Tennessee	$18,178	24	2	5.8×
Michigan	$18,020	42	3	5.0×
Illinois	$17,626	64	4	7.3×
North Carolina	$17,524	13	1	2.7×
Virginia	$17,522	59	3	4.7×
Pennsylvania	$17,355	42	3	6.1×
Alabama	$17,103	14	1	7.6×
Arizona	$17,074	14	1	6.0×
Georgia	$17,005	54	4	8.2×
Nebraska	$16,814	11	1	3.5×
Florida	$16,239	279	14	8.1×
Texas	$15,961	116	8	11.4×
Ohio	$15,381	52	3	5.1×
Louisiana	$15,224	35	3	5.4×
Kentucky	$14,413	47	3	8.8×
United States	$18,928	1,480	93	7.2×

How much hospitals vary

Each hospital’s own average Medicare payment for MS‑DRG 478.

10th percentile	$14,872
25th percentile	$15,910
Median hospital	$17,486
75th percentile	$21,016
90th percentile	$25,201

Related analysis

Transfers and the per-diem rule: when a short stay pays less than the full DRG · Inpatient DRG
DRG validation and the single-MCC claim: when one code moves the payment · Payment integrity

Nearby MS‑DRG numbers

Questions

What did Medicare pay for MS‑DRG 478 in 2024?

An average of $18,928 per discharge across 1,480 fee-for-service discharges at 93 hospitals, $28.0M in total.

Which state paid the most for MS‑DRG 478?

Connecticut, at $25,496 per case; Kentucky paid the least, $14,413.

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.