MS‑DRG 493: Lower Extremity and Humerus Procedures except Hip, Foot and Femur with CC

What Medicare paid hospitals for MS‑DRG 493 in 2024: nationally, state by state and across hospitals.

Paid per case$18,7311.2× the all-DRG average

Discharges10,2230.21% of all Medicare discharges

Total paid$191.5M88th largest MS‑DRG by spending

Hospitals493in 49 states and DC

Charges ÷ paid6.7×$124,600 average charge

Relative weight2.5528FY2027, 4.2-day geometric mean stay; FY2026 2.5361 (+0.7%)

In 2024 Medicare paid hospitals an average of $18,731 per discharge for MS‑DRG 493, across 10,223 fee-for-service discharges at 493 hospitals: 0.21% of all Medicare inpatient discharges and $191.5M in total, the 88th largest MS‑DRG by Medicare spending.

By state, the average ran from $14,370 in Alabama to $25,398 in California. Across hospitals, half were paid between $15,495 and $20,359 per case, and the median hospital $17,178; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.

Hospitals charged $124,600 on average for these stays, 6.7 times what Medicare paid: charges are list prices, while Medicare pays a fixed amount per MS‑DRG.

See MS‑DRG 493 on the interactive map Price an MS‑DRG 493 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 493, FY2026 and FY2027
	FY2026	FY2027	Change
Relative weight	2.5361	2.5528	+0.7%
Geometric mean stay (days)	4.2	4.2	0.0
Average stay (days)	5.1	5.1	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)

$18,859.96

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 493
MS‑DRG	Severity	Payment ($)	Step ($)
492	with MCC	27,271.88	+8,411.92
493	with CC	18,859.96	—
494	without CC/MCC	14,965.77	−3,894.19

FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 493 at a hospital

Paid per case, by state

MS‑DRG 493 by state, 2024
State	Paid per case	Discharges	Hospitals	Charges ÷ paid
Maryland*	$33,488	195	11	1.2×
California	$25,398	770	40	7.9×
Alaska	$24,695	34	2	5.0×
Connecticut	$23,859	73	4	3.7×
New York	$23,820	458	19	6.5×
District of Columbia	$23,527	45	3	7.4×
Massachusetts	$23,478	302	10	3.2×
Rhode Island	$22,599	33	1	2.6×
New Hampshire	$21,644	31	2	7.9×
Wyoming	$21,046	12	1	4.8×
Oregon	$20,374	131	8	4.3×
Nevada	$19,969	61	3	9.0×
Hawaii	$19,656	13	1	6.7×
Washington	$19,618	133	6	5.7×
Georgia	$19,343	217	8	7.6×
New Mexico	$19,263	46	3	4.1×
Delaware	$18,991	55	1	4.5×
New Jersey	$18,352	272	14	8.4×
Pennsylvania	$18,313	541	26	7.1×
Arizona	$18,264	237	14	7.9×
Illinois	$17,968	447	25	5.6×
Minnesota	$17,790	302	14	4.0×
Utah	$17,524	100	5	3.7×
Wisconsin	$17,391	174	8	5.2×
Oklahoma	$17,320	121	5	8.2×
North Carolina	$17,275	284	12	5.7×
Texas	$17,210	836	38	8.8×
Montana	$17,127	27	2	3.9×
Nebraska	$17,019	122	5	5.1×
Ohio	$16,938	343	17	6.2×
South Dakota	$16,917	62	3	5.0×
North Dakota	$16,819	33	2	3.5×
South Carolina	$16,718	261	13	7.8×
Kansas	$16,709	119	5	6.9×
Missouri	$16,648	312	14	5.0×
Maine	$16,643	35	2	5.1×
Colorado	$16,640	108	7	8.9×
Florida	$16,545	1,008	45	10.6×
Idaho	$16,539	56	3	4.7×
Kentucky	$16,513	136	6	6.8×
Indiana	$16,396	216	10	6.3×
Tennessee	$16,280	295	14	6.3×
Louisiana	$16,198	94	6	6.6×
Iowa	$16,148	76	3	5.9×
Mississippi	$16,129	72	4	4.0×
Virginia	$16,104	391	18	6.6×
Michigan	$16,011	211	12	4.5×
West Virginia	$15,171	85	5	5.0×
Arkansas	$14,831	103	6	4.2×
Alabama	$14,370	135	7	8.3×
United States	$18,731	10,223	493	6.7×

* 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 493.

10th percentile	$14,164
25th percentile	$15,495
Median hospital	$17,178
75th percentile	$20,359
90th percentile	$24,286

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

The same condition at other severities

Nearby MS‑DRG numbers

Questions

What did Medicare pay for MS‑DRG 493 in 2024?

An average of $18,731 per discharge across 10,223 fee-for-service discharges at 493 hospitals, $191.5M in total.

Which state paid the most for MS‑DRG 493?

California, at $25,398 per case; Alabama paid the least, $14,370.

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.