MS‑DRG 542: Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with MCC
What Medicare paid hospitals for MS‑DRG 542 in 2024: nationally, state by state and across hospitals.
In 2024 Medicare paid hospitals an average of $15,129 per discharge for MS‑DRG 542, across 3,536 fee-for-service discharges at 184 hospitals: 0.07% of all Medicare inpatient discharges and $53.5M in total, the 189th largest MS‑DRG by Medicare spending.
By state, the average ran from $10,760 in Nebraska to $21,098 in California. Across hospitals, half were paid between $12,075 and $16,315 per case, and the median hospital $13,833; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.
Hospitals charged $89,227 on average for these stays, 5.9 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 | 1.7665 | 1.7211 | −2.6% |
| Geometric mean stay (days) | 5.0 | 4.9 | −0.1 |
| Average stay (days) | 6.8 | 6.6 | −0.2 |
- Not capped: the −2.6% 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)
$12,715.40
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 ($) |
|---|---|---|---|
| 542 | with MCC | 12,715.40 | — |
| 543 | with CC | 7,432.28 | −5,283.12 |
| 544 | without CC/MCC | 5,471.52 | −7,243.88 |
FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 542 at a hospital
Paid per case, by state
| State | Paid per case | Discharges | Hospitals | Charges ÷ paid |
|---|---|---|---|---|
| Maryland* | $52,737 | 17 | 1 | 1.3× |
| California | $21,098 | 237 | 13 | 9.2× |
| New York | $20,166 | 276 | 13 | 8.1× |
| Connecticut | $20,031 | 19 | 1 | 4.7× |
| District of Columbia | $18,912 | 12 | 1 | 5.9× |
| Alaska | $17,678 | 12 | 1 | 10.4× |
| Oregon | $16,844 | 63 | 3 | 3.2× |
| Utah | $16,182 | 22 | 1 | 3.2× |
| Pennsylvania | $16,091 | 168 | 10 | 8.9× |
| New Jersey | $15,894 | 120 | 7 | 7.5× |
| Massachusetts | $15,862 | 369 | 15 | 3.3× |
| New Hampshire | $15,790 | 30 | 2 | 3.7× |
| Minnesota | $15,424 | 126 | 6 | 3.8× |
| New Mexico | $15,308 | 46 | 3 | 3.3× |
| Iowa | $15,032 | 17 | 1 | 7.6× |
| Rhode Island | $14,864 | 43 | 1 | 3.2× |
| North Dakota | $14,669 | 13 | 1 | 4.8× |
| North Carolina | $14,661 | 55 | 4 | 4.2× |
| Delaware | $14,550 | 19 | 1 | 5.3× |
| Washington | $14,350 | 88 | 5 | 4.1× |
| Mississippi | $14,260 | 16 | 1 | 3.7× |
| Nevada | $14,116 | 24 | 2 | 9.3× |
| Wisconsin | $13,714 | 103 | 5 | 4.7× |
| Missouri | $13,545 | 97 | 5 | 4.5× |
| Georgia | $13,204 | 28 | 2 | 5.4× |
| Michigan | $13,160 | 84 | 5 | 5.3× |
| Texas | $13,102 | 68 | 5 | 9.2× |
| Colorado | $13,084 | 48 | 4 | 11.0× |
| Illinois | $13,011 | 298 | 13 | 5.0× |
| Arkansas | $12,695 | 11 | 1 | 2.1× |
| Ohio | $12,645 | 201 | 6 | 4.4× |
| Tennessee | $12,592 | 56 | 4 | 5.3× |
| Arizona | $12,575 | 148 | 8 | 7.0× |
| South Dakota | $12,552 | 14 | 1 | 5.4× |
| Virginia | $12,543 | 122 | 5 | 4.0× |
| South Carolina | $12,532 | 40 | 3 | 4.4× |
| Florida | $12,521 | 241 | 15 | 7.4× |
| Kentucky | $11,952 | 37 | 2 | 6.4× |
| Kansas | $11,933 | 27 | 2 | 7.1× |
| Oklahoma | $11,805 | 34 | 1 | 4.6× |
| Idaho | $11,702 | 24 | 1 | 4.3× |
| Indiana | $11,110 | 52 | 2 | 4.0× |
| Nebraska | $10,760 | 11 | 1 | 3.1× |
| United States | $15,129 | 3,536 | 184 | 5.9× |
* 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 542.
| 10th percentile | $10,899 |
|---|---|
| 25th percentile | $12,075 |
| Median hospital | $13,833 |
| 75th percentile | $16,315 |
| 90th percentile | $19,604 |
Related analysis
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Questions
What did Medicare pay for MS‑DRG 542 in 2024?
An average of $15,129 per discharge across 3,536 fee-for-service discharges at 184 hospitals, $53.5M in total.
Which state paid the most for MS‑DRG 542?
California, at $21,098 per case; Nebraska paid the least, $10,760.
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.