MS‑DRG 551: Medical Back Problems with MCC

What Medicare paid hospitals for MS‑DRG 551 in 2024: nationally, state by state and across hospitals.

Paid per case$13,3100.9× the all-DRG average

Discharges8,9320.18% of all Medicare discharges

Total paid$118.9M118th largest MS‑DRG by spending

Hospitals465in 48 states and DC

Charges ÷ paid6.5×$86,481 average charge

Relative weight1.6358FY2027, 4.4-day geometric mean stay; FY2026 1.6761 (−2.4%)

In 2024 Medicare paid hospitals an average of $13,310 per discharge for MS‑DRG 551, across 8,932 fee-for-service discharges at 465 hospitals: 0.18% of all Medicare inpatient discharges and $118.9M in total, the 118th largest MS‑DRG by Medicare spending.

By state, the average ran from $4,808 in Vermont to $18,080 in Oregon. Across hospitals, half were paid between $10,851 and $14,467 per case, and the median hospital $12,238; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.

Hospitals charged $86,481 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 551 on the interactive map Price an MS‑DRG 551 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 551, FY2026 and FY2027
	FY2026	FY2027	Change
Relative weight	1.6761	1.6358	−2.4%
Geometric mean stay (days)	4.5	4.4	−0.1
Average stay (days)	5.9	5.7	−0.2

Not capped: the −2.4% 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)

$12,085.21

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 551
MS‑DRG	Severity	Payment ($)	Step ($)
551	with MCC	12,085.21	—
552	without MCC	7,080.61	−5,004.60

FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 551 at a hospital

Paid per case, by state

MS‑DRG 551 by state, 2024
State	Paid per case	Discharges	Hospitals	Charges ÷ paid
Maryland*	$23,701	150	9	1.2×
Oregon	$18,080	24	2	3.6×
California	$17,491	867	50	8.3×
New York	$16,673	776	30	7.0×
Georgia	$15,539	176	9	6.9×
District of Columbia	$15,510	17	1	6.2×
Connecticut	$15,348	104	6	4.2×
Rhode Island	$15,342	14	1	2.9×
Massachusetts	$14,854	438	19	3.0×
Washington	$14,576	139	9	5.6×
New Jersey	$14,094	313	17	7.8×
Hawaii	$13,580	26	1	5.0×
New Hampshire	$13,361	69	5	4.6×
Nevada	$13,053	146	8	11.1×
North Dakota	$12,980	40	2	4.4×
Delaware	$12,976	47	1	4.0×
Arizona	$12,414	130	8	6.5×
Montana	$12,335	13	1	3.0×
Minnesota	$12,250	210	12	4.2×
Pennsylvania	$12,173	454	23	7.0×
North Carolina	$12,051	232	13	4.8×
Michigan	$12,001	241	15	3.6×
West Virginia	$11,961	24	1	3.9×
Indiana	$11,947	182	9	5.3×
Wisconsin	$11,918	93	5	5.5×
Virginia	$11,764	260	14	6.1×
Alabama	$11,742	86	5	6.7×
Texas	$11,736	615	34	8.2×
Illinois	$11,734	408	21	5.4×
South Dakota	$11,607	12	1	4.0×
Oklahoma	$11,506	111	5	5.2×
Ohio	$11,494	298	16	4.7×
Tennessee	$11,466	272	13	6.6×
Missouri	$11,443	227	12	6.4×
Kansas	$11,400	144	6	8.6×
Nebraska	$11,392	65	3	4.5×
Utah	$11,381	35	2	4.1×
Idaho	$11,372	20	1	5.6×
South Carolina	$11,307	124	7	8.8×
Florida	$11,218	929	45	8.7×
Maine	$11,207	23	1	5.1×
Kentucky	$10,816	84	5	6.0×
Louisiana	$10,802	25	2	6.0×
Iowa	$10,734	100	5	5.6×
Colorado	$10,400	58	3	14.2×
Mississippi	$10,234	51	3	3.7×
Arkansas	$9,680	35	2	6.2×
New Mexico	$8,319	13	1	4.5×
Vermont	$4,808	12	1	8.2×
United States	$13,310	8,932	465	6.5×

* 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 551.

10th percentile	$9,912
25th percentile	$10,851
Median hospital	$12,238
75th percentile	$14,467
90th percentile	$16,999

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

552Medical Back Problems without MCC · $7,114

Nearby MS‑DRG numbers

Questions

What did Medicare pay for MS‑DRG 551 in 2024?

An average of $13,310 per discharge across 8,932 fee-for-service discharges at 465 hospitals, $118.9M in total.

Which state paid the most for MS‑DRG 551?

Oregon, at $18,080 per case; Vermont paid the least, $4,808.

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.