MS‑DRG 560: Aftercare, Musculoskeletal System and Connective Tissue with CC
What Medicare paid hospitals for MS‑DRG 560 in 2024: nationally, state by state and across hospitals.
In 2024 Medicare paid hospitals an average of $21,554 per discharge for MS‑DRG 560, across 1,076 fee-for-service discharges at 36 hospitals: 0.02% of all Medicare inpatient discharges and $23.2M in total, the 252nd largest MS‑DRG by Medicare spending.
By state, the average ran from $5,069 in Texas to $13,060 in California. Across hospitals, half were paid between $7,639 and $16,890 per case, and the median hospital $8,958; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.
Hospitals charged $45,278 on average for these stays, 2.1 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 | 1.1261 | 1.1238 | −0.2% |
| Geometric mean stay (days) | 3.8 | 3.8 | 0.0 |
| Average stay (days) | 5.2 | 5.1 | −0.1 |
- Not capped: the −0.2% 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)
$8,302.58
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 ($) |
|---|---|---|---|
| 559 | with MCC | 13,363.32 | +5,060.74 |
| 560 | with CC | 8,302.58 | — |
| 561 | without CC/MCC | 6,100.97 | −2,201.61 |
FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 560 at a hospital
Paid per case, by state
| State | Paid per case | Discharges | Hospitals | Charges ÷ paid |
|---|---|---|---|---|
| Maryland* | $28,623 | 693 | 9 | 1.2× |
| California | $13,060 | 45 | 3 | 9.7× |
| New York | $11,548 | 60 | 4 | 8.1× |
| Massachusetts | $11,113 | 15 | 1 | 4.4× |
| Missouri | $9,093 | 13 | 1 | 4.2× |
| Pennsylvania | $8,487 | 13 | 1 | 8.7× |
| Illinois | $8,007 | 24 | 2 | 5.0× |
| Ohio | $7,922 | 12 | 1 | 3.7× |
| North Carolina | $7,897 | 11 | 1 | 5.1× |
| Delaware | $7,767 | 11 | 1 | 3.1× |
| New Jersey | $7,668 | 11 | 1 | 11.5× |
| Florida | $7,288 | 113 | 7 | 7.0× |
| Michigan | $6,326 | 11 | 1 | 4.1× |
| Tennessee | $5,894 | 25 | 2 | 5.6× |
| Texas | $5,069 | 19 | 1 | 22.2× |
| United States | $21,554 | 1,076 | 36 | 2.1× |
* 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 560.
| 10th percentile | $6,248 |
|---|---|
| 25th percentile | $7,639 |
| Median hospital | $8,958 |
| 75th percentile | $16,890 |
| 90th percentile | $30,945 |
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Questions
What did Medicare pay for MS‑DRG 560 in 2024?
An average of $21,554 per discharge across 1,076 fee-for-service discharges at 36 hospitals, $23.2M in total.
Which state paid the most for MS‑DRG 560?
California, at $13,060 per case; Texas paid the least, $5,069.
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.