MS‑DRG 641: Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes without MCC
What Medicare paid hospitals for MS‑DRG 641 in 2024: nationally, state by state and across hospitals.
In 2024 Medicare paid hospitals an average of $5,830 per discharge for MS‑DRG 641, across 61,771 fee-for-service discharges at 1,940 hospitals: 1.25% of all Medicare inpatient discharges and $360.1M in total, the 54th largest MS‑DRG by Medicare spending.
By state, the average ran from $3,092 in Vermont to $8,923 in Alaska. Across hospitals, half were paid between $4,718 and $6,374 per case, and the median hospital $5,344; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.
Hospitals charged $37,589 on average for these stays, 6.5 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 | 0.7782 | 0.7865 | +1.1% |
| Geometric mean stay (days) | 2.6 | 2.5 | −0.1 |
| Average stay (days) | 3.3 | 3.2 | −0.1 |
- Not capped: the +1.1% 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)
$5,810.62
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 ($) |
|---|---|---|---|
| 640 | with MCC | 9,896.16 | +4,085.54 |
| 641 | without MCC | 5,810.62 | — |
FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 641 at a hospital
Paid per case, by state
| State | Paid per case | Discharges | Hospitals | Charges ÷ paid |
|---|---|---|---|---|
| Maryland* | $9,297 | 1,881 | 38 | 1.3× |
| Alaska | $8,923 | 92 | 4 | 7.0× |
| California | $7,710 | 6,005 | 188 | 7.9× |
| New York | $7,397 | 3,734 | 103 | 6.3× |
| Hawaii | $7,316 | 156 | 7 | 4.4× |
| Wyoming | $6,996 | 123 | 6 | 3.5× |
| District of Columbia | $6,707 | 147 | 5 | 7.2× |
| Connecticut | $6,694 | 548 | 20 | 4.9× |
| Oregon | $6,249 | 413 | 19 | 4.7× |
| New Mexico | $6,239 | 309 | 14 | 5.2× |
| Massachusetts | $6,072 | 2,127 | 48 | 3.1× |
| Nevada | $6,048 | 554 | 16 | 11.2× |
| New Jersey | $5,991 | 2,152 | 53 | 10.2× |
| Texas | $5,986 | 3,825 | 124 | 7.3× |
| Georgia | $5,978 | 1,861 | 64 | 5.8× |
| Rhode Island | $5,865 | 217 | 9 | 4.3× |
| Utah | $5,779 | 243 | 12 | 4.5× |
| Minnesota | $5,715 | 716 | 26 | 5.1× |
| Maine | $5,709 | 164 | 9 | 4.2× |
| Delaware | $5,677 | 310 | 6 | 5.2× |
| Washington | $5,596 | 793 | 33 | 6.6× |
| South Dakota | $5,486 | 212 | 7 | 5.3× |
| North Carolina | $5,470 | 2,336 | 61 | 4.9× |
| Arizona | $5,398 | 1,175 | 39 | 7.5× |
| Idaho | $5,357 | 248 | 9 | 5.5× |
| Illinois | $5,310 | 2,746 | 83 | 5.9× |
| New Hampshire | $5,306 | 282 | 12 | 5.3× |
| Colorado | $5,301 | 495 | 23 | 10.8× |
| Florida | $5,296 | 5,399 | 137 | 9.0× |
| Oklahoma | $5,282 | 987 | 35 | 5.8× |
| Michigan | $5,202 | 1,640 | 51 | 4.8× |
| Nebraska | $5,184 | 337 | 14 | 5.0× |
| Pennsylvania | $5,165 | 2,815 | 94 | 7.9× |
| South Carolina | $5,145 | 1,398 | 39 | 6.3× |
| Wisconsin | $5,096 | 697 | 27 | 5.5× |
| Indiana | $5,078 | 1,425 | 52 | 5.6× |
| Missouri | $5,073 | 1,346 | 45 | 6.1× |
| North Dakota | $5,071 | 148 | 5 | 4.4× |
| Ohio | $4,898 | 2,279 | 78 | 5.8× |
| Virginia | $4,882 | 1,690 | 55 | 6.1× |
| Tennessee | $4,848 | 1,363 | 49 | 6.5× |
| Montana | $4,840 | 189 | 8 | 4.8× |
| Alabama | $4,769 | 1,091 | 37 | 6.1× |
| Kansas | $4,751 | 554 | 19 | 8.6× |
| Mississippi | $4,709 | 817 | 28 | 5.4× |
| Iowa | $4,615 | 507 | 20 | 5.4× |
| Arkansas | $4,496 | 683 | 24 | 5.4× |
| West Virginia | $4,491 | 503 | 17 | 5.3× |
| Louisiana | $4,427 | 945 | 33 | 6.5× |
| Kentucky | $4,394 | 983 | 32 | 6.2× |
| Vermont | $3,092 | 111 | 3 | 9.8× |
| United States | $5,830 | 61,771 | 1,940 | 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 641.
| 10th percentile | $4,237 |
|---|---|
| 25th percentile | $4,718 |
| Median hospital | $5,344 |
| 75th percentile | $6,374 |
| 90th percentile | $7,617 |
Related analysis
The same condition at other severities
Questions
What did Medicare pay for MS‑DRG 641 in 2024?
An average of $5,830 per discharge across 61,771 fee-for-service discharges at 1,940 hospitals, $360.1M in total.
Which state paid the most for MS‑DRG 641?
Alaska, at $8,923 per case; Vermont paid the least, $3,092.
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.