MS‑DRG 809: Major Hematological and Immunological Diagnoses except Sickle Cell Crisis and Coagulation Disorders with CC
What Medicare paid hospitals for MS‑DRG 809 in 2024: nationally, state by state and across hospitals.
In 2024 Medicare paid hospitals an average of $11,264 per discharge for MS‑DRG 809, across 3,674 fee-for-service discharges at 203 hospitals: 0.07% of all Medicare inpatient discharges and $41.4M in total, the 206th largest MS‑DRG by Medicare spending.
By state, the average ran from $5,271 in Vermont to $15,704 in California. Across hospitals, half were paid between $8,506 and $11,890 per case, and the median hospital $9,579; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.
Hospitals charged $73,295 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 | 1.2659 | 1.2262 | −3.1% |
| Geometric mean stay (days) | 3.3 | 3.3 | 0.0 |
| Average stay (days) | 4.3 | 4.2 | −0.1 |
- Not capped: the −3.1% 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)
$9,059.10
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 ($) |
|---|---|---|---|
| 808 | with MCC | 16,035.55 | +6,976.45 |
| 809 | with CC | 9,059.10 | — |
| 810 | without CC/MCC | 7,942.05 | −1,117.05 |
FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 809 at a hospital
Paid per case, by state
| State | Paid per case | Discharges | Hospitals | Charges ÷ paid |
|---|---|---|---|---|
| Maryland* | $20,816 | 160 | 9 | 1.2× |
| California | $15,704 | 222 | 14 | 8.7× |
| Massachusetts | $13,944 | 195 | 10 | 4.0× |
| Arizona | $13,281 | 67 | 3 | 4.8× |
| Colorado | $12,956 | 23 | 2 | 11.1× |
| Oregon | $11,951 | 38 | 2 | 4.5× |
| New York | $11,942 | 221 | 13 | 8.9× |
| Connecticut | $11,907 | 44 | 2 | 3.8× |
| Pennsylvania | $11,883 | 191 | 11 | 9.8× |
| North Carolina | $11,800 | 170 | 8 | 4.5× |
| Georgia | $11,498 | 87 | 5 | 6.8× |
| Virginia | $11,443 | 96 | 6 | 5.9× |
| Missouri | $11,085 | 62 | 3 | 7.2× |
| Illinois | $11,082 | 110 | 7 | 5.4× |
| Minnesota | $10,972 | 94 | 5 | 4.9× |
| Ohio | $10,705 | 107 | 6 | 6.5× |
| Kansas | $10,572 | 61 | 1 | 7.9× |
| Wisconsin | $10,192 | 44 | 2 | 4.7× |
| Michigan | $10,126 | 82 | 5 | 4.2× |
| Tennessee | $10,120 | 105 | 5 | 8.4× |
| Indiana | $10,059 | 70 | 4 | 6.7× |
| New Jersey | $9,989 | 266 | 13 | 9.1× |
| Mississippi | $9,698 | 58 | 3 | 3.9× |
| Iowa | $9,673 | 16 | 1 | 4.8× |
| Nevada | $9,669 | 24 | 2 | 12.1× |
| Texas | $9,156 | 220 | 11 | 9.2× |
| South Carolina | $9,120 | 63 | 4 | 5.8× |
| Washington | $9,074 | 38 | 1 | 4.7× |
| Oklahoma | $9,044 | 57 | 4 | 7.2× |
| North Dakota | $9,033 | 31 | 2 | 4.7× |
| Delaware | $8,938 | 36 | 2 | 4.3× |
| Idaho | $8,907 | 12 | 1 | 5.7× |
| Florida | $8,894 | 293 | 15 | 8.2× |
| Rhode Island | $8,763 | 12 | 1 | 5.6× |
| Alabama | $8,702 | 17 | 1 | 4.3× |
| South Dakota | $8,693 | 20 | 1 | 5.6× |
| District of Columbia | $8,685 | 14 | 1 | 4.3× |
| West Virginia | $8,533 | 11 | 1 | 4.6× |
| Nebraska | $8,485 | 32 | 2 | 5.2× |
| New Hampshire | $8,480 | 27 | 2 | 5.3× |
| Kentucky | $8,385 | 58 | 3 | 6.4× |
| Arkansas | $8,218 | 48 | 4 | 4.2× |
| Louisiana | $7,331 | 59 | 4 | 6.1× |
| Vermont | $5,271 | 13 | 1 | 9.7× |
| United States | $11,264 | 3,674 | 203 | 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 809.
| 10th percentile | $7,490 |
|---|---|
| 25th percentile | $8,506 |
| Median hospital | $9,579 |
| 75th percentile | $11,890 |
| 90th percentile | $14,680 |
Related analysis
- DRG validation and the single-MCC claim: when one code moves the payment · Payment integrity
The same condition at other severities
More in Blood and immunological disorders
Nearby MS‑DRG numbers
Questions
What did Medicare pay for MS‑DRG 809 in 2024?
An average of $11,264 per discharge across 3,674 fee-for-service discharges at 203 hospitals, $41.4M in total.
Which state paid the most for MS‑DRG 809?
California, at $15,704 per case; Vermont paid the least, $5,271.
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.