MS‑DRG 811: Red Blood Cell Disorders with MCC
What Medicare paid hospitals for MS‑DRG 811 in 2024: nationally, state by state and across hospitals.
In 2024 Medicare paid hospitals an average of $11,546 per discharge for MS‑DRG 811, across 21,895 fee-for-service discharges at 989 hospitals: 0.44% of all Medicare inpatient discharges and $252.8M in total, the 67th largest MS‑DRG by Medicare spending.
By state, the average ran from $8,621 in Kentucky to $15,029 in California. Across hospitals, half were paid between $9,315 and $12,377 per case, and the median hospital $10,334; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.
Hospitals charged $71,055 on average for these stays, 6.2 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 | 1.4043 | 1.3988 | −0.4% |
| Geometric mean stay (days) | 3.7 | 3.6 | −0.1 |
| Average stay (days) | 4.9 | 4.8 | −0.1 |
- Not capped: the −0.4% 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)
$10,334.26
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 ($) |
|---|---|---|---|
| 811 | with MCC | 10,334.26 | — |
| 812 | without MCC | 6,822.03 | −3,512.23 |
FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 811 at a hospital
Paid per case, by state
| State | Paid per case | Discharges | Hospitals | Charges ÷ paid |
|---|---|---|---|---|
| Maryland* | $18,085 | 620 | 32 | 1.2× |
| California | $15,029 | 1,413 | 76 | 7.5× |
| New York | $14,932 | 1,815 | 62 | 6.7× |
| Connecticut | $14,011 | 287 | 14 | 3.8× |
| Maine | $13,357 | 47 | 2 | 3.3× |
| District of Columbia | $13,089 | 109 | 4 | 5.3× |
| Delaware | $13,071 | 171 | 4 | 4.3× |
| Colorado | $12,542 | 49 | 3 | 10.3× |
| Massachusetts | $12,397 | 902 | 31 | 3.1× |
| Rhode Island | $12,336 | 46 | 3 | 3.6× |
| Montana | $12,272 | 29 | 2 | 3.9× |
| Minnesota | $12,179 | 266 | 12 | 4.5× |
| Oregon | $12,171 | 140 | 8 | 3.5× |
| Georgia | $12,152 | 735 | 38 | 5.7× |
| New Jersey | $12,060 | 968 | 40 | 8.7× |
| Tennessee | $11,909 | 540 | 20 | 6.2× |
| Nevada | $11,867 | 193 | 9 | 11.6× |
| Pennsylvania | $10,906 | 927 | 47 | 7.2× |
| South Dakota | $10,797 | 64 | 3 | 5.8× |
| Alaska | $10,778 | 23 | 2 | 7.3× |
| Utah | $10,746 | 55 | 4 | 4.8× |
| Washington | $10,716 | 433 | 24 | 5.5× |
| Texas | $10,661 | 1,750 | 75 | 7.1× |
| New Hampshire | $10,611 | 162 | 9 | 4.6× |
| Illinois | $10,574 | 1,054 | 49 | 5.5× |
| North Carolina | $10,478 | 865 | 30 | 4.3× |
| Wisconsin | $10,297 | 165 | 10 | 4.5× |
| Michigan | $10,288 | 613 | 31 | 4.0× |
| Arizona | $10,229 | 153 | 10 | 6.2× |
| Florida | $10,222 | 2,391 | 96 | 8.9× |
| Virginia | $10,178 | 858 | 36 | 6.1× |
| Idaho | $10,169 | 29 | 2 | 5.3× |
| Indiana | $10,058 | 336 | 20 | 5.6× |
| North Dakota | $9,997 | 65 | 3 | 3.8× |
| South Carolina | $9,921 | 534 | 20 | 6.1× |
| Missouri | $9,851 | 286 | 16 | 6.3× |
| Ohio | $9,730 | 713 | 39 | 5.5× |
| Nebraska | $9,700 | 88 | 5 | 4.8× |
| Oklahoma | $9,467 | 288 | 12 | 5.9× |
| Iowa | $9,319 | 157 | 9 | 4.9× |
| Kansas | $9,314 | 157 | 7 | 9.7× |
| Arkansas | $9,198 | 211 | 12 | 4.5× |
| Mississippi | $9,049 | 216 | 11 | 5.2× |
| New Mexico | $9,008 | 24 | 1 | 3.9× |
| Louisiana | $8,969 | 247 | 12 | 5.6× |
| Alabama | $8,949 | 181 | 9 | 5.8× |
| West Virginia | $8,720 | 217 | 11 | 5.3× |
| Vermont | $8,661 | 53 | 3 | 6.3× |
| Kentucky | $8,621 | 250 | 11 | 6.0× |
| United States | $11,546 | 21,895 | 989 | 6.2× |
* 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 811.
| 10th percentile | $8,475 |
|---|---|
| 25th percentile | $9,315 |
| Median hospital | $10,334 |
| 75th percentile | $12,377 |
| 90th percentile | $15,007 |
Related analysis
- DRG validation and the single-MCC claim: when one code moves the payment · Payment integrity
The same condition at other severities
Questions
What did Medicare pay for MS‑DRG 811 in 2024?
An average of $11,546 per discharge across 21,895 fee-for-service discharges at 989 hospitals, $252.8M in total.
Which state paid the most for MS‑DRG 811?
California, at $15,029 per case; Kentucky paid the least, $8,621.
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.