MS‑DRG 981: Extensive O.R. Procedures Unrelated to Principal Diagnosis with MCC

What Medicare paid hospitals for MS‑DRG 981 in 2024: nationally, state by state and across hospitals.

Paid per case$40,2772.7× the all-DRG average

Discharges14,9590.30% of all Medicare discharges

Total paid$602.5M28th largest MS‑DRG by spending

Hospitals680in 50 states and DC

Charges ÷ paid5.6×$226,646 average charge

Relative weight4.7412FY2027, 8.4-day geometric mean stay; FY2026 4.6918 (+1.1%)

In 2024 Medicare paid hospitals an average of $40,277 per discharge for MS‑DRG 981, across 14,959 fee-for-service discharges at 680 hospitals: 0.30% of all Medicare inpatient discharges and $602.5M in total, the 28th largest MS‑DRG by Medicare spending.

By state, the average ran from $21,528 in Vermont to $55,720 in California. Across hospitals, half were paid between $30,750 and $43,437 per case, and the median hospital $35,651; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.

Hospitals charged $226,646 on average for these stays, 5.6 times what Medicare paid: charges are list prices, while Medicare pays a fixed amount per MS‑DRG.

See MS‑DRG 981 on the interactive map Price an MS‑DRG 981 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 981, FY2026 and FY2027
	FY2026	FY2027	Change
Relative weight	4.6918	4.7412	+1.1%
Geometric mean stay (days)	8.4	8.4	0.0
Average stay (days)	11.8	11.9	+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)

$35,027.75

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 981
MS‑DRG	Severity	Payment ($)	Step ($)
981	with MCC	35,027.75	—
982	with CC	17,915.04	−17,112.71
983	without CC/MCC	11,918.98	−23,108.77

FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 981 at a hospital

Paid per case, by state

MS‑DRG 981 by state, 2024
State	Paid per case	Discharges	Hospitals	Charges ÷ paid
Maryland*	$64,023	341	19	1.2×
California	$55,720	1,312	65	7.0×
New York	$52,206	1,191	39	5.8×
Alaska	$51,780	37	2	5.5×
Massachusetts	$50,049	512	19	3.2×
District of Columbia	$48,912	83	3	6.2×
Wisconsin	$47,546	141	5	4.9×
Oregon	$43,923	164	6	2.7×
Wyoming	$43,906	11	1	3.2×
Hawaii	$42,894	38	1	5.3×
New Mexico	$42,876	41	3	2.4×
Minnesota	$42,506	314	12	3.9×
Rhode Island	$42,101	19	1	4.6×
Delaware	$42,086	80	3	4.0×
Connecticut	$42,054	159	6	4.3×
Washington	$41,871	259	15	5.1×
Pennsylvania	$41,613	647	30	6.9×
New Hampshire	$41,188	41	2	4.1×
Arizona	$40,566	279	16	5.8×
New Jersey	$40,143	680	29	7.5×
Illinois	$38,700	759	33	5.0×
Colorado	$38,399	82	6	7.2×
Maine	$37,910	50	2	4.3×
Nevada	$37,773	194	8	8.0×
Utah	$37,470	109	5	3.8×
Kansas	$37,179	99	4	6.6×
South Dakota	$36,741	105	3	4.6×
Michigan	$35,606	432	25	4.0×
North Carolina	$35,426	501	20	4.6×
Georgia	$35,240	303	16	6.4×
Nebraska	$35,115	114	5	5.1×
Missouri	$35,089	259	15	5.3×
Idaho	$34,945	66	4	4.7×
Montana	$34,460	34	2	2.6×
Texas	$34,416	962	47	6.9×
Ohio	$34,165	415	19	5.2×
Virginia	$34,116	442	21	5.0×
Florida	$34,039	1,137	47	7.6×
Louisiana	$33,686	122	7	6.5×
West Virginia	$33,429	127	6	5.4×
Indiana	$33,422	342	17	5.2×
South Carolina	$32,307	205	10	5.7×
North Dakota	$31,508	58	3	3.4×
Oklahoma	$31,456	248	8	5.8×
Iowa	$31,365	147	7	5.3×
Alabama	$31,115	252	11	6.1×
Kentucky	$30,572	256	13	5.8×
Tennessee	$30,219	360	17	5.0×
Arkansas	$27,877	202	11	5.1×
Mississippi	$27,339	206	10	5.6×
Vermont	$21,528	22	1	7.4×
United States	$40,277	14,959	680	5.6×

* 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 981.

10th percentile	$27,784
25th percentile	$30,750
Median hospital	$35,651
75th percentile	$43,437
90th percentile	$53,032

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

982Extensive O.R. Procedures Unrelated to Principal Diagnosis with CC · $20,080

Nearby MS‑DRG numbers

Questions

What did Medicare pay for MS‑DRG 981 in 2024?

An average of $40,277 per discharge across 14,959 fee-for-service discharges at 680 hospitals, $602.5M in total.

Which state paid the most for MS‑DRG 981?

California, at $55,720 per case; Vermont paid the least, $21,528.

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.