MS-DRG 216
CARDIAC VALVE AND OTHER MA
Relative Weight
9.7828
Geometric Mean LOS
10.6 Days
Arithmetic Mean LOS
13.6 Days
National Average Medicare Payments (FY 2024)
| Discharges | Avg Submitted Covered Charge | Avg Total Payment | Avg Medicare Payment |
|---|---|---|---|
| 2,577 | $508,349.94 | $102,713.44 | $86,949.98 |
State Average Medicare Payments (FY 2024)
| State | Discharges | Avg Total Payment | Avg Medicare Payment |
|---|---|---|---|
| AL | 35 | $81,597.16 | $67,247.68 |
| AR | 37 | $65,992.86 | $61,567.13 |
| AZ | 79 | $99,067.74 | $86,057.18 |
| CA | 159 | $154,475.77 | $128,989.52 |
| CT | 28 | $114,708.56 | $91,591.54 |
| DC | 50 | $117,706.94 | $93,259.56 |
| FL | 113 | $85,487.26 | $76,601.94 |
| GA | 43 | $87,630.81 | $72,801.50 |
| IA | 11 | $69,398.45 | $51,973.27 |
| IL | 54 | $110,598.75 | $89,198.26 |
| IN | 25 | $71,969.56 | $70,990.36 |
| KS | 23 | $80,342.51 | $77,153.13 |
| KY | 35 | $75,643.01 | $68,149.35 |
| MA | 109 | $116,945.35 | $104,121.68 |
| MD | 60 | $154,543.04 | $142,590.18 |
| ME | 26 | $92,698.37 | $70,874.17 |
| MI | 66 | $113,924.29 | $93,124.14 |
| MN | 104 | $100,575.61 | $88,882.96 |
| MO | 47 | $104,971.67 | $72,485.30 |
| NC | 77 | $88,885.50 | $71,434.15 |
| NE | 14 | $91,869.50 | $80,945.93 |
| NH | 17 | $127,155.24 | $83,000.35 |
| NJ | 109 | $106,994.24 | $86,316.23 |
| NM | 38 | $76,969.62 | $62,270.96 |
| NV | 26 | $95,241.16 | $85,099.47 |
| NY | 360 | $114,123.03 | $97,689.97 |
| OH | 222 | $93,959.77 | $73,315.57 |
| OK | 15 | $63,737.00 | $56,458.67 |
| OR | 30 | $105,548.33 | $102,967.19 |
| PA | 88 | $108,085.70 | $96,079.01 |
| SC | 27 | $93,683.09 | $79,670.01 |
| TN | 80 | $83,432.13 | $69,528.16 |
| TX | 171 | $90,895.14 | $77,582.03 |
| VA | 76 | $102,633.10 | $77,890.08 |
| VT | 14 | $79,631.86 | $74,665.29 |
| WA | 34 | $88,763.92 | $86,906.74 |
| WI | 41 | $117,013.88 | $86,548.52 |
| WV | 14 | $88,552.29 | $72,757.93 |
| WY | 20 | $89,122.30 | $87,667.10 |
Historical DRG Logic
| Effective Date | Weight | GMLOS | Post Acute Care |
|---|---|---|---|
| 2025-10-01 | 9.7828 | 10.6 | Yes |
| 2024-10-01 | 9.6511 | 10.7 | Yes |
| 2023-10-01 | 9.7053 | 11.2 | Yes |
| 2022-10-01 | 9.7419 | 11.3 | Yes |
| 2021-10-01 | 10.0393 | 11.6 | Yes |
| 2020-10-01 | 10.4301 | 14.2 | Yes |
| 2019-10-01 | 10.0424 | 13.7 | Yes |
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