MS-DRG 469
MAJOR HIP AND KNEE JOINT R
Relative Weight
3.0332
Geometric Mean LOS
3.3 Days
Arithmetic Mean LOS
4.4 Days
National Average Medicare Payments (FY 2024)
| Discharges | Avg Submitted Covered Charge | Avg Total Payment | Avg Medicare Payment |
|---|---|---|---|
| 1,160 | $174,935.92 | $31,835.25 | $27,163.31 |
State Average Medicare Payments (FY 2024)
| State | Discharges | Avg Total Payment | Avg Medicare Payment |
|---|---|---|---|
| AK | 11 | $29,086.55 | $27,454.55 |
| CA | 155 | $39,444.52 | $34,991.85 |
| CO | 37 | $46,972.94 | $42,980.35 |
| FL | 76 | $28,289.43 | $19,421.05 |
| IA | 15 | $22,749.67 | $21,254.53 |
| IL | 91 | $30,471.74 | $24,579.31 |
| IN | 14 | $23,584.57 | $22,127.43 |
| KS | 24 | $26,861.04 | $22,978.57 |
| MA | 107 | $34,024.95 | $29,414.99 |
| MI | 31 | $29,463.31 | $21,734.79 |
| MN | 29 | $36,977.99 | $31,693.19 |
| MO | 14 | $19,709.14 | $18,377.57 |
| NC | 58 | $29,871.56 | $25,746.82 |
| NJ | 34 | $29,764.50 | $24,737.54 |
| NV | 17 | $28,513.00 | $23,256.76 |
| NY | 179 | $37,955.74 | $32,701.79 |
| OH | 12 | $32,231.25 | $28,409.00 |
| OK | 11 | $22,949.73 | $17,944.00 |
| PA | 41 | $36,334.65 | $29,214.77 |
| SD | 23 | $24,179.57 | $22,300.30 |
| TN | 11 | $21,292.82 | $16,753.09 |
| TX | 83 | $22,625.14 | $20,553.98 |
| UT | 14 | $32,439.14 | $28,170.07 |
| VA | 25 | $26,984.00 | $20,974.53 |
| WA | 23 | $31,921.54 | $28,775.79 |
| WI | 14 | $32,500.57 | $27,917.50 |
| WV | 11 | $23,984.91 | $22,340.09 |
Historical DRG Logic
| Effective Date | Weight | GMLOS | Post Acute Care |
|---|---|---|---|
| 2025-10-01 | 3.0332 | 3.3 | Yes |
| 2024-10-01 | 3.2687 | 3.5 | Yes |
| 2023-10-01 | 3.3298 | 3.5 | Yes |
| 2022-10-01 | 3.2314 | 3.1 | Yes |
| 2021-10-01 | 3.0859 | 3.1 | Yes |
| 2020-10-01 | 3.0844 | 3.1 | Yes |
| 2019-10-01 | 3.1399 | 4.7 | Yes |
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