MS-DRG 494
LOWER EXTREMITY AND HUMERU
Relative Weight
2.0065
Geometric Mean LOS
2.8 Days
Arithmetic Mean LOS
3.4 Days
National Average Medicare Payments (FY 2024)
| Discharges | Avg Submitted Covered Charge | Avg Total Payment | Avg Medicare Payment |
|---|---|---|---|
| 1,650 | $99,978.21 | $18,028.20 | $14,305.64 |
State Average Medicare Payments (FY 2024)
| State | Discharges | Avg Total Payment | Avg Medicare Payment |
|---|---|---|---|
| AK | 11 | $21,240.91 | $17,765.55 |
| AL | 20 | $26,313.25 | $9,742.85 |
| AR | 15 | $13,315.53 | $11,758.60 |
| AZ | 103 | $15,763.93 | $13,481.15 |
| CA | 139 | $20,383.57 | $17,774.20 |
| DE | 26 | $18,711.58 | $12,726.96 |
| FL | 222 | $17,333.61 | $12,750.62 |
| GA | 16 | $33,648.13 | $13,873.06 |
| IA | 28 | $13,597.86 | $11,042.33 |
| ID | 16 | $15,384.94 | $13,640.38 |
| IL | 20 | $16,287.40 | $14,281.00 |
| IN | 47 | $16,816.83 | $13,304.16 |
| KS | 26 | $13,664.17 | $12,118.77 |
| KY | 12 | $13,591.17 | $12,143.83 |
| LA | 11 | $13,698.18 | $9,875.55 |
| MA | 85 | $19,296.82 | $16,852.63 |
| MD | 36 | $22,196.14 | $19,054.51 |
| MI | 11 | $19,615.91 | $9,474.18 |
| MN | 11 | $17,081.09 | $15,105.64 |
| MO | 32 | $16,718.23 | $13,561.23 |
| MS | 22 | $15,354.91 | $12,785.14 |
| NC | 72 | $17,764.18 | $14,180.96 |
| NE | 13 | $14,908.85 | $11,028.23 |
| NH | 13 | $15,186.92 | $13,830.54 |
| NJ | 36 | $17,889.67 | $13,217.39 |
| NV | 11 | $17,077.82 | $14,779.36 |
| NY | 167 | $23,123.79 | $17,443.10 |
| OH | 47 | $16,393.55 | $13,863.51 |
| OR | 11 | $20,117.00 | $17,658.91 |
| PA | 78 | $17,808.51 | $13,697.21 |
| SC | 63 | $15,720.86 | $13,199.93 |
| TN | 58 | $15,907.57 | $12,525.34 |
| TX | 86 | $15,345.68 | $12,662.03 |
| UT | 11 | $19,663.36 | $16,449.18 |
| VA | 26 | $14,607.87 | $11,181.12 |
| WA | 15 | $22,774.93 | $17,608.53 |
| WI | 23 | $20,437.96 | $14,723.00 |
| WV | 11 | $19,485.64 | $12,413.73 |
Historical DRG Logic
| Effective Date | Weight | GMLOS | Post Acute Care |
|---|---|---|---|
| 2025-10-01 | 2.0065 | 2.8 | Yes |
| 2024-10-01 | 1.8854 | 2.7 | Yes |
| 2023-10-01 | 1.8692 | 2.8 | Yes |
| 2022-10-01 | 1.8888 | 2.7 | Yes |
| 2021-10-01 | 1.8517 | 2.7 | Yes |
| 2020-10-01 | 1.8519 | 2.7 | Yes |
| 2019-10-01 | 1.8114 | 2.7 | Yes |
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