MS-DRG 542
PATHOLOGICAL FRACTURES AND
Relative Weight
1.7665
Geometric Mean LOS
5.0 Days
Arithmetic Mean LOS
6.8 Days
National Average Medicare Payments (FY 2024)
| Discharges | Avg Submitted Covered Charge | Avg Total Payment | Avg Medicare Payment |
|---|---|---|---|
| 3,536 | $90,261.84 | $18,572.32 | $15,092.21 |
State Average Medicare Payments (FY 2024)
| State | Discharges | Avg Total Payment | Avg Medicare Payment |
|---|---|---|---|
| AK | 12 | $21,020.75 | $17,677.58 |
| AR | 11 | $14,092.91 | $12,694.64 |
| AZ | 148 | $14,859.24 | $12,468.97 |
| CA | 237 | $27,510.95 | $20,969.65 |
| CO | 48 | $14,878.79 | $13,200.52 |
| CT | 19 | $24,183.37 | $20,031.32 |
| DC | 12 | $23,303.33 | $18,911.67 |
| DE | 19 | $17,149.74 | $14,549.95 |
| FL | 241 | $15,092.12 | $12,466.23 |
| GA | 28 | $14,911.83 | $13,203.68 |
| IA | 17 | $19,869.35 | $15,031.82 |
| ID | 24 | $13,090.33 | $11,702.33 |
| IL | 298 | $16,612.89 | $13,209.71 |
| IN | 52 | $12,920.89 | $11,334.08 |
| KS | 27 | $15,843.61 | $11,737.36 |
| KY | 37 | $14,676.74 | $11,139.43 |
| MA | 369 | $19,169.55 | $15,957.03 |
| MD | 17 | $58,919.06 | $52,736.53 |
| MI | 84 | $17,401.21 | $13,092.66 |
| MN | 126 | $18,967.12 | $14,523.69 |
| MO | 97 | $16,505.66 | $13,468.22 |
| MS | 16 | $17,158.13 | $14,260.44 |
| NC | 55 | $20,812.65 | $14,631.76 |
| ND | 13 | $16,991.23 | $14,669.00 |
| NE | 11 | $12,630.45 | $10,760.09 |
| NH | 30 | $17,382.02 | $15,282.52 |
| NJ | 120 | $17,515.48 | $15,622.50 |
| NM | 46 | $18,052.68 | $15,292.37 |
| NV | 24 | $16,438.87 | $14,082.87 |
| NY | 276 | $24,015.56 | $19,897.51 |
| OH | 201 | $14,382.11 | $12,295.30 |
| OK | 34 | $13,236.24 | $11,805.03 |
| OR | 63 | $20,069.71 | $16,901.63 |
| PA | 168 | $21,530.07 | $17,139.87 |
| RI | 43 | $19,241.26 | $14,863.79 |
| SC | 40 | $15,269.02 | $12,506.53 |
| SD | 14 | $14,798.71 | $12,551.93 |
| TN | 56 | $17,435.56 | $12,265.03 |
| TX | 68 | $17,605.50 | $13,668.70 |
| UT | 22 | $20,110.18 | $16,182.27 |
| VA | 122 | $15,173.20 | $12,396.32 |
| WA | 88 | $16,712.15 | $14,215.09 |
| WI | 103 | $16,175.71 | $13,102.41 |
Historical DRG Logic
| Effective Date | Weight | GMLOS | Post Acute Care |
|---|---|---|---|
| 2025-10-01 | 1.7665 | 5.0 | Yes |
| 2024-10-01 | 1.8651 | 5.2 | Yes |
| 2023-10-01 | 1.8237 | 5.2 | Yes |
| 2022-10-01 | 1.8280 | 5.1 | Yes |
| 2021-10-01 | 1.8092 | 5.0 | Yes |
| 2020-10-01 | 1.8053 | 5.0 | Yes |
| 2019-10-01 | 1.8248 | 5.1 | Yes |
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