MS-DRG 543
PATHOLOGICAL FRACTURES AND
Relative Weight
1.0280
Geometric Mean LOS
3.5 Days
Arithmetic Mean LOS
4.4 Days
National Average Medicare Payments (FY 2024)
| Discharges | Avg Submitted Covered Charge | Avg Total Payment | Avg Medicare Payment |
|---|---|---|---|
| 8,898 | $48,885.54 | $10,328.60 | $8,053.22 |
State Average Medicare Payments (FY 2024)
| State | Discharges | Avg Total Payment | Avg Medicare Payment |
|---|---|---|---|
| AK | 22 | $11,017.91 | $8,813.41 |
| AL | 30 | $8,466.79 | $6,870.44 |
| AR | 38 | $8,253.88 | $6,784.90 |
| AZ | 364 | $9,574.44 | $7,356.22 |
| CA | 706 | $13,064.25 | $10,724.77 |
| CO | 40 | $8,180.04 | $6,793.18 |
| CT | 67 | $12,799.28 | $9,280.36 |
| DE | 29 | $10,038.48 | $8,017.93 |
| FL | 705 | $8,940.72 | $7,138.09 |
| GA | 89 | $11,118.03 | $8,837.44 |
| IA | 53 | $8,660.97 | $6,502.55 |
| ID | 51 | $8,493.30 | $7,033.99 |
| IL | 660 | $10,275.63 | $7,650.15 |
| IN | 137 | $8,148.37 | $6,724.65 |
| KS | 87 | $9,135.62 | $6,968.22 |
| KY | 86 | $8,934.50 | $6,498.68 |
| LA | 27 | $8,422.90 | $6,301.44 |
| MA | 751 | $11,016.14 | $8,919.06 |
| MD | 120 | $13,580.12 | $12,209.13 |
| ME | 75 | $9,191.22 | $7,215.90 |
| MI | 159 | $10,241.86 | $7,423.88 |
| MN | 335 | $9,659.78 | $7,491.22 |
| MO | 222 | $9,293.59 | $6,963.41 |
| MS | 33 | $10,469.41 | $7,769.66 |
| MT | 12 | $8,084.00 | $6,776.67 |
| NC | 282 | $10,840.91 | $7,759.10 |
| ND | 35 | $9,031.44 | $7,328.20 |
| NE | 39 | $10,606.52 | $7,779.55 |
| NH | 39 | $9,781.71 | $7,982.84 |
| NJ | 377 | $10,321.20 | $8,141.59 |
| NM | 37 | $9,726.61 | $7,728.42 |
| NV | 27 | $12,879.21 | $9,749.93 |
| NY | 522 | $12,552.34 | $9,827.73 |
| OH | 560 | $9,069.36 | $6,915.05 |
| OK | 91 | $8,369.50 | $6,956.35 |
| OR | 91 | $10,522.91 | $8,945.45 |
| PA | 572 | $10,004.55 | $7,494.63 |
| RI | 87 | $11,105.32 | $8,830.89 |
| SC | 107 | $9,650.40 | $7,397.15 |
| SD | 59 | $9,555.03 | $7,707.07 |
| TN | 91 | $9,772.80 | $7,073.32 |
| TX | 170 | $9,379.17 | $7,428.90 |
| UT | 65 | $11,151.79 | $8,445.85 |
| VA | 290 | $9,385.53 | $7,023.39 |
| VT | 25 | $7,930.37 | $3,662.74 |
| WA | 222 | $10,115.81 | $7,918.16 |
| WI | 183 | $10,582.10 | $7,476.05 |
| WV | 15 | $10,663.80 | $7,617.73 |
| WY | 14 | $10,051.79 | $8,594.21 |
Historical DRG Logic
| Effective Date | Weight | GMLOS | Post Acute Care |
|---|---|---|---|
| 2025-10-01 | 1.0280 | 3.5 | Yes |
| 2024-10-01 | 1.0609 | 3.5 | Yes |
| 2023-10-01 | 1.0907 | 3.5 | Yes |
| 2022-10-01 | 1.0890 | 3.4 | Yes |
| 2021-10-01 | 1.0452 | 3.5 | Yes |
| 2020-10-01 | 1.0433 | 3.5 | Yes |
| 2019-10-01 | 1.0563 | 3.6 | Yes |
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