MS-DRG 865
VIRAL ILLNESS WITH MCC
Relative Weight
1.4983
Geometric Mean LOS
4.0 Days
Arithmetic Mean LOS
5.7 Days
National Average Medicare Payments (FY 2024)
| Discharges | Avg Submitted Covered Charge | Avg Total Payment | Avg Medicare Payment |
|---|---|---|---|
| 272 | $122,627.07 | $22,285.47 | $17,368.58 |
State Average Medicare Payments (FY 2024)
| State | Discharges | Avg Total Payment | Avg Medicare Payment |
|---|---|---|---|
| CA | 12 | $55,076.17 | $45,094.58 |
| CT | 23 | $20,606.43 | $17,671.65 |
| DE | 14 | $15,102.14 | $12,397.14 |
| FL | 17 | $17,230.06 | $9,579.94 |
| IL | 11 | $16,750.09 | $13,896.64 |
| MA | 62 | $20,470.36 | $15,963.15 |
| NC | 12 | $22,288.58 | $15,782.33 |
| NJ | 17 | $13,950.35 | $12,796.00 |
| NY | 82 | $26,875.09 | $20,971.77 |
| TN | 11 | $12,103.45 | $9,292.73 |
| TX | 11 | $16,363.91 | $11,015.18 |
Historical DRG Logic
| Effective Date | Weight | GMLOS | Post Acute Care |
|---|---|---|---|
| 2025-10-01 | 1.4983 | 4.0 | No |
| 2024-10-01 | 1.4759 | 4.0 | No |
| 2023-10-01 | 1.6399 | 4.3 | No |
| 2022-10-01 | 1.6728 | 4.2 | No |
| 2021-10-01 | 1.4778 | 3.9 | No |
| 2020-10-01 | 1.4789 | 3.9 | No |
| 2019-10-01 | 1.3933 | 3.9 | No |
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