Medicare inpatient bundled payment

MS-DRG 028: $41,157

Spinal Procedures with MCC. The federally-set bundled payment under the Inpatient Prospective Payment System — covers the entire inpatient hospital stay (pre-op, OR time, recovery, in-stay drugs and supplies).

Data updated 1 day ago·Source: CMS MS-DRG (Inpatient Bundled Payment Classifications)

Medicare national-average estimate

$41,157

CMS MS-DRG 028 bundled-payment estimate. Relative weight 6.0083 × FY2026 operating base rate ($6,850 national average).

Mean length of stay

12.2 days

Geometric mean LOS

9.5 days

What MS-DRG 028 actually covers

SPINAL PROCEDURES WITH MCC

Under the Inpatient Prospective Payment System (42 CFR Part 412), CMS pays hospitals a single bundled rate for each inpatient stay based on the DRG assigned. The bundle includes:

  • Pre-operative work after admission
  • Operating-room time and surgical procedure
  • Drugs, supplies, and devices used during the stay
  • Routine post-operative recovery
  • Discharge planning

Separate professional fees from non-employed physicians (e.g. a surgeon billing through their private practice rather than as a hospital employee) may still be billed under CPT codes alongside the DRG bundled charge.

Hospital published prices

Aggregated across 1 hospital that publish MS-DRG 028 in their federally-required HPT files.

Gross charge distribution

Min

$229,736

25th percentile

$229,736

Median

$229,736

75th percentile

$229,736

Max

$229,736

Median cash / self-pay

$103,381

Median commercial negotiated

$167,822

Source: each hospital’s own Hospital Price Transparency file, published under 45 CFR §180.50. Aggregated via the DoltHub HPT v3 community dataset.

Highest published gross

Lowest published gross

Related DRGs

Frequently asked

What does MS-DRG 028 cover?+

MS-DRG 028 is the Medicare inpatient bundled-payment classification for spinal procedures with mcc. Under the CMS Inpatient Prospective Payment System, a single payment covers the entire inpatient hospital stay including pre-op, OR time, drugs and supplies during the admission, and routine post-op recovery. Separate professional fees from non-employed physicians (e.g. surgeons billing through their private practice) may still be billed under CPT codes.

How much does Medicare pay for MS-DRG 028?+

Medicare's national-average payment estimate is $41,157 (DRG weight × FY2026 operating base rate ~$6,850). Hospital-specific payments vary by wage index, indirect medical education adjustments, disproportionate share hospital adjustments, and other factors. The hospital's published HPT rates for this DRG are typically higher than the Medicare benchmark.

Why is my inpatient bill for spinal procedures with mcc so much higher than $41,157?+

Commercial insurance and uninsured / self-pay rates routinely run multiples of the Medicare-allowed payment. Each hospital publishes its own gross / cash / commercial-negotiated rates for every DRG in its federally-required Hospital Price Transparency file (45 CFR §180.50). The bigger the gap between what you were billed and the hospital's own published cash-pay rate, the stronger the basis for your dispute.

Can I dispute an MS-DRG charge?+

Yes. Federal and state law gives every patient the right to (1) request an itemized bill (HIPAA §164.524), (2) receive a Good Faith Estimate before scheduled care (No Surprises Act, 2022), (3) dispute charges that materially exceed the GFE by more than $400, and (4) apply for charity care if the facility is a 501(c)(3) nonprofit (ACA §501(r)). DRG bills are bundled — separately-itemized charges for drugs, supplies, or services already covered by the DRG bundle are also disputable.

What's the source of this number?+

MS-DRG codes, descriptions, and relative weights are published annually by the Centers for Medicare & Medicaid Services in the IPPS Final Rule. The hospital pricing distribution is aggregated from individual hospital Hospital Price Transparency files via the DoltHub community dataset. Source freshness: 2025-10-01.