Medicare inpatient bundled payment
MS-DRG 476: $8,084
Amputation For Musculoskeletal System And Connective Tissue Disorders without CC/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).
Medicare national-average estimate
$8,084
CMS MS-DRG 476 bundled-payment estimate. Relative weight 1.1802 × FY2026 operating base rate ($6,850 national average).
Mean length of stay
3.6 days
Geometric mean LOS
2.7 days
What MS-DRG 476 actually covers
AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/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.
No hospital-specific published prices for MS-DRG 476 are in our database yet. Each U.S. hospital is required by 45 CFR §180.50 to publish their gross / cash / commercial-negotiated rates per DRG. Our quarterly ingest pulls these from the DoltHub HPT v3 community dataset; coverage is still expanding.
Related DRGs
- DRG 402SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL
- DRG 426MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT…
- DRG 427MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT…
- DRG 428MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT…
- DRG 429COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC
- DRG 430COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC
Frequently asked
What does MS-DRG 476 cover?+
MS-DRG 476 is the Medicare inpatient bundled-payment classification for amputation for musculoskeletal system and connective tissue disorders without cc/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 476?+
Medicare's national-average payment estimate is $8,084 (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 amputation for musculoskeletal system and connective tissue disorders without cc/mcc so much higher than $8,084?+
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.