Inpatient stays / DRG 438
MS-DRG 438 · 169 hospitals · 9,283 stays
DRG 438: Disorders of Pancreas except Malignancy with MCC
Medicare patients had 9,283 stays in DRG 438 in 2024. Hospitals charged an average of $79,250 per stay and were paid $16,600 — a ratio of 4.8 to 1 — of which Medicare's own share averaged $13,231. Average charges ran from $24,288 at the least expensive hospital to $357,880 at the most; half of hospitals charged between $49,758 and $100,064.
- 1Average charge $79,250
- 2Average paid $16,600
- 3Reporting hospitals 169
- 4Medicare stays 9,283
By state
Average charges for DRG 438 were highest in New Jersey ($129,421) and lowest in Maryland ($27,810). Payments vary far less than charges, because Medicare sets them: they range across states from $11,986 to $25,166.
| State | Stays | Avg charge | Avg paid | Ratio |
|---|---|---|---|---|
| New Jersey | 231 | $129,421 | $17,130 | 7.6× |
| Nevada | 102 | $123,910 | $16,148 | 7.7× |
| California | 892 | $122,578 | $20,699 | 5.9× |
| Alaska | 29 | $108,171 | $19,510 | 5.5× |
| New York | 444 | $103,446 | $21,561 | 4.8× |
| Colorado | 124 | $100,870 | $15,755 | 6.4× |
| Texas | 643 | $100,594 | $15,335 | 6.6× |
| Florida | 680 | $97,190 | $14,622 | 6.6× |
| Pennsylvania | 373 | $92,095 | $15,872 | 5.8× |
| Arizona | 182 | $90,468 | $17,003 | 5.3× |
| Alabama | 123 | $89,978 | $15,325 | 5.9× |
| District of Columbia | 34 | $88,385 | $22,041 | 4× |
| Washington | 176 | $87,186 | $18,362 | 4.7× |
| Kansas | 104 | $81,436 | $13,858 | 5.9× |
| Oklahoma | 135 | $78,056 | $15,118 | 5.2× |
| New Mexico | 37 | $76,996 | $15,212 | 5.1× |
| South Carolina | 180 | $74,941 | $16,331 | 4.6× |
| Maine | 27 | $73,051 | $21,411 | 3.4× |
| Georgia | 242 | $72,453 | $16,111 | 4.5× |
| New Hampshire | 40 | $72,240 | $15,326 | 4.7× |
| Mississippi | 94 | $69,063 | $12,835 | 5.4× |
| Rhode Island | 28 | $67,747 | $18,933 | 3.6× |
| Indiana | 275 | $67,554 | $14,831 | 4.6× |
| Hawaii | 29 | $67,314 | $23,604 | 2.9× |
| Connecticut | 119 | $65,677 | $19,008 | 3.5× |
| Oregon | 113 | $64,343 | $20,157 | 3.2× |
| Tennessee | 224 | $64,220 | $13,426 | 4.8× |
| Virginia | 273 | $64,156 | $15,630 | 4.1× |
| Missouri | 196 | $63,811 | $14,318 | 4.5× |
| Iowa | 89 | $62,974 | $12,857 | 4.9× |
| Illinois | 406 | $62,897 | $16,187 | 3.9× |
| South Dakota | 56 | $60,236 | $14,005 | 4.3× |
| Wisconsin | 151 | $59,746 | $15,689 | 3.8× |
| Louisiana | 120 | $58,456 | $12,608 | 4.6× |
| Minnesota | 182 | $58,059 | $16,877 | 3.4× |
| North Carolina | 275 | $57,522 | $15,965 | 3.6× |
| Idaho | 39 | $57,080 | $11,986 | 4.8× |
| Nebraska | 62 | $53,540 | $14,165 | 3.8× |
| Delaware | 35 | $53,241 | $15,413 | 3.5× |
| Ohio | 349 | $53,029 | $14,491 | 3.7× |
| Utah | 70 | $50,506 | $15,719 | 3.2× |
| West Virginia | 58 | $50,469 | $14,022 | 3.6× |
| Kentucky | 134 | $50,315 | $13,191 | 3.8× |
| Michigan | 341 | $48,336 | $16,318 | 3× |
| Massachusetts | 365 | $48,199 | $17,968 | 2.7× |
| Arkansas | 114 | $47,275 | $12,213 | 3.9× |
| North Dakota | 38 | $46,202 | $14,814 | 3.1× |
| Wyoming | 19 | $41,324 | $17,686 | 2.3× |
| Montana | 34 | $39,539 | $12,955 | 3.1× |
| Vermont | 19 | $37,819 | $13,400 | 2.8× |
| Maryland | 178 | $27,810 | $25,166 | 1.1× |
Highest average charges
| Hospital | Charge | Paid |
|---|---|---|
| Westchester Medical Center Valhalla, NY · 11 stays | $357,880 | $32,846 |
| Stanford Health Care Stanford, CA · 16 stays | $350,458 | $37,339 |
| Cedars-Sinai Medical Center Los Angeles, CA · 29 stays | $279,435 | $25,167 |
| New York-Presbyterian Hospital New York, NY · 26 stays | $194,419 | $31,691 |
| Wesley Medical Center Wichita, KS · 11 stays | $191,508 | $15,141 |
| Medical City Plano Plano, TX · 15 stays | $191,192 | $12,646 |
| Cjw Medical Center Richmond, VA · 11 stays | $190,103 | $11,579 |
| Montefiore Medical Center Bronx, NY · 12 stays | $186,926 | $26,604 |
| Los Robles Hospital & Medical Center Thousand Oaks, CA · 14 stays | $185,609 | $16,577 |
| Lehigh Valley Hospital Allentown, PA · 20 stays | $183,788 | $16,943 |
Lowest average charges
| Hospital | Charge | Paid |
|---|---|---|
| Fort Sanders Regional Medical Center Knoxville, TN · 12 stays | $24,288 | $12,379 |
| South Shore Hospital South Weymouth, MA · 15 stays | $26,688 | $12,771 |
| Saint Mary's Regional Medical Center Reno, NV · 18 stays | $27,086 | $13,617 |
| Silver Cross Hospital and Medical Centers New Lenox, IL · 12 stays | $27,668 | $11,682 |
| Cape Cod Hospital Hyannis, MA · 18 stays | $28,215 | $20,512 |
| Trinity Health Ann Arbor Hospital Ann Arbor, MI · 12 stays | $28,232 | $13,784 |
| Winchester Medical Center Winchester, VA · 23 stays | $28,523 | $15,148 |
| Boone Hospital Center Columbia, MO · 13 stays | $28,677 | $10,097 |
| Suburban Hospital Bethesda, MD · 11 stays | $30,865 | $27,340 |
| Owensboro Health Regional Hospital Owensboro, KY · 11 stays | $33,052 | $14,590 |
These are averages over each hospital's Medicare stays in this DRG, which mix simple and complicated cases. A high average charge is the hospital's pricing, not a sign of better or worse care, and not what a patient pays: Medicare patients owe the inpatient deductible, and people with other coverage pay their plan's negotiated rate.
Sources: CMS Medicare Inpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024. Hospitals with fewer than 11 stays are suppressed by CMS. Checked 2026-10-24. Methodology.