Enter a DRG’s relative weight and the hospital’s base rate to estimate the inpatient payment — the core arithmetic of hospital reimbursement.
How DRG payment works
Inpatient prospective payment compresses an entire hospital stay into one multiplication: every DRG carries a relative weight expressing its average resource intensity, and every hospital carries a blended base rate; weight times rate is the core payment. Enter both — and any add-on adjustments — and this calculator returns the estimate with the weight-1.0 baseline shown for scale.
How to use it
- Enter the DRG’s relative weight (published in the payment tables your payer uses).
- Enter the hospital’s base rate — the wage-adjusted blended rate.
- Add IME/DSH/outlier adjustments if you know them.
The formula
A worked example
A DRG weighted at 1.5000 against a $6,500 base rate pays $9,750 — half again the hospital’s $6,500 weight-1.0 baseline, because the weight is the payment lever. It’s also why documentation that legitimately captures a CC or MCC matters: the shift to a higher-weighted DRG in the same family can move the weight by 0.3–0.8, which on this base rate is $2,000–$5,000 per case.
Estimates only — payer contracts, plan documents and the EOB are always the source of truth, and nothing here is billing, legal or medical advice. The calculator runs entirely in your browser: no patient data is entered, transmitted or stored.
Real inpatient payment adds transfer rules, outlier thresholds, and hospital-specific adjustments — this is the core arithmetic for estimation and education, not a grouper or a pricer.