For data year 2023, the data element TOTCHG_2023 is included in the National Inpatient Sample (NIS). It represents the total hospital charges for discharges in included states (data element TOTCHG), adjusted to account for missing states (AL, CA, ID, NV, and VT). Charges from the included states are inflated to approximate the total hospital charges for discharges in those missing states, with adjustments applied within Medicare-Severity Diagnosis Related Group (MS-DRG), age, and sex categories to ensure comparability. The 2023 adjustment is based on the change in average charge between 2021 and 2022, under the assumption that discharge volume remained unchanged from 2022. All values are benchmarked against external sources for validation. Additional relevant information can be found in the 2023 NIS Introduction.