OBJECTIVES: To evaluate the annual acute and long-term hospitalizations cost of MR from a French National Payer perspective. METHODS: A 12 months retrospective population-based study was conducted using the 2009–2010 French Medical Information System (PMSI). This exhaustive database covers all public and private hospitals in France and it is based on standardized hospital discharge reports. Each patient is identified using a unique anonymous identification number allowing a longitudinal follow-up. Extracted variables included patients’ demographics, outcomes, acute hospital and post-discharge resource utilizations. RESULTS: 19,868 MR patients were identified and analyzed in two sub-groups depending on their therapeutic management. In the surgical group (n=4,099), the index hospitalization length of stay was 17 days, 77% of patients were discharged to a rehabilitation facility and the average re-hospitalization rate was of 33% over a 6 month period. The average total cost per patient was €22.152. In the non-surgical group (n=15,769), patients were hospitalized on average 3.1 times over 12 months with an average length of stay of 7.7 days. Among those patients, 24% were admitted to a rehabilitation facility (on average 1.5 times) with an average length of stay of 27.9 days. The average total cost per patient was €12.177, varying between €9.957 to €13.538, without and with heart failure respectively. Detailed analysis showed 2 to 3 times higher costs in the 9th and 10th percentiles. By sub-group, the average cost of the 10th percentile was €50.268 for the surgical group and €36.503 for the non-surgical group. CONCLUSIONS: The total observed cost in this population was €283 million over 12 months. Significant differences were observed in cost and resource used between the surgical and non-surgical groups and depending on type of surgery or presence of heart failure within each subgroup. This is the first study reporting hospital costs associated to MR in France.