Dental and Oral Diseases with CC
Major Diagnostic Category 03·Grouped by diagnosis·FY 2027
MS-DRG 158 is a Medical Medicare Severity Diagnosis Related Group under Major Diagnostic Category 03 (MDC 03) with a Complication or Comorbidity (CC). It maps to 75 ICD-10-CM diagnosis codes. For FY 2027 it carries a relative weight of 0.9366 with a geometric mean length of stay of 2.8 days and an arithmetic mean of 3.5 days. Hospitals use this grouping to determine reimbursement for inpatient stays under Medicare.
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FY 2027 payment data
From Table 5 of the FY 2027 IPPS Final Rule (CMS).
- Relative weight:
- 0.9366 (payment multiplier vs. the average case (1.0))
- Geometric mean stay:
- 2.8 days (used for transfer payments)
- Average stay:
- 3.5 days (arithmetic mean)
- Post-acute transfer policy:
- No (not subject to it)
Same condition, other severity levels
CMS splits one condition into separate DRGs by how sick the patient is. With MCC pays more than with CC, which pays more than without CC/MCC.
Diagnosis codes (75)
As the principal diagnosis, these ICD-10-CM codes can group to DRG 158. 100% of the codes listed are billable.
- A68.9Relapsing fever, unspecified
- B00.1Herpesviral vesicular dermatitis
- B36.9Superficial mycosis, unspecified
- B37.82Candidal enteritis
- D09.9Carcinoma in situ, unspecified
- D16.32Benign neoplasm of short bones of left lower limb
- J99Respiratory disorders in diseases classified elsewhere
- M25.9Joint disorder, unspecified
- Q18.4Macrostomia
- Q18.5Microstomia
- Q18.6Macrocheilia
- Q18.7Microcheilia
- Q34.9Congenital malformation of respiratory system, unspecified
- Q38.5Congenital malformations of palate, not elsewhere classified
- R68.83Chills (without fever)
- S01.459SOpen bite of unspecified cheek and temporomandibular area, sequela
- S01.501SUnspecified open wound of lip, sequela
- S01.502SUnspecified open wound of oral cavity, sequela
- S01.511SLaceration without foreign body of lip, sequela
- S01.512SLaceration without foreign body of oral cavity, sequela
- S01.521SLaceration with foreign body of lip, sequela
- S01.522SLaceration with foreign body of oral cavity, sequela
- S01.531SPuncture wound without foreign body of lip, sequela
- S01.532SPuncture wound without foreign body of oral cavity, sequela
- S01.541SPuncture wound with foreign body of lip, sequela
- S01.542SPuncture wound with foreign body of oral cavity, sequela
- S01.551SOpen bite of lip, sequela
- S02.32XSFracture of orbital floor, left side, sequela
- S02.400SMalar fracture, unspecified side, sequela
- S02.401SMaxillary fracture, unspecified side, sequela
- S02.402SZygomatic fracture, unspecified side, sequela
- S02.40ASMalar fracture, right side, sequela
- S02.40BSMalar fracture, left side, sequela
- S02.40CSMaxillary fracture, right side, sequela
- S02.40DSMaxillary fracture, left side, sequela
- S02.40ESZygomatic fracture, right side, sequela
- S02.40FSZygomatic fracture, left side, sequela
- S02.411SLeFort I fracture, sequela
- S02.412SLeFort II fracture, sequela
- S02.5XXAFracture of tooth (traumatic), initial encounter for closed fracture
- S02.5XXBFracture of tooth (traumatic), initial encounter for open fracture
- S02.5XXSFracture of tooth (traumatic), sequela
- S02.600SFracture of unspecified part of body of mandible, unspecified side, sequela
- S02.601SFracture of unspecified part of body of right mandible, sequela
- S02.602SFracture of unspecified part of body of left mandible, sequela
- S02.609SFracture of mandible, unspecified, sequela
- S02.610SFracture of condylar process of mandible, unspecified side, sequela
- S02.611SFracture of condylar process of right mandible, sequela
- S02.612SFracture of condylar process of left mandible, sequela
- S02.620SFracture of subcondylar process of mandible, unspecified side, sequela
- S02.621SFracture of subcondylar process of right mandible, sequela
- S02.622SFracture of subcondylar process of left mandible, sequela
- S02.630SFracture of coronoid process of mandible, unspecified side, sequela
- S02.631SFracture of coronoid process of right mandible, sequela
- S02.632SFracture of coronoid process of left mandible, sequela
- S02.640SFracture of ramus of mandible, unspecified side, sequela
- S02.641SFracture of ramus of right mandible, sequela
- S02.642SFracture of ramus of left mandible, sequela
- S02.650SFracture of angle of mandible, unspecified side, sequela
- S02.651SFracture of angle of right mandible, sequela
- S02.652SFracture of angle of left mandible, sequela
- S02.66XSFracture of symphysis of mandible, sequela
- S02.670SFracture of alveolus of mandible, unspecified side, sequela
- S02.671SFracture of alveolus of right mandible, sequela
- S02.672SFracture of alveolus of left mandible, sequela
- S02.92XSUnspecified fracture of facial bones, sequela
- S03.00XSDislocation of jaw, unspecified side, sequela
- S03.01XSDislocation of jaw, right side, sequela
- S03.02XSDislocation of jaw, left side, sequela
- S03.2XXADislocation of tooth, initial encounter
- S03.40XASprain of jaw, unspecified side, initial encounter
- S03.41XASprain of jaw, right side, initial encounter
- S03.42XASprain of jaw, left side, initial encounter
- S03.43XASprain of jaw, bilateral, initial encounter
- T17.998SOther foreign object in respiratory tract, part unspecified causing other injury, sequela
