Pulmonary Embolism with MCC or Acute Cor Pulmonale
Major Diagnostic Category 04·Grouped by diagnosis·FY 2027
MS-DRG 175 is a Medical Medicare Severity Diagnosis Related Group under Major Diagnostic Category 04 (MDC 04) with a Major Complication or Comorbidity (MCC). It maps to 16 ICD-10-CM diagnosis codes. For FY 2027 it carries a relative weight of 1.3652 with a geometric mean length of stay of 3.7 days and an arithmetic mean of 4.8 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:
- 1.3652 (payment multiplier vs. the average case (1.0))
- Geometric mean stay:
- 3.7 days (used for transfer payments)
- Average stay:
- 4.8 days (arithmetic mean)
- Post-acute transfer policy:
- Yes (early transfers can be paid less)
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.
| DRG | Title | Relative weight | Mean stay |
|---|---|---|---|
| 175 | Pulmonary Embolism with MCC or Acute Cor Pulmonale (this page) | 1.3652 | 3.7 days |
| 176 | Pulmonary Embolism without MCC | 0.8063 | 2.4 days |
Diagnosis codes (16)
As the principal diagnosis, these ICD-10-CM codes can group to DRG 175. 100% of the codes listed are billable.
- I26.01Septic pulmonary embolism with acute cor pulmonale
- I26.02Saddle embolus of pulmonary artery with acute cor pulmonale
- I26.03Cement embolism of pulmonary artery with acute cor pulmonale
- I26.04Fat embolism of pulmonary artery with acute cor pulmonale
- I26.09Other pulmonary embolism with acute cor pulmonale
- I26.90Septic pulmonary embolism without acute cor pulmonale
- I26.92Saddle embolus of pulmonary artery without acute cor pulmonale
- I26.93Single subsegmental thrombotic pulmonary embolism without acute cor pulmonale
- I26.94Multiple subsegmental thrombotic pulmonary emboli without acute cor pulmonale
- I26.95Cement embolism of pulmonary artery without acute cor pulmonale
- I26.96Fat embolism of pulmonary artery without acute cor pulmonale
- I26.99Other pulmonary embolism without acute cor pulmonale
- I27.82Chronic pulmonary embolism
- T79.0XXAAir embolism (traumatic), initial encounter
- T79.1XXAFat embolism (traumatic), initial encounter
- T80.0XXAAir embolism following infusion, transfusion and therapeutic injection, initial encounter
