MS-DRG 194Medical

Simple Pneumonia and Pleurisy with CC

Major Diagnostic Category 04·Grouped by diagnosis·FY 2027

MS-DRG 194 is a Medical Medicare Severity Diagnosis Related Group under Major Diagnostic Category 04 (MDC 04) with a Complication or Comorbidity (CC). It maps to 34 ICD-10-CM diagnosis codes. For FY 2027 it carries a relative weight of 0.7888 with a geometric mean length of stay of 2.7 days and an arithmetic mean of 3.3 days. Hospitals use this grouping to determine reimbursement for inpatient stays under Medicare.

FY 2027 payment data

From Table 5 of the FY 2027 IPPS Final Rule (CMS).

Relative weight:: 0.7888 (payment multiplier vs. the average case (1.0))
Geometric mean stay:: 2.7 days (used for transfer payments)
Average stay:: 3.3 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
193	Simple Pneumonia and Pleurisy with MCC	1.2825	3.8 days
194	Simple Pneumonia and Pleurisy with CC (this page)	0.7888	2.7 days
195	Simple Pneumonia and Pleurisy without CC/MCC	0.6063	2.2 days

Diagnosis codes (34)

As the principal diagnosis, these ICD-10-CM codes can group to DRG 194. 100% of the codes listed are billable.