Digestive Malignancy with MCC
Major Diagnostic Category 06·Grouped by diagnosis·FY 2027
MS-DRG 374 is a Medical Medicare Severity Diagnosis Related Group under Major Diagnostic Category 06 (MDC 06) with a Major Complication or Comorbidity (MCC). It maps to 93 ICD-10-CM diagnosis codes. For FY 2027 it carries a relative weight of 2.1109 with a geometric mean length of stay of 5.4 days and an arithmetic mean of 7.4 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:
- 2.1109 (payment multiplier vs. the average case (1.0))
- Geometric mean stay:
- 5.4 days (used for transfer payments)
- Average stay:
- 7.4 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.
Diagnosis codes (93)
As the principal diagnosis, these ICD-10-CM codes can group to DRG 374. 100% of the codes listed are billable.
- C15.3Malignant neoplasm of upper third of esophagus
- C15.4Malignant neoplasm of middle third of esophagus
- C15.5Malignant neoplasm of lower third of esophagus
- C15.8Malignant neoplasm of overlapping sites of esophagus
- C15.9Malignant neoplasm of esophagus, unspecified
- C16.0Malignant neoplasm of cardia
- C16.1Malignant neoplasm of fundus of stomach
- C16.2Malignant neoplasm of body of stomach
- C16.3Malignant neoplasm of pyloric antrum
- C16.4Malignant neoplasm of pylorus
- C16.5Malignant neoplasm of lesser curvature of stomach, unspecified
- C16.6Malignant neoplasm of greater curvature of stomach, unspecified
- C16.8Malignant neoplasm of overlapping sites of stomach
- C16.9Malignant neoplasm of stomach, unspecified
- C17.0Malignant neoplasm of duodenum
- C17.1Malignant neoplasm of jejunum
- C17.2Malignant neoplasm of ileum
- C17.3Meckel's diverticulum, malignant
- C17.8Malignant neoplasm of overlapping sites of small intestine
- C17.9Malignant neoplasm of small intestine, unspecified
- C18.0Malignant neoplasm of cecum
- C18.1Malignant neoplasm of appendix
- C18.2Malignant neoplasm of ascending colon
- C18.3Malignant neoplasm of hepatic flexure
- C18.4Malignant neoplasm of transverse colon
- C18.5Malignant neoplasm of splenic flexure
- C18.6Malignant neoplasm of descending colon
- C18.7Malignant neoplasm of sigmoid colon
- C18.8Malignant neoplasm of overlapping sites of colon
- C18.9Malignant neoplasm of colon, unspecified
- C19Malignant neoplasm of rectosigmoid junction
- C20Malignant neoplasm of rectum
- C21.0Malignant neoplasm of anus, unspecified
- C21.1Malignant neoplasm of anal canal
- C21.2Malignant neoplasm of cloacogenic zone
- C21.8Malignant neoplasm of overlapping sites of rectum, anus and anal canal
- C26.0Malignant neoplasm of intestinal tract, part unspecified
- C26.9Malignant neoplasm of ill-defined sites within the digestive system
- C45.1Mesothelioma of peritoneum
- C46.4Kaposi's sarcoma of gastrointestinal sites
- C48.1Malignant neoplasm of specified parts of peritoneum
- C48.2Malignant neoplasm of peritoneum, unspecified
- C48.8Malignant neoplasm of overlapping sites of retroperitoneum and peritoneum
- C49.A0Gastrointestinal stromal tumor, unspecified site
- C49.A1Gastrointestinal stromal tumor of esophagus
- C49.A2Gastrointestinal stromal tumor of stomach
- C49.A3Gastrointestinal stromal tumor of small intestine
- C49.A4Gastrointestinal stromal tumor of large intestine
- C49.A5Gastrointestinal stromal tumor of rectum
- C49.A9Gastrointestinal stromal tumor of other sites
- C76.2Malignant neoplasm of abdomen
- C78.4Secondary malignant neoplasm of small intestine
- C78.5Secondary malignant neoplasm of large intestine and rectum
- C78.6Secondary malignant neoplasm of retroperitoneum and peritoneum
- C78.80Secondary malignant neoplasm of unspecified digestive organ
- C78.89Secondary malignant neoplasm of other digestive organs
- C7A.010Malignant carcinoid tumor of the duodenum
- C7A.011Malignant carcinoid tumor of the jejunum
- C7A.012Malignant carcinoid tumor of the ileum
- C7A.019Malignant carcinoid tumor of the small intestine, unspecified portion
- C7A.020Malignant carcinoid tumor of the appendix
- C7A.021Malignant carcinoid tumor of the cecum
- C7A.022Malignant carcinoid tumor of the ascending colon
- C7A.023Malignant carcinoid tumor of the transverse colon
- C7A.024Malignant carcinoid tumor of the descending colon
- C7A.025Malignant carcinoid tumor of the sigmoid colon
- C7A.026Malignant carcinoid tumor of the rectum
- C7A.029Malignant carcinoid tumor of the large intestine, unspecified portion
- C7A.092Malignant carcinoid tumor of the stomach
- C7A.094Malignant carcinoid tumor of the foregut, unspecified
- C7A.095Malignant carcinoid tumor of the midgut, unspecified
- C7A.096Malignant carcinoid tumor of the hindgut, unspecified
- C7B.04Secondary carcinoid tumors of peritoneum
- D00.1Carcinoma in situ of esophagus
- D00.2Carcinoma in situ of stomach
- D01.0Carcinoma in situ of colon
- D01.1Carcinoma in situ of rectosigmoid junction
- D01.2Carcinoma in situ of rectum
- D01.3Carcinoma in situ of anus and anal canal
- D01.40Carcinoma in situ of unspecified part of intestine
- D01.49Carcinoma in situ of other parts of intestine
- D01.7Carcinoma in situ of other specified digestive organs
- D01.9Carcinoma in situ of digestive organ, unspecified
- D37.1Neoplasm of uncertain behavior of stomach
- D37.2Neoplasm of uncertain behavior of small intestine
- D37.3Neoplasm of uncertain behavior of appendix
- D37.4Neoplasm of uncertain behavior of colon
- D37.5Neoplasm of uncertain behavior of rectum
- D37.8Neoplasm of uncertain behavior of other specified digestive organs
- D37.9Neoplasm of uncertain behavior of digestive organ, unspecified
- D48.3Neoplasm of uncertain behavior of retroperitoneum
- D48.4Neoplasm of uncertain behavior of peritoneum
- D49.0Neoplasm of unspecified behavior of digestive system
