DRG 438
Medical DRGDisorders of Pancreas Except Malignancy with MCC
What is MS-DRG 438?
MS-DRG 438 is a Medical Medicare Severity Diagnosis Related Group under Major Diagnostic Category 07 (MDC 07) with a Major Complication or Comorbidity (MCC). It maps to 66 ICD-10-CM diagnosis codes. For FY 2026 it carries a relative weight of 1.6302 with a geometric mean length of stay of 4.6 days and an arithmetic mean of 6.3 days. Hospitals use this grouping to determine reimbursement for inpatient stays under Medicare.
FY 2026 Payment Data
Official values from Table 5 of the FY 2026 IPPS Final Rule (CMS).
Related MS-DRGs in This Severity Group
The same clinical condition is split into separate DRGs by complication severity. MCC pays more than CC, which pays more than no CC/MCC.
Linked ICD-10-CM Diagnosis Mappings
- B25.2
Cytomegaloviral pancreatitis
BillableChapter 1 - B26.3
Mumps pancreatitis
BillableChapter 1 - D13.6
Benign neoplasm of pancreas
BillableChapter 2 - K85.00
Idiopathic acute pancreatitis without necrosis or infection
BillableChapter 11 - K85.01
Idiopathic acute pancreatitis with uninfected necrosis
BillableChapter 11 - K85.02
Idiopathic acute pancreatitis with infected necrosis
BillableChapter 11 - K85.10
Biliary acute pancreatitis without necrosis or infection
BillableChapter 11 - K85.11
Biliary acute pancreatitis with uninfected necrosis
BillableChapter 11 - K85.12
Biliary acute pancreatitis with infected necrosis
BillableChapter 11 - K85.20
Alcohol induced acute pancreatitis without necrosis or infection
BillableChapter 11 - K85.21
Alcohol induced acute pancreatitis with uninfected necrosis
BillableChapter 11 - K85.22
Alcohol induced acute pancreatitis with infected necrosis
BillableChapter 11 - K85.30
Drug induced acute pancreatitis without necrosis or infection
BillableChapter 11 - K85.31
Drug induced acute pancreatitis with uninfected necrosis
BillableChapter 11 - K85.32
Drug induced acute pancreatitis with infected necrosis
BillableChapter 11 - K85.80
Other acute pancreatitis without necrosis or infection
BillableChapter 11 - K85.81
Other acute pancreatitis with uninfected necrosis
BillableChapter 11 - K85.82
Other acute pancreatitis with infected necrosis
BillableChapter 11 - K85.90
Acute pancreatitis without necrosis or infection, unspecified
BillableChapter 11 - K85.91
Acute pancreatitis with uninfected necrosis, unspecified
BillableChapter 11 - K85.92
Acute pancreatitis with infected necrosis, unspecified
BillableChapter 11 - K86.0
Alcohol-induced chronic pancreatitis
BillableChapter 11 - K86.1
Other chronic pancreatitis
BillableChapter 11 - K86.2
Cyst of pancreas
BillableChapter 11 - K86.3
Pseudocyst of pancreas
BillableChapter 11 - K86.81
Exocrine pancreatic insufficiency
BillableChapter 11 - K86.89
Other specified diseases of pancreas
BillableChapter 11 - K86.9
Disease of pancreas, unspecified
BillableChapter 11 - Q45.0
Agenesis, aplasia and hypoplasia of pancreas
BillableChapter 17 - Q45.1
Annular pancreas
BillableChapter 17 - Q45.2
Congenital pancreatic cyst
BillableChapter 17 - Q45.3
Other congenital malformations of pancreas and pancreatic duct
BillableChapter 17 - S36.200A
Unspecified injury of head of pancreas, initial encounter
BillableChapter 19 - S36.201A
Unspecified injury of body of pancreas, initial encounter
BillableChapter 19 - S36.202A
Unspecified injury of tail of pancreas, initial encounter
BillableChapter 19 - S36.209A
Unspecified injury of unspecified part of pancreas, initial encounter
BillableChapter 19 - S36.220A
Contusion of head of pancreas, initial encounter
BillableChapter 19 - S36.221A
Contusion of body of pancreas, initial encounter
BillableChapter 19 - S36.222A
Contusion of tail of pancreas, initial encounter
BillableChapter 19 - S36.229A
Contusion of unspecified part of pancreas, initial encounter
BillableChapter 19 - S36.230A
Laceration of head of pancreas, unspecified degree, initial encounter
BillableChapter 19 - S36.231A
Laceration of body of pancreas, unspecified degree, initial encounter
BillableChapter 19 - S36.232A
Laceration of tail of pancreas, unspecified degree, initial encounter
BillableChapter 19 - S36.239A
Laceration of unspecified part of pancreas, unspecified degree, initial encounter
BillableChapter 19 - S36.240A
Minor laceration of head of pancreas, initial encounter
BillableChapter 19 - S36.241A
Minor laceration of body of pancreas, initial encounter
BillableChapter 19 - S36.242A
Minor laceration of tail of pancreas, initial encounter
BillableChapter 19 - S36.249A
Minor laceration of unspecified part of pancreas, initial encounter
BillableChapter 19 - S36.250A
Moderate laceration of head of pancreas, initial encounter
BillableChapter 19 - S36.251A
Moderate laceration of body of pancreas, initial encounter
BillableChapter 19 - S36.252A
Moderate laceration of tail of pancreas, initial encounter
BillableChapter 19 - S36.259A
Moderate laceration of unspecified part of pancreas, initial encounter
BillableChapter 19 - S36.260A
Major laceration of head of pancreas, initial encounter
BillableChapter 19 - S36.261A
Major laceration of body of pancreas, initial encounter
BillableChapter 19 - S36.262A
Major laceration of tail of pancreas, initial encounter
BillableChapter 19 - S36.269A
Major laceration of unspecified part of pancreas, initial encounter
BillableChapter 19 - S36.290A
Other injury of head of pancreas, initial encounter
BillableChapter 19 - S36.291A
Other injury of body of pancreas, initial encounter
BillableChapter 19 - S36.292A
Other injury of tail of pancreas, initial encounter
BillableChapter 19 - S36.299A
Other injury of unspecified part of pancreas, initial encounter
BillableChapter 19 - T86.890
Other transplanted tissue rejection
BillableChapter 19 - T86.891
Other transplanted tissue failure
BillableChapter 19 - T86.892
Other transplanted tissue infection
BillableChapter 19 - T86.898
Other complications of other transplanted tissue
BillableChapter 19 - T86.899
Unspecified complication of other transplanted tissue
BillableChapter 19 - Z94.83
Pancreas transplant status
BillableChapter 21