MS-DRG 521Surgical

Hip Replacement with Principal Diagnosis of Hip Fracture with MCC

Major Diagnostic Category 08·Grouped by procedure·FY 2027

MS-DRG 521 is a Surgical Medicare Severity Diagnosis Related Group under Major Diagnostic Category 08 (MDC 08) with a Major Complication or Comorbidity (MCC). It maps to 1,232 ICD-10-CM diagnosis codes. For FY 2027 it carries a relative weight of 2.8515 with a geometric mean length of stay of 5.9 days and an arithmetic mean of 6.9 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:: 2.8515 (payment multiplier vs. the average case (1.0))
Geometric mean stay:: 5.9 days (used for transfer payments)
Average stay:: 6.9 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
521	Hip Replacement with Principal Diagnosis of Hip Fracture with MCC (this page)	2.8515	5.9 days
522	Hip Replacement with Principal Diagnosis of Hip Fracture without MCC	2.1158	4 days

Procedure codes (96)

ICD-10-PCS procedures that can group a stay to DRG 521.

Diagnosis codes (1,232)

As the principal diagnosis, these ICD-10-CM codes can group to DRG 521. 100% of the codes listed are billable.

Showing the first 1,000 of 1,232 codes. Use search to find a specific code.