MS-DRG 523Surgical
Extensive or Complex Spinal Fusion Procedures Except Cervical with MCC
Major Diagnostic Category 08·Grouped by procedure·FY 2027
MS-DRG 523 is a Surgical Medicare Severity Diagnosis Related Group under Major Diagnostic Category 08 (MDC 08) with a Major Complication or Comorbidity (MCC). For FY 2027 it carries a relative weight of 13.7443 with a geometric mean length of stay of 9.2 days and an arithmetic mean of 11 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:
- 13.7443 (payment multiplier vs. the average case (1.0))
- Geometric mean stay:
- 9.2 days (used for transfer payments)
- Average stay:
- 11 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 |
|---|---|---|---|
| 523 | Extensive or Complex Spinal Fusion Procedures Except Cervical with MCC (this page) | 13.7443 | 9.2 days |
| 524 | Extensive or Complex Spinal Fusion Procedures Except Cervical with CC | 9.8365 | 5.6 days |
| 525 | Extensive or Complex Spinal Fusion Procedures Except Cervical without CC/MCC | 7.2982 | 3.2 days |
Procedure codes (128)
ICD-10-PCS procedures that can group a stay to DRG 523.
- 0RG7070Fusion of 2 to 7 Thoracic Vertebral Joints with Autologous Tissue Substitute, Anterior Approach, Anterior Column, Open Approach
- 0RG7071Fusion of 2 to 7 Thoracic Vertebral Joints with Autologous Tissue Substitute, Posterior Approach, Posterior Column, Open Approach
- 0RG707JFusion of 2 to 7 Thoracic Vertebral Joints with Autologous Tissue Substitute, Posterior Approach, Anterior Column, Open Approach
- 0RG70A0Fusion of 2 to 7 Thoracic Vertebral Joints with Interbody Fusion Device, Anterior Approach, Anterior Column, Open Approach
- 0RG70AJFusion of 2 to 7 Thoracic Vertebral Joints with Interbody Fusion Device, Posterior Approach, Anterior Column, Open Approach
- 0RG70J0Fusion of 2 to 7 Thoracic Vertebral Joints with Synthetic Substitute, Anterior Approach, Anterior Column, Open Approach
- 0RG70J1Fusion of 2 to 7 Thoracic Vertebral Joints with Synthetic Substitute, Posterior Approach, Posterior Column, Open Approach
- 0RG70JJFusion of 2 to 7 Thoracic Vertebral Joints with Synthetic Substitute, Posterior Approach, Anterior Column, Open Approach
- 0RG70K0Fusion of 2 to 7 Thoracic Vertebral Joints with Nonautologous Tissue Substitute, Anterior Approach, Anterior Column, Open Approach
- 0RG70K1Fusion of 2 to 7 Thoracic Vertebral Joints with Nonautologous Tissue Substitute, Posterior Approach, Posterior Column, Open Approach
- 0RG70KJFusion of 2 to 7 Thoracic Vertebral Joints with Nonautologous Tissue Substitute, Posterior Approach, Anterior Column, Open Approach
- 0RG7370Fusion of 2 to 7 Thoracic Vertebral Joints with Autologous Tissue Substitute, Anterior Approach, Anterior Column, Percutaneous Approach
- 0RG7371Fusion of 2 to 7 Thoracic Vertebral Joints with Autologous Tissue Substitute, Posterior Approach, Posterior Column, Percutaneous Approach
- 0RG737JFusion of 2 to 7 Thoracic Vertebral Joints with Autologous Tissue Substitute, Posterior Approach, Anterior Column, Percutaneous Approach
- 0RG73A0Fusion of 2 to 7 Thoracic Vertebral Joints with Interbody Fusion Device, Anterior Approach, Anterior Column, Percutaneous Approach
- 0RG73AJFusion of 2 to 7 Thoracic Vertebral Joints with Interbody Fusion Device, Posterior Approach, Anterior Column, Percutaneous Approach
- 0RG73J0Fusion of 2 to 7 Thoracic Vertebral Joints with Synthetic Substitute, Anterior Approach, Anterior Column, Percutaneous Approach
- 0RG73J1Fusion of 2 to 7 Thoracic Vertebral Joints with Synthetic Substitute, Posterior Approach, Posterior Column, Percutaneous Approach
- 0RG73JJFusion of 2 to 7 Thoracic Vertebral Joints with Synthetic Substitute, Posterior Approach, Anterior Column, Percutaneous Approach
- 0RG73K0Fusion of 2 to 7 Thoracic Vertebral Joints with Nonautologous Tissue Substitute, Anterior Approach, Anterior Column, Percutaneous Approach
- 0RG73K1Fusion of 2 to 7 Thoracic Vertebral Joints with Nonautologous Tissue Substitute, Posterior Approach, Posterior Column, Percutaneous Approach
- 0RG73KJFusion of 2 to 7 Thoracic Vertebral Joints with Nonautologous Tissue Substitute, Posterior Approach, Anterior Column, Percutaneous Approach
- 0RG7470Fusion of 2 to 7 Thoracic Vertebral Joints with Autologous Tissue Substitute, Anterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0RG7471Fusion of 2 to 7 Thoracic Vertebral Joints with Autologous Tissue Substitute, Posterior Approach, Posterior Column, Percutaneous Endoscopic Approach
- 0RG747JFusion of 2 to 7 Thoracic Vertebral Joints with Autologous Tissue Substitute, Posterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0RG74A0Fusion of 2 to 7 Thoracic Vertebral Joints with Interbody Fusion Device, Anterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0RG74AJFusion of 2 to 7 Thoracic Vertebral Joints with Interbody Fusion Device, Posterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0RG74J0Fusion of 2 to 7 Thoracic Vertebral Joints with Synthetic Substitute, Anterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0RG74J1Fusion of 2 to 7 Thoracic Vertebral Joints with Synthetic Substitute, Posterior Approach, Posterior Column, Percutaneous Endoscopic Approach
- 0RG74JJFusion of 2 to 7 Thoracic Vertebral Joints with Synthetic Substitute, Posterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0RG74K0Fusion of 2 to 7 Thoracic Vertebral Joints with Nonautologous Tissue Substitute, Anterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0RG74K1Fusion of 2 to 7 Thoracic Vertebral Joints with Nonautologous Tissue Substitute, Posterior Approach, Posterior Column, Percutaneous Endoscopic Approach
- 0RG74KJFusion of 2 to 7 Thoracic Vertebral Joints with Nonautologous Tissue Substitute, Posterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0RG8070Fusion of 8 or more Thoracic Vertebral Joints with Autologous Tissue Substitute, Anterior Approach, Anterior Column, Open Approach
- 0RG8071Fusion of 8 or more Thoracic Vertebral Joints with Autologous Tissue Substitute, Posterior Approach, Posterior Column, Open Approach
- 0RG807JFusion of 8 or more Thoracic Vertebral Joints with Autologous Tissue Substitute, Posterior Approach, Anterior Column, Open Approach
- 0RG80A0Fusion of 8 or more Thoracic Vertebral Joints with Interbody Fusion Device, Anterior Approach, Anterior Column, Open Approach
- 0RG80AJFusion of 8 or more Thoracic Vertebral Joints with Interbody Fusion Device, Posterior Approach, Anterior Column, Open Approach
- 0RG80J0Fusion of 8 or more Thoracic Vertebral Joints with Synthetic Substitute, Anterior Approach, Anterior Column, Open Approach
- 0RG80J1Fusion of 8 or more Thoracic Vertebral Joints with Synthetic Substitute, Posterior Approach, Posterior Column, Open Approach
- 0RG80JJFusion of 8 or more Thoracic Vertebral Joints with Synthetic Substitute, Posterior Approach, Anterior Column, Open Approach
- 0RG80K0Fusion of 8 or more Thoracic Vertebral Joints with Nonautologous Tissue Substitute, Anterior Approach, Anterior Column, Open Approach
- 0RG80K1Fusion of 8 or more Thoracic Vertebral Joints with Nonautologous Tissue Substitute, Posterior Approach, Posterior Column, Open Approach
- 0RG80KJFusion of 8 or more Thoracic Vertebral Joints with Nonautologous Tissue Substitute, Posterior Approach, Anterior Column, Open Approach
- 0RG8370Fusion of 8 or more Thoracic Vertebral Joints with Autologous Tissue Substitute, Anterior Approach, Anterior Column, Percutaneous Approach
- 0RG8371Fusion of 8 or more Thoracic Vertebral Joints with Autologous Tissue Substitute, Posterior Approach, Posterior Column, Percutaneous Approach
- 0RG837JFusion of 8 or more Thoracic Vertebral Joints with Autologous Tissue Substitute, Posterior Approach, Anterior Column, Percutaneous Approach
- 0RG83A0Fusion of 8 or more Thoracic Vertebral Joints with Interbody Fusion Device, Anterior Approach, Anterior Column, Percutaneous Approach
- 0RG83AJFusion of 8 or more Thoracic Vertebral Joints with Interbody Fusion Device, Posterior Approach, Anterior Column, Percutaneous Approach
- 0RG83J0Fusion of 8 or more Thoracic Vertebral Joints with Synthetic Substitute, Anterior Approach, Anterior Column, Percutaneous Approach
- 0RG83J1Fusion of 8 or more Thoracic Vertebral Joints with Synthetic Substitute, Posterior Approach, Posterior Column, Percutaneous Approach
- 0RG83JJFusion of 8 or more Thoracic Vertebral Joints with Synthetic Substitute, Posterior Approach, Anterior Column, Percutaneous Approach
- 0RG83K0Fusion of 8 or more Thoracic Vertebral Joints with Nonautologous Tissue Substitute, Anterior Approach, Anterior Column, Percutaneous Approach
- 0RG83K1Fusion of 8 or more Thoracic Vertebral Joints with Nonautologous Tissue Substitute, Posterior Approach, Posterior Column, Percutaneous Approach
- 0RG83KJFusion of 8 or more Thoracic Vertebral Joints with Nonautologous Tissue Substitute, Posterior Approach, Anterior Column, Percutaneous Approach
- 0RG8470Fusion of 8 or more Thoracic Vertebral Joints with Autologous Tissue Substitute, Anterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0RG8471Fusion of 8 or more Thoracic Vertebral Joints with Autologous Tissue Substitute, Posterior Approach, Posterior Column, Percutaneous Endoscopic Approach
- 0RG847JFusion of 8 or more Thoracic Vertebral Joints with Autologous Tissue Substitute, Posterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0RG84A0Fusion of 8 or more Thoracic Vertebral Joints with Interbody Fusion Device, Anterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0RG84AJFusion of 8 or more Thoracic Vertebral Joints with Interbody Fusion Device, Posterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0RG84J0Fusion of 8 or more Thoracic Vertebral Joints with Synthetic Substitute, Anterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0RG84J1Fusion of 8 or more Thoracic Vertebral Joints with Synthetic Substitute, Posterior Approach, Posterior Column, Percutaneous Endoscopic Approach
- 0RG84JJFusion of 8 or more Thoracic Vertebral Joints with Synthetic Substitute, Posterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0RG84K0Fusion of 8 or more Thoracic Vertebral Joints with Nonautologous Tissue Substitute, Anterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0RG84K1Fusion of 8 or more Thoracic Vertebral Joints with Nonautologous Tissue Substitute, Posterior Approach, Posterior Column, Percutaneous Endoscopic Approach
- 0RG84KJFusion of 8 or more Thoracic Vertebral Joints with Nonautologous Tissue Substitute, Posterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0RGA0E0Fusion of Thoracolumbar Vertebral Joint with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Anterior Approach, Anterior Column, Open Approach
- 0RGA0EJFusion of Thoracolumbar Vertebral Joint with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Posterior Approach, Anterior Column, Open Approach
- 0RGA3E0Fusion of Thoracolumbar Vertebral Joint with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Anterior Approach, Anterior Column, Percutaneous Approach
- 0RGA3EJFusion of Thoracolumbar Vertebral Joint with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Posterior Approach, Anterior Column, Percutaneous Approach
- 0RGA4E0Fusion of Thoracolumbar Vertebral Joint with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Anterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0RGA4EJFusion of Thoracolumbar Vertebral Joint with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Posterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0SG00E0Fusion of Lumbar Vertebral Joint with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Anterior Approach, Anterior Column, Open Approach
- 0SG00EJFusion of Lumbar Vertebral Joint with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Posterior Approach, Anterior Column, Open Approach
- 0SG03E0Fusion of Lumbar Vertebral Joint with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Anterior Approach, Anterior Column, Percutaneous Approach
- 0SG03EJFusion of Lumbar Vertebral Joint with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Posterior Approach, Anterior Column, Percutaneous Approach
- 0SG04E0Fusion of Lumbar Vertebral Joint with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Anterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0SG04EJFusion of Lumbar Vertebral Joint with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Posterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0SG1070Fusion of 2 or more Lumbar Vertebral Joints with Autologous Tissue Substitute, Anterior Approach, Anterior Column, Open Approach
- 0SG1071Fusion of 2 or more Lumbar Vertebral Joints with Autologous Tissue Substitute, Posterior Approach, Posterior Column, Open Approach
- 0SG107JFusion of 2 or more Lumbar Vertebral Joints with Autologous Tissue Substitute, Posterior Approach, Anterior Column, Open Approach
- 0SG10A0Fusion of 2 or more Lumbar Vertebral Joints with Interbody Fusion Device, Anterior Approach, Anterior Column, Open Approach
- 0SG10AJFusion of 2 or more Lumbar Vertebral Joints with Interbody Fusion Device, Posterior Approach, Anterior Column, Open Approach
- 0SG10E0Fusion of 2 or more Lumbar Vertebral Joints with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Anterior Approach, Anterior Column, Open Approach
- 0SG10EJFusion of 2 or more Lumbar Vertebral Joints with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Posterior Approach, Anterior Column, Open Approach
- 0SG10J0Fusion of 2 or more Lumbar Vertebral Joints with Synthetic Substitute, Anterior Approach, Anterior Column, Open Approach
- 0SG10J1Fusion of 2 or more Lumbar Vertebral Joints with Synthetic Substitute, Posterior Approach, Posterior Column, Open Approach
- 0SG10JJFusion of 2 or more Lumbar Vertebral Joints with Synthetic Substitute, Posterior Approach, Anterior Column, Open Approach
- 0SG10K0Fusion of 2 or more Lumbar Vertebral Joints with Nonautologous Tissue Substitute, Anterior Approach, Anterior Column, Open Approach
- 0SG10K1Fusion of 2 or more Lumbar Vertebral Joints with Nonautologous Tissue Substitute, Posterior Approach, Posterior Column, Open Approach
- 0SG10KJFusion of 2 or more Lumbar Vertebral Joints with Nonautologous Tissue Substitute, Posterior Approach, Anterior Column, Open Approach
- 0SG1370Fusion of 2 or more Lumbar Vertebral Joints with Autologous Tissue Substitute, Anterior Approach, Anterior Column, Percutaneous Approach
- 0SG1371Fusion of 2 or more Lumbar Vertebral Joints with Autologous Tissue Substitute, Posterior Approach, Posterior Column, Percutaneous Approach
- 0SG137JFusion of 2 or more Lumbar Vertebral Joints with Autologous Tissue Substitute, Posterior Approach, Anterior Column, Percutaneous Approach
- 0SG13A0Fusion of 2 or more Lumbar Vertebral Joints with Interbody Fusion Device, Anterior Approach, Anterior Column, Percutaneous Approach
- 0SG13AJFusion of 2 or more Lumbar Vertebral Joints with Interbody Fusion Device, Posterior Approach, Anterior Column, Percutaneous Approach
- 0SG13E0Fusion of 2 or more Lumbar Vertebral Joints with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Anterior Approach, Anterior Column, Percutaneous Approach
- 0SG13EJFusion of 2 or more Lumbar Vertebral Joints with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Posterior Approach, Anterior Column, Percutaneous Approach
- 0SG13J0Fusion of 2 or more Lumbar Vertebral Joints with Synthetic Substitute, Anterior Approach, Anterior Column, Percutaneous Approach
- 0SG13J1Fusion of 2 or more Lumbar Vertebral Joints with Synthetic Substitute, Posterior Approach, Posterior Column, Percutaneous Approach
- 0SG13JJFusion of 2 or more Lumbar Vertebral Joints with Synthetic Substitute, Posterior Approach, Anterior Column, Percutaneous Approach
- 0SG13K0Fusion of 2 or more Lumbar Vertebral Joints with Nonautologous Tissue Substitute, Anterior Approach, Anterior Column, Percutaneous Approach
- 0SG13K1Fusion of 2 or more Lumbar Vertebral Joints with Nonautologous Tissue Substitute, Posterior Approach, Posterior Column, Percutaneous Approach
- 0SG13KJFusion of 2 or more Lumbar Vertebral Joints with Nonautologous Tissue Substitute, Posterior Approach, Anterior Column, Percutaneous Approach
- 0SG1470Fusion of 2 or more Lumbar Vertebral Joints with Autologous Tissue Substitute, Anterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0SG1471Fusion of 2 or more Lumbar Vertebral Joints with Autologous Tissue Substitute, Posterior Approach, Posterior Column, Percutaneous Endoscopic Approach
- 0SG147JFusion of 2 or more Lumbar Vertebral Joints with Autologous Tissue Substitute, Posterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0SG14A0Fusion of 2 or more Lumbar Vertebral Joints with Interbody Fusion Device, Anterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0SG14AJFusion of 2 or more Lumbar Vertebral Joints with Interbody Fusion Device, Posterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0SG14E0Fusion of 2 or more Lumbar Vertebral Joints with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Anterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0SG14EJFusion of 2 or more Lumbar Vertebral Joints with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Posterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0SG14J0Fusion of 2 or more Lumbar Vertebral Joints with Synthetic Substitute, Anterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0SG14J1Fusion of 2 or more Lumbar Vertebral Joints with Synthetic Substitute, Posterior Approach, Posterior Column, Percutaneous Endoscopic Approach
- 0SG14JJFusion of 2 or more Lumbar Vertebral Joints with Synthetic Substitute, Posterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0SG14K0Fusion of 2 or more Lumbar Vertebral Joints with Nonautologous Tissue Substitute, Anterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0SG14K1Fusion of 2 or more Lumbar Vertebral Joints with Nonautologous Tissue Substitute, Posterior Approach, Posterior Column, Percutaneous Endoscopic Approach
- 0SG14KJFusion of 2 or more Lumbar Vertebral Joints with Nonautologous Tissue Substitute, Posterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0SG30E0Fusion of Lumbosacral Joint with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Anterior Approach, Anterior Column, Open Approach
- 0SG30EJFusion of Lumbosacral Joint with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Posterior Approach, Anterior Column, Open Approach
- 0SG33E0Fusion of Lumbosacral Joint with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Anterior Approach, Anterior Column, Percutaneous Approach
- 0SG33EJFusion of Lumbosacral Joint with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Posterior Approach, Anterior Column, Percutaneous Approach
- 0SG34E0Fusion of Lumbosacral Joint with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Anterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- 0SG34EJFusion of Lumbosacral Joint with Interbody Fusion Device, Custom-Made Anatomically and Virtually Designed, Posterior Approach, Anterior Column, Percutaneous Endoscopic Approach
- XRGC0EAFusion of 2 or more Lumbar Vertebral Joints using Facet Joint Fusion Device, Paired Titanium Cages, Open Approach, New Technology Group 10
- XRGE058Fusion of Right Sacroiliac Joint using Internal Fixation Device with Tulip Connector, Open Approach, New Technology Group 8
- XRGE358Fusion of Right Sacroiliac Joint using Internal Fixation Device with Tulip Connector, Percutaneous Approach, New Technology Group 8
- XRGF058Fusion of Left Sacroiliac Joint using Internal Fixation Device with Tulip Connector, Open Approach, New Technology Group 8
- XRGF358Fusion of Left Sacroiliac Joint using Internal Fixation Device with Tulip Connector, Percutaneous Approach, New Technology Group 8