Reticuloendothelial and Immunity Disorders with MCC
Major Diagnostic Category 16·Grouped by diagnosis·FY 2027
MS-DRG 814 is a Medical Medicare Severity Diagnosis Related Group under Major Diagnostic Category 16 (MDC 16) with a Major Complication or Comorbidity (MCC). It maps to 137 ICD-10-CM diagnosis codes. For FY 2027 it carries a relative weight of 2.0729 with a geometric mean length of stay of 4.8 days and an arithmetic mean of 6.8 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:
- 2.0729 (payment multiplier vs. the average case (1.0))
- Geometric mean stay:
- 4.8 days (used for transfer payments)
- Average stay:
- 6.8 days (arithmetic mean)
- Post-acute transfer policy:
- No (not subject to it)
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 (137)
As the principal diagnosis, these ICD-10-CM codes can group to DRG 814. 100% of the codes listed are billable.
- A18.2Tuberculous peripheral lymphadenopathy
- A18.85Tuberculosis of spleen
- A28.1Cat-scratch disease
- D15.0Benign neoplasm of thymus
- D18.1Lymphangioma, any site
- D36.0Benign neoplasm of lymph nodes
- D3A.091Benign carcinoid tumor of the thymus
- D47.2Monoclonal gammopathy
- D47.3Essential (hemorrhagic) thrombocythemia
- D47.4Osteomyelofibrosis
- D68.312Antiphospholipid antibody with hemorrhagic disorder
- D68.51Activated protein C resistance
- D68.52Prothrombin gene mutation
- D68.59Other primary thrombophilia
- D68.61Antiphospholipid syndrome
- D68.62Lupus anticoagulant syndrome
- D68.69Other thrombophilia
- D72.10Eosinophilia, unspecified
- D72.110Idiopathic hypereosinophilic syndrome [IHES]
- D72.111Lymphocytic Variant Hypereosinophilic Syndrome [LHES]
- D72.118Other hypereosinophilic syndrome
- D72.119Hypereosinophilic syndrome [HES], unspecified
- D72.12Drug rash with eosinophilia and systemic symptoms syndrome
- D72.18Eosinophilia in diseases classified elsewhere
- D72.19Other eosinophilia
- D72.810Lymphocytopenia
- D72.818Other decreased white blood cell count
- D72.819Decreased white blood cell count, unspecified
- D72.820Lymphocytosis (symptomatic)
- D72.821Monocytosis (symptomatic)
- D72.822Plasmacytosis
- D72.823Leukemoid reaction
- D72.824Basophilia
- D72.825Bandemia
- D72.828Other elevated white blood cell count
- D72.829Elevated white blood cell count, unspecified
- D72.89Other specified disorders of white blood cells
- D72.9Disorder of white blood cells, unspecified
- D73.0Hyposplenism
- D73.1Hypersplenism
- D73.2Chronic congestive splenomegaly
- D73.3Abscess of spleen
- D73.4Cyst of spleen
- D73.5Infarction of spleen
- D73.81Neutropenic splenomegaly
- D73.89Other diseases of spleen
- D73.9Disease of spleen, unspecified
- D75.0Familial erythrocytosis
- D75.1Secondary polycythemia
- D75.838Other thrombocytosis
- D75.839Thrombocytosis, unspecified
- D75.89Other specified diseases of blood and blood-forming organs
- D75.9Disease of blood and blood-forming organs, unspecified
- D75.AGlucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
- D76.1Hemophagocytic lymphohistiocytosis
- D76.2Hemophagocytic syndrome, infection-associated
- D76.3Other histiocytosis syndromes
- D77Other disorders of blood and blood-forming organs in diseases classified elsewhere
- D80.0Hereditary hypogammaglobulinemia
- D80.1Nonfamilial hypogammaglobulinemia
- D80.2Selective deficiency of immunoglobulin A [IgA]
- D80.3Selective deficiency of immunoglobulin G [IgG] subclasses
- D80.4Selective deficiency of immunoglobulin M [IgM]
- D80.5Immunodeficiency with increased immunoglobulin M [IgM]
- D80.7Transient hypogammaglobulinemia of infancy
- D82.2Immunodeficiency with short-limbed stature
- D82.3Immunodeficiency following hereditary defective response to Epstein-Barr virus
- D82.4Hyperimmunoglobulin E [IgE] syndrome
- D82.8Immunodeficiency associated with other specified major defects
- D82.9Immunodeficiency associated with major defect, unspecified
- D83.0Common variable immunodeficiency with predominant abnormalities of B-cell numbers and function
- D83.1Common variable immunodeficiency with predominant immunoregulatory T-cell disorders
- D83.2Common variable immunodeficiency with autoantibodies to B- or T-cells
- D83.8Other common variable immunodeficiencies
- D83.9Common variable immunodeficiency, unspecified
- D84.0Lymphocyte function antigen-1 [LFA-1] defect
- D84.81Immunodeficiency due to conditions classified elsewhere
- D84.821Immunodeficiency due to drugs
- D84.822Immunodeficiency due to external causes
- D84.89Other immunodeficiencies
- D84.9Immunodeficiency, unspecified
- D89.0Polyclonal hypergammaglobulinemia
- D89.2Hypergammaglobulinemia, unspecified
- D89.3Immune reconstitution syndrome
- D89.40Mast cell activation, unspecified
- D89.41Monoclonal mast cell activation syndrome
- D89.42Idiopathic mast cell activation syndrome
- D89.43Secondary mast cell activation
- D89.44Hereditary alpha tryptasemia
- D89.49Other mast cell activation disorder
- D89.831Cytokine release syndrome, grade 1
- D89.832Cytokine release syndrome, grade 2
- D89.833Cytokine release syndrome, grade 3
- D89.834Cytokine release syndrome, grade 4
- D89.835Cytokine release syndrome, grade 5
- D89.839Cytokine release syndrome, grade unspecified
- D89.84IgG4-related disease
- D89.89Other specified disorders involving the immune mechanism, not elsewhere classified
- D89.9Disorder involving the immune mechanism, unspecified
- E32.0Persistent hyperplasia of thymus
- E32.1Abscess of thymus
- E32.8Other diseases of thymus
- E32.9Disease of thymus, unspecified
- I88.1Chronic lymphadenitis, except mesenteric
- I88.8Other nonspecific lymphadenitis
- I88.9Nonspecific lymphadenitis, unspecified
- I89.8Other specified noninfective disorders of lymphatic vessels and lymph nodes
- I89.9Noninfective disorder of lymphatic vessels and lymph nodes, unspecified
- L04.0Acute lymphadenitis of face, head and neck
- L04.1Acute lymphadenitis of trunk
- L04.2Acute lymphadenitis of upper limb
- L04.3Acute lymphadenitis of lower limb
- L04.8Acute lymphadenitis of other sites
- L04.9Acute lymphadenitis, unspecified
- Q89.01Asplenia (congenital)
- Q89.09Congenital malformations of spleen
- R16.1Splenomegaly, not elsewhere classified
- R59.0Localized enlarged lymph nodes
- R59.1Generalized enlarged lymph nodes
- R59.9Enlarged lymph nodes, unspecified
- R75Inconclusive laboratory evidence of human immunodeficiency virus [HIV]
- R76.0Raised antibody titer
- R76.81Abnormal rheumatoid factor and anti-citrullinated protein antibody without rheumatoid arthritis
- R76.89Other specified abnormal immunological findings in serum
- R76.9Abnormal immunological finding in serum, unspecified
- S36.00XAUnspecified injury of spleen, initial encounter
- S36.020AMinor contusion of spleen, initial encounter
- S36.021AMajor contusion of spleen, initial encounter
- S36.029AUnspecified contusion of spleen, initial encounter
- S36.030ASuperficial (capsular) laceration of spleen, initial encounter
- S36.031AModerate laceration of spleen, initial encounter
- S36.032AMajor laceration of spleen, initial encounter
- S36.039AUnspecified laceration of spleen, initial encounter
- S36.09XAOther injury of spleen, initial encounter
- T80.82XAComplication of immune effector cellular therapy, initial encounter
- Z94.81Bone marrow transplant status
- Z94.84Stem cells transplant status
