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MS-DRG 005 · MDC PRE · Surgical

MS-DRG 005: Liver Transplant with MCC or Intestinal Transplant

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Data effective
Data currency: IPPS Table 5 FY2027 final rule (effective October 1, 2026); Definitions Manual v44 (effective October 1, 2026). Next CMS release: April 1, 2027 (v44.1 mid-year update), then the FY2028 final rule in August 2027.

Key facts for DRG 005

FY2027 relative weight
10.4740
Higher than 99% of all MS-DRGs
Change vs FY2026
+1.6%
FY2026 weight 10.3100
Geometric mean LOS
13.1 days
Arithmetic mean 18.2 days
MDC
PRE
Pre-MDC (transplants, tracheostomy, ECMO)
Severity level
with MCC (major complication or comorbidity)
Transfer policy
Not a transfer DRG

TL;DR

MS-DRG 005 is a surgical group in MDC PRE (Pre-MDC (transplants, tracheostomy, ECMO)) at the highest-severity level of its family. CMS assigns it a FY2027 relative weight of 10.4740 with a geometric mean length of stay of 13.1 days and an arithmetic mean of 18.2. Its weight moved up 1.6% from FY2026 (10.3100). That weight is higher than 99% of all surgical and medical MS-DRGs. Its CC/MCC family (DRG 006) spans weights 4.5750 to 10.4740. The v44 Definitions Manual assigns it through 9 operating room procedures codes.

What changed from FY2026 to FY2027

CMS recalibrates every MS-DRG weight annually from the prior year's MedPAR claims. For DRG 005 the FY2027 relative weight is 10.4740 against 10.3100 in FY2026, a rise of 1.59%.

FY2026 versus FY2027 payment factors for MS-DRG 005
MetricFY2026FY2027Change
Relative weight10.310010.4740+0.1640
Geometric mean LOS (days)14.013.1-0.9
Arithmetic mean LOS (days)19.118.2-0.9
Weights shown are the FY2027 final values after the 10% cap on year-over-year reductions where applicable.

CC and MCC family

DRG 005 shares its base definition with 1 other MS-DRG split by severity. The family's weights span 4.5750 to 10.4740, a 2.29× spread, which is the payment effect of documenting qualifying complications and comorbidities.

MS-DRGs in the same base group as DRG 005
DRGTitleFY2027 weightGMLOS
005Liver Transplant with MCC or Intestinal Transplant10.474013.1
006Liver Transplant without MCC4.57507.1

Grouper logic (v44 Definitions Manual)

Operating Room Procedures: 9 ICD-10 codes drive assignment to this group.

Operating Room Procedures codes assigned to DRG 005 (sample)
ICD-10 codeDescription
0FY00Z0Transplantation of Liver, Allogeneic, Open Approach
0FY00Z1Transplantation of Liver, Syngeneic, Open Approach
0FY00Z2Transplantation of Liver, Zooplastic, Open Approach
0DY80Z0Transplantation of Small Intestine, Allogeneic, Open Approach
0DY80Z1Transplantation of Small Intestine, Syngeneic, Open Approach
0DY80Z2Transplantation of Small Intestine, Zooplastic, Open Approach
0DYE0Z0Transplantation of Large Intestine, Allogeneic, Open Approach
0DYE0Z1Transplantation of Large Intestine, Syngeneic, Open Approach
0DYE0Z2Transplantation of Large Intestine, Zooplastic, Open Approach

Documentation and denial exposure

As a surgical DRG, assignment depends on a qualifying operating-room procedure being coded from the operative report; a missing or non-OR procedure code drops the stay into a medical DRG in MDC PRE with a lower weight. Because this family splits by severity, auditors target CC and MCC capture: each secondary diagnosis must be documented as present, monitored, evaluated or treated during the stay to survive a DRG-validation review. Typical inpatient denial codes for this group: CARC 16 (claim lacks information needed to group the stay), CARC 50 (the admission or procedure is judged not medically necessary), CARC 97 (a service is bundled into the DRG payment).

How QuickIntell uses DRG 005 data

QuickCode groups inpatient encounters against the current v44 logic, flags CC and MCC candidates that lack supporting documentation, and shows the weight difference across the family before the claim drops. QuickScribe captures the attending's language that supports severity, and QuickRCM works DRG-validation denials with the grouper evidence attached.

Frequently asked questions — DRG 005

What is MS-DRG 005?

MS-DRG 005 is "Liver Transplant with MCC or Intestinal Transplant", a surgical Medicare Severity Diagnosis-Related Group in MDC PRE, Pre-MDC (transplants, tracheostomy, ECMO). Medicare pays inpatient stays grouped here at the hospital's base rate multiplied by the DRG relative weight.

What is the FY2027 relative weight for DRG 005?

The FY2027 relative weight is 10.4740 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 10.3100, a change of +1.6%.

What is the average length of stay for DRG 005?

CMS reports a geometric mean length of stay of 13.1 days and an arithmetic mean of 18.2 days for FY2027. The geometric mean is used for transfer-payment calculations.

Which DRGs are in the same CC/MCC family as 005?

DRG 006 (Liver Transplant without MCC, weight 4.5750). The family's weights range from 4.5750 to 10.4740, so documented complications and comorbidities change payment materially.

What documentation supports the severity level of DRG 005?

DRG 005 requires at least one secondary diagnosis on the CMS Major Complication or Comorbidity list, documented as present and clinically addressed during the stay (monitored, evaluated, treated or extending the stay). Conditions such as acute respiratory failure, severe sepsis or acute kidney injury with specified cause qualify only when the attending's note states the diagnosis itself, not just the lab values. Recovery auditors downgrade this group to the CC or base level when the MCC rests on an unconfirmed query or a resolved historical condition, so the query response and the discharge summary must agree.

Which codes group to DRG 005?

The v44 Definitions Manual lists 9 operating room procedures codes for this group. Examples from the operating room procedures list: 0FY00Z0 (Transplantation of Liver, Allogeneic, Open Approach); 0FY00Z1 (Transplantation of Liver, Syngeneic, Open Approach); 0FY00Z2 (Transplantation of Liver, Zooplastic, Open Approach); 0DY80Z0 (Transplantation of Small Intestine, Allogeneic, Open Approach).

Is DRG 005 a post-acute transfer DRG?

No. DRG 005 is not on the FY2027 post-acute care transfer list, so the transfer per-diem policy does not apply to it.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-01. Verify against the primary file before billing or contracting decisions.

Disclaimer

This page is an operational reference compiled from the CMS IPPS FY2027 final rule (Table 5) and the v44 ICD-10 MS-DRG Definitions Manual. Relative weights are national factors; actual payment depends on each hospital's wage-adjusted base rate, add-ons, outliers and transfer adjustments. Nothing here is legal, clinical or billing advice; verify grouping against your encoder and the published CMS files.