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MS-DRG 065 · MDC 01 · Medical

MS-DRG 065: Intracranial Hemorrhage or Cerebral Infarction with CC or tPA in 24 Hours

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 065

FY2027 relative weight
0.9910
Higher than 21% of all MS-DRGs
Change vs FY2026
-1.9%
FY2026 weight 1.0100
Geometric mean LOS
2.8 days
Arithmetic mean 3.5 days
MDC
01
Assignment of Diagnosis Codes
Severity level
with CC (complication or comorbidity)
Transfer policy
Post-acute transfer DRG

TL;DR

MS-DRG 065 is a medical group in MDC 01 (Assignment of Diagnosis Codes) at the middle severity level of its family. CMS assigns it a FY2027 relative weight of 0.9910 with a geometric mean length of stay of 2.8 days and an arithmetic mean of 3.5. Its weight moved down 1.9% from FY2026 (1.0100). That weight is higher than 21% of all medical and surgical MS-DRGs. CMS does not split this group by severity. The v44 Definitions Manual assigns it through 124 principal diagnosis codes and 1 secondary diagnosis codes.

What changed from FY2026 to FY2027

CMS recalibrates every MS-DRG weight annually from the prior year's MedPAR claims. For DRG 065 the FY2027 relative weight is 0.9910 against 1.0100 in FY2026, a fall of 1.88%.

FY2026 versus FY2027 payment factors for MS-DRG 065
MetricFY2026FY2027Change
Relative weight1.01000.9910-0.0190
Geometric mean LOS (days)2.82.8+0.0
Arithmetic mean LOS (days)3.63.5-0.1
Weights shown are the FY2027 final values after the 10% cap on year-over-year reductions where applicable.

CC and MCC family

DRG 065 stands alone: CMS does not split this base group by CC or MCC severity, so complication documentation does not move the assignment, although it still affects quality and risk-adjustment reporting.

Grouper logic (v44 Definitions Manual)

Principal Diagnosis: 124 ICD-10 codes drive assignment to this group; the first 12 are shown.

Principal Diagnosis codes assigned to DRG 065 (sample)
ICD-10 codeDescription
I6000Nontraumatic subarachnoid hemorrhage from unspecified carotid siphon and bifurcation
I6001Nontraumatic subarachnoid hemorrhage from right carotid siphon and bifurcation
I6002Nontraumatic subarachnoid hemorrhage from left carotid siphon and bifurcation
I6010Nontraumatic subarachnoid hemorrhage from unspecified middle cerebral artery
I6011Nontraumatic subarachnoid hemorrhage from right middle cerebral artery
I6012Nontraumatic subarachnoid hemorrhage from left middle cerebral artery
I602Nontraumatic subarachnoid hemorrhage from anterior communicating artery
I6030Nontraumatic subarachnoid hemorrhage from unspecified posterior communicating artery
I6031Nontraumatic subarachnoid hemorrhage from right posterior communicating artery
I6032Nontraumatic subarachnoid hemorrhage from left posterior communicating artery
I604Nontraumatic subarachnoid hemorrhage from basilar artery
I6050Nontraumatic subarachnoid hemorrhage from unspecified vertebral artery

Secondary Diagnosis: 1 ICD-10 code drive assignment to this group.

Secondary Diagnosis codes assigned to DRG 065 (sample)
ICD-10 codeDescription
Z9282Status post administration of tPA (rtPA) in a different facility within the last 24 hours prior to admission to current facility

Documentation and denial exposure

As a medical DRG, assignment depends on the principal diagnosis sequenced from the attending's documentation; a secondary condition sequenced first, or a symptom code in place of the confirmed diagnosis, changes the MDC or the DRG. Because this family has no severity split, review risk concentrates on medical-necessity of the admission itself and on the two-midnight benchmark. 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 065 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.

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Frequently asked questions — DRG 065

What is MS-DRG 065?

MS-DRG 065 is "Intracranial Hemorrhage or Cerebral Infarction with CC or tPA in 24 Hours", a medical Medicare Severity Diagnosis-Related Group in MDC 01, Assignment of Diagnosis Codes. 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 065?

The FY2027 relative weight is 0.9910 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 1.0100, a change of -1.9%.

What is the average length of stay for DRG 065?

CMS reports a geometric mean length of stay of 2.8 days and an arithmetic mean of 3.5 days for FY2027. The geometric mean is used for transfer-payment calculations.

What documentation supports the severity level of DRG 065?

DRG 065 is reached when the stay carries a secondary diagnosis from the CMS Complication or Comorbidity list but none from the MCC list. Common CC captures include chronic kidney disease stage 3 and above, uncontrolled diabetes with manifestations, malnutrition of specified severity and heart failure of a stated type. Each must be documented by the treating clinician and show clinical relevance in the record; a condition listed only in the problem list without assessment is the most frequent reason a CC is removed on audit and the stay drops to the base DRG.

Which codes group to DRG 065?

The v44 Definitions Manual lists 124 principal diagnosis codes and 1 secondary diagnosis codes for this group. Examples from the principal diagnosis list: I6000 (Nontraumatic subarachnoid hemorrhage from unspecified carotid siphon and bifurcation); I6001 (Nontraumatic subarachnoid hemorrhage from right carotid siphon and bifurcation); I6002 (Nontraumatic subarachnoid hemorrhage from left carotid siphon and bifurcation); I6010 (Nontraumatic subarachnoid hemorrhage from unspecified middle cerebral artery).

Is DRG 065 a post-acute transfer DRG?

Yes. CMS flags DRG 065 under the post-acute care transfer policy, so a discharge to a qualifying post-acute setting before the geometric mean length of stay is paid a per-diem amount rather than the full DRG payment.

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.