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MS-DRG 095 · MDC 01 · Medical

MS-DRG 095: Bacterial and Tuberculous Infections of Nervous System with CC

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 095

FY2027 relative weight
2.3500
Higher than 70% of all MS-DRGs
Change vs FY2026
-8.9%
FY2026 weight 2.5790
Geometric mean LOS
5.5 days
Arithmetic mean 6.8 days
MDC
01
Assignment of Diagnosis Codes
Severity level
with CC (complication or comorbidity)
Transfer policy
Not a transfer DRG

TL;DR

MS-DRG 095 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 2.3500 with a geometric mean length of stay of 5.5 days and an arithmetic mean of 6.8. Its weight moved down 8.9% from FY2026 (2.5790). That weight is higher than 70% of all medical and surgical MS-DRGs. Its CC/MCC family (DRG 094, DRG 096) spans weights 2.3210 to 3.4110. The v44 Definitions Manual assigns it through 23 principal diagnosis codes.

What changed from FY2026 to FY2027

CMS recalibrates every MS-DRG weight annually from the prior year's MedPAR claims. For DRG 095 the FY2027 relative weight is 2.3500 against 2.5790 in FY2026, a fall of 8.88%, which exceeds the 2% threshold worth re-checking in contract models.

FY2026 versus FY2027 payment factors for MS-DRG 095
MetricFY2026FY2027Change
Relative weight2.57902.3500-0.2290
Geometric mean LOS (days)5.65.5-0.1
Arithmetic mean LOS (days)6.86.8+0.0
Weights shown are the FY2027 final values after the 10% cap on year-over-year reductions where applicable.

CC and MCC family

DRG 095 shares its base definition with 2 other MS-DRGs split by severity. The family's weights span 2.3210 to 3.4110, a 1.47× spread, which is the payment effect of documenting qualifying complications and comorbidities.

MS-DRGs in the same base group as DRG 095
DRGTitleFY2027 weightGMLOS
094Bacterial and Tuberculous Infections of Nervous System with MCC3.41107.7
095Bacterial and Tuberculous Infections of Nervous System with CC2.35005.5
096Bacterial and Tuberculous Infections of Nervous System without CC/MCC2.32104.5

Grouper logic (v44 Definitions Manual)

Principal Diagnosis: 23 ICD-10 codes drive assignment to this group; the first 12 are shown.

Principal Diagnosis codes assigned to DRG 095 (sample)
ICD-10 codeDescription
A0221Salmonella meningitis
A170Tuberculous meningitis
A171Meningeal tuberculoma
A1781Tuberculoma of brain and spinal cord
A1782Tuberculous meningoencephalitis
A1783Tuberculous neuritis
A1789Other tuberculosis of nervous system
A390Meningococcal meningitis
A3981Meningococcal encephalitis
A5481Gonococcal meningitis
G000Hemophilus meningitis
G001Pneumococcal meningitis

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 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 095 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 095

What is MS-DRG 095?

MS-DRG 095 is "Bacterial and Tuberculous Infections of Nervous System with CC", 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 095?

The FY2027 relative weight is 2.3500 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 2.5790, a change of -8.9%.

What is the average length of stay for DRG 095?

CMS reports a geometric mean length of stay of 5.5 days and an arithmetic mean of 6.8 days for FY2027. The geometric mean is used for transfer-payment calculations.

Which DRGs are in the same CC/MCC family as 095?

DRG 094 (Bacterial and Tuberculous Infections of Nervous System with MCC, weight 3.4110); DRG 096 (Bacterial and Tuberculous Infections of Nervous System without CC/MCC, weight 2.3210). The family's weights range from 2.3210 to 3.4110, so documented complications and comorbidities change payment materially.

What documentation supports the severity level of DRG 095?

DRG 095 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 095?

The v44 Definitions Manual lists 23 principal diagnosis codes for this group. Examples from the principal diagnosis list: A0221 (Salmonella meningitis); A170 (Tuberculous meningitis); A171 (Meningeal tuberculoma); A1781 (Tuberculoma of brain and spinal cord).

Is DRG 095 a post-acute transfer DRG?

No. DRG 095 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.