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MS-DRG 115 · MDC 02 · Surgical

MS-DRG 115: Extraocular Procedures Except Orbit

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 115

FY2027 relative weight
1.4790
Higher than 42% of all MS-DRGs
Change vs FY2026
-3.7%
FY2026 weight 1.5350
Geometric mean LOS
3.7 days
Arithmetic mean 4.9 days
MDC
02
Assignment of Diagnosis Codes
Severity level
single severity level
Transfer policy
Not a transfer DRG

TL;DR

MS-DRG 115 is a surgical group in MDC 02 (Assignment of Diagnosis Codes) at a single-severity group of its family. CMS assigns it a FY2027 relative weight of 1.4790 with a geometric mean length of stay of 3.7 days and an arithmetic mean of 4.9. Its weight moved down 3.7% from FY2026 (1.5350). That weight is higher than 42% of all surgical and medical MS-DRGs. CMS does not split this group by severity. The v44 Definitions Manual assigns it through 722 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 115 the FY2027 relative weight is 1.4790 against 1.5350 in FY2026, a fall of 3.65%, which exceeds the 2% threshold worth re-checking in contract models.

FY2026 versus FY2027 payment factors for MS-DRG 115
MetricFY2026FY2027Change
Relative weight1.53501.4790-0.0560
Geometric mean LOS (days)3.83.7-0.1
Arithmetic mean LOS (days)5.34.9-0.4
Weights shown are the FY2027 final values after the 10% cap on year-over-year reductions where applicable.

CC and MCC family

DRG 115 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)

Operating Room Procedures: 722 ICD-10 codes drive assignment to this group; the first 12 are shown.

Operating Room Procedures codes assigned to DRG 115 (sample)
ICD-10 codeDescription
039S0ZXDrainage of Right Temporal Artery, Open Approach, Diagnostic
039S4ZXDrainage of Right Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic
039T0ZXDrainage of Left Temporal Artery, Open Approach, Diagnostic
039T4ZXDrainage of Left Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic
03BS0ZXExcision of Right Temporal Artery, Open Approach, Diagnostic
03BS3ZXExcision of Right Temporal Artery, Percutaneous Approach, Diagnostic
03BS4ZXExcision of Right Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic
03BT0ZXExcision of Left Temporal Artery, Open Approach, Diagnostic
03BT3ZXExcision of Left Temporal Artery, Percutaneous Approach, Diagnostic
03BT4ZXExcision of Left Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic
081X0J3Bypass Right Lacrimal Duct to Nasal Cavity with Synthetic Substitute, Open Approach
081X0K3Bypass Right Lacrimal Duct to Nasal Cavity with Nonautologous Tissue Substitute, 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 02 with a lower weight. 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 115 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 115

What is MS-DRG 115?

MS-DRG 115 is "Extraocular Procedures Except Orbit", a surgical Medicare Severity Diagnosis-Related Group in MDC 02, 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 115?

The FY2027 relative weight is 1.4790 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 1.5350, a change of -3.7%.

What is the average length of stay for DRG 115?

CMS reports a geometric mean length of stay of 3.7 days and an arithmetic mean of 4.9 days for FY2027. The geometric mean is used for transfer-payment calculations.

What documentation supports the severity level of DRG 115?

DRG 115 has no CC or MCC sibling, so secondary-diagnosis capture does not change the group or its weight. Review effort belongs instead on the principal diagnosis sequencing and the procedure codes that place the stay in this group, and on medical necessity of the inpatient admission itself under the two-midnight benchmark, which is where denials for single-severity groups concentrate.

Which codes group to DRG 115?

The v44 Definitions Manual lists 722 operating room procedures codes for this group. Examples from the operating room procedures list: 039S0ZX (Drainage of Right Temporal Artery, Open Approach, Diagnostic); 039S4ZX (Drainage of Right Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic); 039T0ZX (Drainage of Left Temporal Artery, Open Approach, Diagnostic); 039T4ZX (Drainage of Left Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic).

Is DRG 115 a post-acute transfer DRG?

No. DRG 115 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.