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MS-DRG 135 · MDC 03 · Surgical

MS-DRG 135: Sinus and Mastoid Procedures with CC/MCC

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 135

FY2027 relative weight
2.1790
Higher than 67% of all MS-DRGs
Change vs FY2026
+0.4%
FY2026 weight 2.1700
Geometric mean LOS
3.7 days
Arithmetic mean 5.3 days
MDC
03
Assignment of Diagnosis Codes
Severity level
with CC (complication or comorbidity)
Transfer policy
Not a transfer DRG

TL;DR

MS-DRG 135 is a surgical group in MDC 03 (Assignment of Diagnosis Codes) at the middle severity level of its family. CMS assigns it a FY2027 relative weight of 2.1790 with a geometric mean length of stay of 3.7 days and an arithmetic mean of 5.3. Its weight moved up 0.4% from FY2026 (2.1700). That weight is higher than 67% of all surgical and medical MS-DRGs. Its CC/MCC family (DRG 136) spans weights 1.0620 to 2.1790. The v44 Definitions Manual assigns it through 497 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 135 the FY2027 relative weight is 2.1790 against 2.1700 in FY2026, a rise of 0.41%.

FY2026 versus FY2027 payment factors for MS-DRG 135
MetricFY2026FY2027Change
Relative weight2.17002.1790+0.0090
Geometric mean LOS (days)3.63.7+0.1
Arithmetic mean LOS (days)5.65.3-0.3
Weights shown are the FY2027 final values after the 10% cap on year-over-year reductions where applicable.

CC and MCC family

DRG 135 shares its base definition with 1 other MS-DRG split by severity. The family's weights span 1.0620 to 2.1790, a 2.05× spread, which is the payment effect of documenting qualifying complications and comorbidities.

MS-DRGs in the same base group as DRG 135
DRGTitleFY2027 weightGMLOS
135Sinus and Mastoid Procedures with CC/MCC2.17903.7
136Sinus and Mastoid Procedures without CC/MCC1.06201.3

Grouper logic (v44 Definitions Manual)

Operating Room Procedures: 497 ICD-10 codes drive assignment to this group; the first 12 are shown.

Operating Room Procedures codes assigned to DRG 135 (sample)
ICD-10 codeDescription
095B0ZZDestruction of Right Mastoid Sinus, Open Approach
095B3ZZDestruction of Right Mastoid Sinus, Percutaneous Approach
095B4ZZDestruction of Right Mastoid Sinus, Percutaneous Endoscopic Approach
095B8ZZDestruction of Right Mastoid Sinus, Via Natural or Artificial Opening Endoscopic
095C0ZZDestruction of Left Mastoid Sinus, Open Approach
095C3ZZDestruction of Left Mastoid Sinus, Percutaneous Approach
095C4ZZDestruction of Left Mastoid Sinus, Percutaneous Endoscopic Approach
095C8ZZDestruction of Left Mastoid Sinus, Via Natural or Artificial Opening Endoscopic
095P0ZZDestruction of Accessory Sinus, Open Approach
095P3ZZDestruction of Accessory Sinus, Percutaneous Approach
095P4ZZDestruction of Accessory Sinus, Percutaneous Endoscopic Approach
095P8ZZDestruction of Accessory Sinus, Via Natural or Artificial Opening Endoscopic

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 03 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 135 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 135

What is MS-DRG 135?

MS-DRG 135 is "Sinus and Mastoid Procedures with CC/MCC", a surgical Medicare Severity Diagnosis-Related Group in MDC 03, 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 135?

The FY2027 relative weight is 2.1790 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 2.1700, a change of +0.4%.

What is the average length of stay for DRG 135?

CMS reports a geometric mean length of stay of 3.7 days and an arithmetic mean of 5.3 days for FY2027. The geometric mean is used for transfer-payment calculations.

Which DRGs are in the same CC/MCC family as 135?

DRG 136 (Sinus and Mastoid Procedures without CC/MCC, weight 1.0620). The family's weights range from 1.0620 to 2.1790, so documented complications and comorbidities change payment materially.

What documentation supports the severity level of DRG 135?

DRG 135 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 135?

The v44 Definitions Manual lists 497 operating room procedures codes for this group. Examples from the operating room procedures list: 095B0ZZ (Destruction of Right Mastoid Sinus, Open Approach); 095B3ZZ (Destruction of Right Mastoid Sinus, Percutaneous Approach); 095B4ZZ (Destruction of Right Mastoid Sinus, Percutaneous Endoscopic Approach); 095B8ZZ (Destruction of Right Mastoid Sinus, Via Natural or Artificial Opening Endoscopic).

Is DRG 135 a post-acute transfer DRG?

No. DRG 135 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.