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MS-DRG 149 · MDC 03 · Medical

MS-DRG 149: Dysequilibrium

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 149

FY2027 relative weight
0.7530
Higher than 8% of all MS-DRGs
Change vs FY2026
+0.1%
FY2026 weight 0.7520
Geometric mean LOS
1.9 days
Arithmetic mean 2.4 days
MDC
03
Assignment of Diagnosis Codes
Severity level
single severity level
Transfer policy
Not a transfer DRG

TL;DR

MS-DRG 149 is a medical group in MDC 03 (Assignment of Diagnosis Codes) at a single-severity group of its family. CMS assigns it a FY2027 relative weight of 0.7530 with a geometric mean length of stay of 1.9 days and an arithmetic mean of 2.4. Its weight moved up 0.1% from FY2026 (0.7520). That weight is higher than 8% of all medical and surgical MS-DRGs. CMS does not split this group by severity. The v44 Definitions Manual assigns it through 51 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 149 the FY2027 relative weight is 0.7530 against 0.7520 in FY2026, a rise of 0.13%.

FY2026 versus FY2027 payment factors for MS-DRG 149
MetricFY2026FY2027Change
Relative weight0.75200.7530+0.0010
Geometric mean LOS (days)1.91.9+0.0
Arithmetic mean LOS (days)2.42.4+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 149 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: 51 ICD-10 codes drive assignment to this group; the first 12 are shown.

Principal Diagnosis codes assigned to DRG 149 (sample)
ICD-10 codeDescription
H8101Meniere's disease, right ear
H8102Meniere's disease, left ear
H8103Meniere's disease, bilateral
H8109Meniere's disease, unspecified ear
H8110Benign paroxysmal vertigo, unspecified ear
H8111Benign paroxysmal vertigo, right ear
H8112Benign paroxysmal vertigo, left ear
H8113Benign paroxysmal vertigo, bilateral
H8120Vestibular neuronitis, unspecified ear
H8121Vestibular neuronitis, right ear
H8122Vestibular neuronitis, left ear
H8123Vestibular neuronitis, bilateral

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 149 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 149

What is MS-DRG 149?

MS-DRG 149 is "Dysequilibrium", a medical 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 149?

The FY2027 relative weight is 0.7530 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 0.7520, a change of +0.1%.

What is the average length of stay for DRG 149?

CMS reports a geometric mean length of stay of 1.9 days and an arithmetic mean of 2.4 days for FY2027. The geometric mean is used for transfer-payment calculations.

What documentation supports the severity level of DRG 149?

DRG 149 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 149?

The v44 Definitions Manual lists 51 principal diagnosis codes for this group. Examples from the principal diagnosis list: H8101 (Meniere's disease, right ear); H8102 (Meniere's disease, left ear); H8103 (Meniere's disease, bilateral); H8109 (Meniere's disease, unspecified ear).

Is DRG 149 a post-acute transfer DRG?

No. DRG 149 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.