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MS-DRG 176 · MDC 04 · Medical

MS-DRG 176: Pulmonary Embolism without 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 176

FY2027 relative weight
0.8060
Higher than 11% of all MS-DRGs
Change vs FY2026
+0.1%
FY2026 weight 0.8050
Geometric mean LOS
2.4 days
Arithmetic mean 3.0 days
MDC
04
Assignment of Diagnosis Codes
Severity level
without MCC
Transfer policy
Post-acute transfer DRG

TL;DR

MS-DRG 176 is a medical group in MDC 04 (Assignment of Diagnosis Codes) at the base severity level of its family. CMS assigns it a FY2027 relative weight of 0.8060 with a geometric mean length of stay of 2.4 days and an arithmetic mean of 3.0. Its weight moved up 0.1% from FY2026 (0.8050). That weight is higher than 11% of all medical and surgical MS-DRGs. Its CC/MCC family (DRG 175) spans weights 0.8060 to 1.3650. The v44 Definitions Manual assigns it through 11 principal diagnosis codes and 5 acute cor pulmonale codes.

What changed from FY2026 to FY2027

CMS recalibrates every MS-DRG weight annually from the prior year's MedPAR claims. For DRG 176 the FY2027 relative weight is 0.8060 against 0.8050 in FY2026, a rise of 0.12%.

FY2026 versus FY2027 payment factors for MS-DRG 176
MetricFY2026FY2027Change
Relative weight0.80500.8060+0.0010
Geometric mean LOS (days)2.42.4+0.0
Arithmetic mean LOS (days)3.03.0+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 176 shares its base definition with 1 other MS-DRG split by severity. The family's weights span 0.8060 to 1.3650, a 1.69× spread, which is the payment effect of documenting qualifying complications and comorbidities.

MS-DRGs in the same base group as DRG 176
DRGTitleFY2027 weightGMLOS
175Pulmonary Embolism with MCC or Acute Cor Pulmonale1.36503.7
176Pulmonary Embolism without MCC0.80602.4

Grouper logic (v44 Definitions Manual)

Principal Diagnosis: 11 ICD-10 codes drive assignment to this group.

Principal Diagnosis codes assigned to DRG 176 (sample)
ICD-10 codeDescription
I2690Septic pulmonary embolism without acute cor pulmonale
I2692Saddle embolus of pulmonary artery without acute cor pulmonale
I2693Single subsegmental thrombotic pulmonary embolism without acute cor pulmonale
I2694Multiple subsegmental thrombotic pulmonary emboli without acute cor pulmonale
I2695Cement embolism of pulmonary artery without acute cor pulmonale
I2696Fat embolism of pulmonary artery without acute cor pulmonale
I2699Other pulmonary embolism without acute cor pulmonale
I2782Chronic pulmonary embolism
T790XXAAir embolism (traumatic), initial encounter
T791XXAFat embolism (traumatic), initial encounter
T800XXAAir embolism following infusion, transfusion and therapeutic injection, initial encounter

Acute Cor Pulmonale: 5 ICD-10 codes drive assignment to this group.

Acute Cor Pulmonale codes assigned to DRG 176 (sample)
ICD-10 codeDescription
I2601Septic pulmonary embolism with acute cor pulmonale
I2602Saddle embolus of pulmonary artery with acute cor pulmonale
I2603Cement embolism of pulmonary artery with acute cor pulmonale
I2604Fat embolism of pulmonary artery with acute cor pulmonale
I2609Other pulmonary embolism with acute cor pulmonale

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 176 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 176

What is MS-DRG 176?

MS-DRG 176 is "Pulmonary Embolism without MCC", a medical Medicare Severity Diagnosis-Related Group in MDC 04, 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 176?

The FY2027 relative weight is 0.8060 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 0.8050, a change of +0.1%.

What is the average length of stay for DRG 176?

CMS reports a geometric mean length of stay of 2.4 days and an arithmetic mean of 3.0 days for FY2027. The geometric mean is used for transfer-payment calculations.

Which DRGs are in the same CC/MCC family as 176?

DRG 175 (Pulmonary Embolism with MCC or Acute Cor Pulmonale, weight 1.3650). The family's weights range from 0.8060 to 1.3650, so documented complications and comorbidities change payment materially.

What documentation supports the severity level of DRG 176?

DRG 176 is the base-severity assignment: no secondary diagnosis on the CC or MCC lists was coded, or the only ones present are excluded for this principal diagnosis. Revenue-integrity review here looks for undercapture, meaning conditions treated during the stay (electrolyte disorders, specified anemia, acute blood loss, pressure injuries present on admission) that were never documented to the specificity the lists require. A compliant query to the attending, not a coder assumption, is the only way to move a stay to the CC or MCC sibling.

Which codes group to DRG 176?

The v44 Definitions Manual lists 11 principal diagnosis codes and 5 acute cor pulmonale codes for this group. Examples from the principal diagnosis list: I2690 (Septic pulmonary embolism without acute cor pulmonale); I2692 (Saddle embolus of pulmonary artery without acute cor pulmonale); I2693 (Single subsegmental thrombotic pulmonary embolism without acute cor pulmonale); I2694 (Multiple subsegmental thrombotic pulmonary emboli without acute cor pulmonale).

Is DRG 176 a post-acute transfer DRG?

Yes. CMS flags DRG 176 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.