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MS-DRG 189 · MDC 04 · Medical

MS-DRG 189: Pulmonary Edema and Respiratory Failure

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 189

FY2027 relative weight
1.2110
Higher than 32% of all MS-DRGs
Change vs FY2026
-1.9%
FY2026 weight 1.2350
Geometric mean LOS
3.4 days
Arithmetic mean 4.6 days
MDC
04
Assignment of Diagnosis Codes
Severity level
single severity level
Transfer policy
Not a transfer DRG

TL;DR

MS-DRG 189 is a medical group in MDC 04 (Assignment of Diagnosis Codes) at a single-severity group of its family. CMS assigns it a FY2027 relative weight of 1.2110 with a geometric mean length of stay of 3.4 days and an arithmetic mean of 4.6. Its weight moved down 1.9% from FY2026 (1.2350). That weight is higher than 32% of all medical and surgical MS-DRGs. CMS does not split this group by severity. The v44 Definitions Manual assigns it through 22 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 189 the FY2027 relative weight is 1.2110 against 1.2350 in FY2026, a fall of 1.94%.

FY2026 versus FY2027 payment factors for MS-DRG 189
MetricFY2026FY2027Change
Relative weight1.23501.2110-0.0240
Geometric mean LOS (days)3.53.4-0.1
Arithmetic mean LOS (days)4.74.6-0.1
Weights shown are the FY2027 final values after the 10% cap on year-over-year reductions where applicable.

CC and MCC family

DRG 189 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: 22 ICD-10 codes drive assignment to this group; the first 12 are shown.

Principal Diagnosis codes assigned to DRG 189 (sample)
ICD-10 codeDescription
J182Hypostatic pneumonia, unspecified organism
J681Pulmonary edema due to chemicals, gases, fumes and vapors
J80Acute respiratory distress syndrome
J810Acute pulmonary edema
J811Chronic pulmonary edema
J951Acute pulmonary insufficiency following thoracic surgery
J952Acute pulmonary insufficiency following nonthoracic surgery
J953Chronic pulmonary insufficiency following surgery
J95821Acute postprocedural respiratory failure
J95822Acute and chronic postprocedural respiratory failure
J9600Acute respiratory failure, unspecified whether with hypoxia or hypercapnia
J9601Acute respiratory failure with hypoxia

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 189 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 189

What is MS-DRG 189?

MS-DRG 189 is "Pulmonary Edema and Respiratory Failure", 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 189?

The FY2027 relative weight is 1.2110 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 1.2350, a change of -1.9%.

What is the average length of stay for DRG 189?

CMS reports a geometric mean length of stay of 3.4 days and an arithmetic mean of 4.6 days for FY2027. The geometric mean is used for transfer-payment calculations.

What documentation supports the severity level of DRG 189?

DRG 189 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 189?

The v44 Definitions Manual lists 22 principal diagnosis codes for this group. Examples from the principal diagnosis list: J182 (Hypostatic pneumonia, unspecified organism); J681 (Pulmonary edema due to chemicals, gases, fumes and vapors); J80 (Acute respiratory distress syndrome); J810 (Acute pulmonary edema).

Is DRG 189 a post-acute transfer DRG?

No. DRG 189 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.