Key facts for DRG 209
- FY2027 relative weight
- 11.5160
- Higher than 99% of all MS-DRGs
- Change vs FY2026
- +1.7%
- FY2026 weight 11.3190
- Geometric mean LOS
- 6.0 days
- Arithmetic mean 9.3 days
- MDC
- 05
- Assignment of Diagnosis Codes
- Severity level
- single severity level
- Transfer policy
- Not a transfer DRG
TL;DR
MS-DRG 209 is a surgical group in MDC 05 (Assignment of Diagnosis Codes) at a single-severity group of its family. CMS assigns it a FY2027 relative weight of 11.5160 with a geometric mean length of stay of 6.0 days and an arithmetic mean of 9.3. Its weight moved up 1.7% from FY2026 (11.3190). That weight is higher than 99% of all surgical and medical MS-DRGs. CMS does not split this group by severity. The v44 Definitions Manual assigns it through 1 operating room procedures codes and 1 or operating room procedures codes and 4 or operating room procedure codes and 64 with one of the following codes.
What changed from FY2026 to FY2027
CMS recalibrates every MS-DRG weight annually from the prior year's MedPAR claims. For DRG 209 the FY2027 relative weight is 11.5160 against 11.3190 in FY2026, a rise of 1.74%.
| Metric | FY2026 | FY2027 | Change |
|---|---|---|---|
| Relative weight | 11.3190 | 11.5160 | +0.1970 |
| Geometric mean LOS (days) | 6.7 | 6.0 | -0.7 |
| Arithmetic mean LOS (days) | 10.6 | 9.3 | -1.3 |
CC and MCC family
DRG 209 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: 1 ICD-10 code drive assignment to this group.
| ICD-10 code | Description |
|---|---|
| 02VX3EZ | Restriction of Thoracic Aorta, Ascending/Arch with Branched or Fenestrated Intraluminal Device, One or Two Arteries, Percutaneous Approach |
Or Operating Room Procedures: 1 ICD-10 code drive assignment to this group.
| ICD-10 code | Description |
|---|---|
| X2RX0N7 | Replacement of Thoracic Aorta, Arch using Branched Synthetic Substitute with Intraluminal Device, Open Approach, New Technology Group 7 |
Or Operating Room Procedure: 4 ICD-10 codes drive assignment to this group.
| ICD-10 code | Description |
|---|---|
| X2VJ3HC | Restriction of Thoracic Aorta, Ascending and Arch using Branched Intraluminal Device, Integrated System with Innominate Branch, Percutaneous Approach, New Technology Group 12 |
| 02VX3EZ | Restriction of Thoracic Aorta, Ascending/Arch with Branched or Fenestrated Intraluminal Device, One or Two Arteries, Percutaneous Approach |
| X2VX0KC | Restriction of Thoracic Aorta, Arch using Branched Intraluminal Device, with Conical Collar, Open Approach, New Technology Group 12 |
| X2VY06B | Restriction of Thoracic Aortic Arch and Descending Thoracic Aorta using Uncovered Intraluminal Device with Support Cuff, Open Approach, New Technology Group 11 |
With One Of The Following: 64 ICD-10 codes drive assignment to this group; the first 12 are shown.
| ICD-10 code | Description |
|---|---|
| 031209K | Bypass Innominate Artery to Left Extracranial Artery with Autologous Venous Tissue, Open Approach |
| 031209Y | Bypass Innominate Artery to Upper Artery with Autologous Venous Tissue, Open Approach |
| 03120AK | Bypass Innominate Artery to Left Extracranial Artery with Autologous Arterial Tissue, Open Approach |
| 03120AY | Bypass Innominate Artery to Upper Artery with Autologous Arterial Tissue, Open Approach |
| 03120JK | Bypass Innominate Artery to Left Extracranial Artery with Synthetic Substitute, Open Approach |
| 03120JY | Bypass Innominate Artery to Upper Artery with Synthetic Substitute, Open Approach |
| 03120KK | Bypass Innominate Artery to Left Extracranial Artery with Nonautologous Tissue Substitute, Open Approach |
| 03120KY | Bypass Innominate Artery to Upper Artery with Nonautologous Tissue Substitute, Open Approach |
| 03120ZK | Bypass Innominate Artery to Left Extracranial Artery, Open Approach |
| 03120ZY | Bypass Innominate Artery to Upper Artery, Open Approach |
| 031409J | Bypass Left Subclavian Artery to Right Extracranial Artery with Autologous Venous Tissue, Open Approach |
| 031409K | Bypass Left Subclavian Artery to Left Extracranial Artery with Autologous Venous Tissue, 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 05 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 209 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 209
What is MS-DRG 209?
MS-DRG 209 is "Complex Aortic Arch Procedures", a surgical Medicare Severity Diagnosis-Related Group in MDC 05, 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 209?
The FY2027 relative weight is 11.5160 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 11.3190, a change of +1.7%.
What is the average length of stay for DRG 209?
CMS reports a geometric mean length of stay of 6.0 days and an arithmetic mean of 9.3 days for FY2027. The geometric mean is used for transfer-payment calculations.
What documentation supports the severity level of DRG 209?
DRG 209 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 209?
The v44 Definitions Manual lists 1 operating room procedures codes and 1 or operating room procedures codes and 4 or operating room procedure codes and 64 with one of the following codes for this group. Examples from the operating room procedures list: 02VX3EZ (Restriction of Thoracic Aorta, Ascending/Arch with Branched or Fenestrated Intraluminal Device, One or Two Arteries, Percutaneous Approach).
Is DRG 209 a post-acute transfer DRG?
No. DRG 209 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.
- IPPS FY2027 Final Rule Table 5 (CMS-1849-F)Version v44 FY2027 · effective 2026-10-01 · file CMS-1849-F Table 5.txtSHA-256 01003dd571c1e2f5…
- IPPS FY2026 Final Rule Table 5 (CMS-1833-F)Version v43 FY2026 · effective 2025-10-01 · file CMS-1833-F Table 5.txtSHA-256 bf8c390d14b3cd3e…
- ICD-10 MS-DRG Definitions Manual v44 (text)Version v44 · effective 2026-10-01 · file fy2027-fr-icd10-ms-drg-definitions-manual-files-v44.zipSHA-256 ae4f6c11727fe91f…
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.