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MS-DRG 231 · MDC 05 · Surgical

MS-DRG 231: Coronary Bypass with PTCA with 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 231

FY2027 relative weight
8.7750
Higher than 98% of all MS-DRGs
Change vs FY2026
+4.1%
FY2026 weight 8.4300
Geometric mean LOS
10.3 days
Arithmetic mean 11.9 days
MDC
05
Assignment of Diagnosis Codes
Severity level
with MCC (major complication or comorbidity)
Transfer policy
Not a transfer DRG

TL;DR

MS-DRG 231 is a surgical group in MDC 05 (Assignment of Diagnosis Codes) at the highest-severity level of its family. CMS assigns it a FY2027 relative weight of 8.7750 with a geometric mean length of stay of 10.3 days and an arithmetic mean of 11.9. Its weight moved up 4.1% from FY2026 (8.4300). That weight is higher than 98% of all surgical and medical MS-DRGs. Its CC/MCC family (DRG 232) spans weights 6.2270 to 8.7750. The v44 Definitions Manual assigns it through 488 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 231 the FY2027 relative weight is 8.7750 against 8.4300 in FY2026, a rise of 4.09%, which exceeds the 2% threshold worth re-checking in contract models.

FY2026 versus FY2027 payment factors for MS-DRG 231
MetricFY2026FY2027Change
Relative weight8.43008.7750+0.3450
Geometric mean LOS (days)10.410.3-0.1
Arithmetic mean LOS (days)12.011.9-0.1
Weights shown are the FY2027 final values after the 10% cap on year-over-year reductions where applicable.

CC and MCC family

DRG 231 shares its base definition with 1 other MS-DRG split by severity. The family's weights span 6.2270 to 8.7750, a 1.41× spread, which is the payment effect of documenting qualifying complications and comorbidities.

MS-DRGs in the same base group as DRG 231
DRGTitleFY2027 weightGMLOS
231Coronary Bypass with PTCA with MCC8.775010.3
232Coronary Bypass with PTCA without MCC6.22707.7

Grouper logic (v44 Definitions Manual)

Operating Room Procedures: 488 ICD-10 codes drive assignment to this group; the first 12 are shown.

Operating Room Procedures codes assigned to DRG 231 (sample)
ICD-10 codeDescription
0210083Bypass Coronary Artery, One Artery from Coronary Artery with Zooplastic Tissue, Open Approach
0210088Bypass Coronary Artery, One Artery from Right Internal Mammary with Zooplastic Tissue, Open Approach
0210089Bypass Coronary Artery, One Artery from Left Internal Mammary with Zooplastic Tissue, Open Approach
021008CBypass Coronary Artery, One Artery from Thoracic Artery with Zooplastic Tissue, Open Approach
021008FBypass Coronary Artery, One Artery from Abdominal Artery with Zooplastic Tissue, Open Approach
021008WBypass Coronary Artery, One Artery from Aorta with Zooplastic Tissue, Open Approach
0210093Bypass Coronary Artery, One Artery from Coronary Artery with Autologous Venous Tissue, Open Approach
0210098Bypass Coronary Artery, One Artery from Right Internal Mammary with Autologous Venous Tissue, Open Approach
0210099Bypass Coronary Artery, One Artery from Left Internal Mammary with Autologous Venous Tissue, Open Approach
021009CBypass Coronary Artery, One Artery from Thoracic Artery with Autologous Venous Tissue, Open Approach
021009FBypass Coronary Artery, One Artery from Abdominal Artery with Autologous Venous Tissue, Open Approach
021009WBypass Coronary Artery, One Artery from Aorta 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 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 231 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 231

What is MS-DRG 231?

MS-DRG 231 is "Coronary Bypass with PTCA with MCC", 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 231?

The FY2027 relative weight is 8.7750 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 8.4300, a change of +4.1%.

What is the average length of stay for DRG 231?

CMS reports a geometric mean length of stay of 10.3 days and an arithmetic mean of 11.9 days for FY2027. The geometric mean is used for transfer-payment calculations.

Which DRGs are in the same CC/MCC family as 231?

DRG 232 (Coronary Bypass with PTCA without MCC, weight 6.2270). The family's weights range from 6.2270 to 8.7750, so documented complications and comorbidities change payment materially.

What documentation supports the severity level of DRG 231?

DRG 231 requires at least one secondary diagnosis on the CMS Major Complication or Comorbidity list, documented as present and clinically addressed during the stay (monitored, evaluated, treated or extending the stay). Conditions such as acute respiratory failure, severe sepsis or acute kidney injury with specified cause qualify only when the attending's note states the diagnosis itself, not just the lab values. Recovery auditors downgrade this group to the CC or base level when the MCC rests on an unconfirmed query or a resolved historical condition, so the query response and the discharge summary must agree.

Which codes group to DRG 231?

The v44 Definitions Manual lists 488 operating room procedures codes for this group. Examples from the operating room procedures list: 0210083 (Bypass Coronary Artery, One Artery from Coronary Artery with Zooplastic Tissue, Open Approach); 0210088 (Bypass Coronary Artery, One Artery from Right Internal Mammary with Zooplastic Tissue, Open Approach); 0210089 (Bypass Coronary Artery, One Artery from Left Internal Mammary with Zooplastic Tissue, Open Approach); 021008C (Bypass Coronary Artery, One Artery from Thoracic Artery with Zooplastic Tissue, Open Approach).

Is DRG 231 a post-acute transfer DRG?

No. DRG 231 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.