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MS-DRG 239 · MDC 05 · Surgical

MS-DRG 239: Amputation for Circulatory System Disorders Except Upper Limb and Toe 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 239

FY2027 relative weight
5.0010
Higher than 91% of all MS-DRGs
Change vs FY2026
+1.6%
FY2026 weight 4.9220
Geometric mean LOS
11.0 days
Arithmetic mean 13.7 days
MDC
05
Assignment of Diagnosis Codes
Severity level
with MCC (major complication or comorbidity)
Transfer policy
Post-acute transfer DRG

TL;DR

MS-DRG 239 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 5.0010 with a geometric mean length of stay of 11.0 days and an arithmetic mean of 13.7. Its weight moved up 1.6% from FY2026 (4.9220). That weight is higher than 91% of all surgical and medical MS-DRGs. Its CC/MCC family (DRG 240, DRG 241) spans weights 1.4820 to 5.0010. The v44 Definitions Manual assigns it through 41 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 239 the FY2027 relative weight is 5.0010 against 4.9220 in FY2026, a rise of 1.61%.

FY2026 versus FY2027 payment factors for MS-DRG 239
MetricFY2026FY2027Change
Relative weight4.92205.0010+0.0790
Geometric mean LOS (days)11.111.0-0.1
Arithmetic mean LOS (days)13.813.7-0.1
Weights shown are the FY2027 final values after the 10% cap on year-over-year reductions where applicable.

CC and MCC family

DRG 239 shares its base definition with 2 other MS-DRGs split by severity. The family's weights span 1.4820 to 5.0010, a 3.37× spread, which is the payment effect of documenting qualifying complications and comorbidities.

MS-DRGs in the same base group as DRG 239
DRGTitleFY2027 weightGMLOS
239Amputation for Circulatory System Disorders Except Upper Limb and Toe with MCC5.001011.0
240Amputation for Circulatory System Disorders Except Upper Limb and Toe with CC2.94707.3
241Amputation for Circulatory System Disorders Except Upper Limb and Toe without CC/MCC1.48204.3

Grouper logic (v44 Definitions Manual)

Operating Room Procedures: 41 ICD-10 codes drive assignment to this group; the first 12 are shown.

Operating Room Procedures codes assigned to DRG 239 (sample)
ICD-10 codeDescription
0Y620ZZDetachment at Right Hindquarter, Open Approach
0Y630ZZDetachment at Left Hindquarter, Open Approach
0Y640ZZDetachment at Bilateral Hindquarter, Open Approach
0Y670ZZDetachment at Right Femoral Region, Open Approach
0Y680ZZDetachment at Left Femoral Region, Open Approach
0Y6C0Z1Detachment at Right Upper Leg, High, Open Approach
0Y6C0Z2Detachment at Right Upper Leg, Mid, Open Approach
0Y6C0Z3Detachment at Right Upper Leg, Low, Open Approach
0Y6D0Z1Detachment at Left Upper Leg, High, Open Approach
0Y6D0Z2Detachment at Left Upper Leg, Mid, Open Approach
0Y6D0Z3Detachment at Left Upper Leg, Low, Open Approach
0Y6F0ZZDetachment at Right Knee Region, 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 239 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 239

What is MS-DRG 239?

MS-DRG 239 is "Amputation for Circulatory System Disorders Except Upper Limb and Toe 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 239?

The FY2027 relative weight is 5.0010 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 4.9220, a change of +1.6%.

What is the average length of stay for DRG 239?

CMS reports a geometric mean length of stay of 11.0 days and an arithmetic mean of 13.7 days for FY2027. The geometric mean is used for transfer-payment calculations.

Which DRGs are in the same CC/MCC family as 239?

DRG 240 (Amputation for Circulatory System Disorders Except Upper Limb and Toe with CC, weight 2.9470); DRG 241 (Amputation for Circulatory System Disorders Except Upper Limb and Toe without CC/MCC, weight 1.4820). The family's weights range from 1.4820 to 5.0010, so documented complications and comorbidities change payment materially.

What documentation supports the severity level of DRG 239?

DRG 239 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 239?

The v44 Definitions Manual lists 41 operating room procedures codes for this group. Examples from the operating room procedures list: 0Y620ZZ (Detachment at Right Hindquarter, Open Approach); 0Y630ZZ (Detachment at Left Hindquarter, Open Approach); 0Y640ZZ (Detachment at Bilateral Hindquarter, Open Approach); 0Y670ZZ (Detachment at Right Femoral Region, Open Approach).

Is DRG 239 a post-acute transfer DRG?

Yes. CMS flags DRG 239 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.