Skip to main content
MS-DRG 265 · MDC 05 · Surgical

MS-DRG 265: AICD Lead Procedures

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 265

FY2027 relative weight
3.2560
Higher than 80% of all MS-DRGs
Change vs FY2026
-10.0%
FY2026 weight 3.6180
Geometric mean LOS
4.1 days
Arithmetic mean 5.6 days
MDC
05
Assignment of Diagnosis Codes
Severity level
single severity level
Transfer policy
Not a transfer DRG

TL;DR

MS-DRG 265 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 3.2560 with a geometric mean length of stay of 4.1 days and an arithmetic mean of 5.6. Its weight moved down 10.0% from FY2026 (3.6180). That weight is higher than 80% of all surgical and medical MS-DRGs. CMS does not split this group by severity. The v44 Definitions Manual assigns it through 36 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 265 the FY2027 relative weight is 3.2560 against 3.6180 in FY2026, a fall of 10.01%, which exceeds the 2% threshold worth re-checking in contract models.

FY2026 versus FY2027 payment factors for MS-DRG 265
MetricFY2026FY2027Change
Relative weight3.61803.2560-0.3620
Geometric mean LOS (days)4.44.1-0.3
Arithmetic mean LOS (days)6.35.6-0.7
Weights shown are the FY2027 final values after the 10% cap on year-over-year reductions where applicable.

CC and MCC family

DRG 265 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: 36 ICD-10 codes drive assignment to this group; the first 12 are shown.

Operating Room Procedures codes assigned to DRG 265 (sample)
ICD-10 codeDescription
02H40KZInsertion of Defibrillator Lead into Coronary Vein, Open Approach
02H43KZInsertion of Defibrillator Lead into Coronary Vein, Percutaneous Approach
02H44KZInsertion of Defibrillator Lead into Coronary Vein, Percutaneous Endoscopic Approach
02H60KZInsertion of Defibrillator Lead into Right Atrium, Open Approach
02H63KZInsertion of Defibrillator Lead into Right Atrium, Percutaneous Approach
02H64KZInsertion of Defibrillator Lead into Right Atrium, Percutaneous Endoscopic Approach
02H70KZInsertion of Defibrillator Lead into Left Atrium, Open Approach
02H73KZInsertion of Defibrillator Lead into Left Atrium, Percutaneous Approach
02H74KZInsertion of Defibrillator Lead into Left Atrium, Percutaneous Endoscopic Approach
02HK0KZInsertion of Defibrillator Lead into Right Ventricle, Open Approach
02HK3KZInsertion of Defibrillator Lead into Right Ventricle, Percutaneous Approach
02HK4KZInsertion of Defibrillator Lead into Right Ventricle, Percutaneous Endoscopic 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 265 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.

Explore QuickCodeExplore QuickScribeBook a demo

Frequently asked questions — DRG 265

What is MS-DRG 265?

MS-DRG 265 is "AICD Lead 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 265?

The FY2027 relative weight is 3.2560 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 3.6180, a change of -10.0%.

What is the average length of stay for DRG 265?

CMS reports a geometric mean length of stay of 4.1 days and an arithmetic mean of 5.6 days for FY2027. The geometric mean is used for transfer-payment calculations.

What documentation supports the severity level of DRG 265?

DRG 265 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 265?

The v44 Definitions Manual lists 36 operating room procedures codes for this group. Examples from the operating room procedures list: 02H40KZ (Insertion of Defibrillator Lead into Coronary Vein, Open Approach); 02H43KZ (Insertion of Defibrillator Lead into Coronary Vein, Percutaneous Approach); 02H44KZ (Insertion of Defibrillator Lead into Coronary Vein, Percutaneous Endoscopic Approach); 02H60KZ (Insertion of Defibrillator Lead into Right Atrium, Open Approach).

Is DRG 265 a post-acute transfer DRG?

No. DRG 265 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.