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MS-DRG 278 · MDC 05 · Surgical

MS-DRG 278: Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures 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 278

FY2027 relative weight
6.3480
Higher than 95% of all MS-DRGs
Change vs FY2026
+14.1%
FY2026 weight 5.5660
Geometric mean LOS
7.9 days
Arithmetic mean 10.7 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 278 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 6.3480 with a geometric mean length of stay of 7.9 days and an arithmetic mean of 10.7. Its weight moved up 14.1% from FY2026 (5.5660). That weight is higher than 95% of all surgical and medical MS-DRGs. Its CC/MCC family (DRG 279) spans weights 4.1310 to 6.3480. The v44 Definitions Manual assigns it through 105 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 278 the FY2027 relative weight is 6.3480 against 5.5660 in FY2026, a rise of 14.05%, which exceeds the 2% threshold worth re-checking in contract models.

FY2026 versus FY2027 payment factors for MS-DRG 278
MetricFY2026FY2027Change
Relative weight5.56606.3480+0.7820
Geometric mean LOS (days)7.27.9+0.7
Arithmetic mean LOS (days)10.410.7+0.3
Weights shown are the FY2027 final values after the 10% cap on year-over-year reductions where applicable.

CC and MCC family

DRG 278 shares its base definition with 1 other MS-DRG split by severity. The family's weights span 4.1310 to 6.3480, a 1.54× spread, which is the payment effect of documenting qualifying complications and comorbidities.

MS-DRGs in the same base group as DRG 278
DRGTitleFY2027 weightGMLOS
278Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures with MCC6.34807.9
279Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures without MCC4.13103.6

Grouper logic (v44 Definitions Manual)

Operating Room Procedures: 105 ICD-10 codes drive assignment to this group; the first 12 are shown.

Operating Room Procedures codes assigned to DRG 278 (sample)
ICD-10 codeDescription
03F23Z0Fragmentation of Innominate Artery, Percutaneous Approach, Ultrasonic
03F23ZZFragmentation of Innominate Artery, Percutaneous Approach
03F33Z0Fragmentation of Right Subclavian Artery, Percutaneous Approach, Ultrasonic
03F33ZZFragmentation of Right Subclavian Artery, Percutaneous Approach
03F43Z0Fragmentation of Left Subclavian Artery, Percutaneous Approach, Ultrasonic
03F43ZZFragmentation of Left Subclavian Artery, Percutaneous Approach
03F53Z0Fragmentation of Right Axillary Artery, Percutaneous Approach, Ultrasonic
03F53ZZFragmentation of Right Axillary Artery, Percutaneous Approach
03F63Z0Fragmentation of Left Axillary Artery, Percutaneous Approach, Ultrasonic
03F63ZZFragmentation of Left Axillary Artery, Percutaneous Approach
03F73Z0Fragmentation of Right Brachial Artery, Percutaneous Approach, Ultrasonic
03F73ZZFragmentation of Right Brachial Artery, Percutaneous 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 278 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.

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Frequently asked questions — DRG 278

What is MS-DRG 278?

MS-DRG 278 is "Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures 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 278?

The FY2027 relative weight is 6.3480 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 5.5660, a change of +14.1%.

What is the average length of stay for DRG 278?

CMS reports a geometric mean length of stay of 7.9 days and an arithmetic mean of 10.7 days for FY2027. The geometric mean is used for transfer-payment calculations.

Which DRGs are in the same CC/MCC family as 278?

DRG 279 (Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures without MCC, weight 4.1310). The family's weights range from 4.1310 to 6.3480, so documented complications and comorbidities change payment materially.

What documentation supports the severity level of DRG 278?

DRG 278 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 278?

The v44 Definitions Manual lists 105 operating room procedures codes for this group. Examples from the operating room procedures list: 03F23Z0 (Fragmentation of Innominate Artery, Percutaneous Approach, Ultrasonic); 03F23ZZ (Fragmentation of Innominate Artery, Percutaneous Approach); 03F33Z0 (Fragmentation of Right Subclavian Artery, Percutaneous Approach, Ultrasonic); 03F33ZZ (Fragmentation of Right Subclavian Artery, Percutaneous Approach).

Is DRG 278 a post-acute transfer DRG?

No. DRG 278 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.