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MS-DRG 424 · MDC 07 · Surgical

MS-DRG 424: Other Hepatobiliary or Pancreas O.R. Procedures with CC

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 424

FY2027 relative weight
2.1590
Higher than 66% of all MS-DRGs
Change vs FY2026
-1.3%
FY2026 weight 2.1880
Geometric mean LOS
4.4 days
Arithmetic mean 5.7 days
MDC
07
Diseases and Disorders of the Hepatobiliary System and Pancreas
Severity level
with CC (complication or comorbidity)
Transfer policy
Not a transfer DRG

TL;DR

MS-DRG 424 is a surgical group in MDC 07 (Diseases and Disorders of the Hepatobiliary System and Pancreas) at the middle severity level of its family. CMS assigns it a FY2027 relative weight of 2.1590 with a geometric mean length of stay of 4.4 days and an arithmetic mean of 5.7. Its weight moved down 1.3% from FY2026 (2.1880). That weight is higher than 66% of all surgical and medical MS-DRGs. Its CC/MCC family (DRG 423, DRG 425) spans weights 1.8820 to 4.1670. The v44 Definitions Manual assigns it through 1106 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 424 the FY2027 relative weight is 2.1590 against 2.1880 in FY2026, a fall of 1.33%.

FY2026 versus FY2027 payment factors for MS-DRG 424
MetricFY2026FY2027Change
Relative weight2.18802.1590-0.0290
Geometric mean LOS (days)4.54.4-0.1
Arithmetic mean LOS (days)5.95.7-0.2
Weights shown are the FY2027 final values after the 10% cap on year-over-year reductions where applicable.

CC and MCC family

DRG 424 shares its base definition with 2 other MS-DRGs split by severity. The family's weights span 1.8820 to 4.1670, a 2.21× spread, which is the payment effect of documenting qualifying complications and comorbidities.

MS-DRGs in the same base group as DRG 424
DRGTitleFY2027 weightGMLOS
423Other Hepatobiliary or Pancreas O.R. Procedures with MCC4.16707.8
424Other Hepatobiliary or Pancreas O.R. Procedures with CC2.15904.4
425Other Hepatobiliary or Pancreas O.R. Procedures without CC/MCC1.88202.6

Grouper logic (v44 Definitions Manual)

Operating Room Procedures: 1106 ICD-10 codes drive assignment to this group; the first 12 are shown.

Operating Room Procedures codes assigned to DRG 424 (sample)
ICD-10 codeDescription
008W0ZZDivision of Cervical Spinal Cord, Open Approach
008W3ZZDivision of Cervical Spinal Cord, Percutaneous Approach
008W4ZZDivision of Cervical Spinal Cord, Percutaneous Endoscopic Approach
008X0ZZDivision of Thoracic Spinal Cord, Open Approach
008X3ZZDivision of Thoracic Spinal Cord, Percutaneous Approach
008X4ZZDivision of Thoracic Spinal Cord, Percutaneous Endoscopic Approach
008Y0ZZDivision of Lumbar Spinal Cord, Open Approach
008Y3ZZDivision of Lumbar Spinal Cord, Percutaneous Approach
008Y4ZZDivision of Lumbar Spinal Cord, Percutaneous Endoscopic Approach
00PT07ZRemoval of Autologous Tissue Substitute from Spinal Meninges, Open Approach
00PT0JZRemoval of Synthetic Substitute from Spinal Meninges, Open Approach
00PT0KZRemoval of Nonautologous Tissue Substitute from Spinal Meninges, 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 07 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 424 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 424

What is MS-DRG 424?

MS-DRG 424 is "Other Hepatobiliary or Pancreas O.R. Procedures with CC", a surgical Medicare Severity Diagnosis-Related Group in MDC 07, Diseases and Disorders of the Hepatobiliary System and Pancreas. 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 424?

The FY2027 relative weight is 2.1590 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 2.1880, a change of -1.3%.

What is the average length of stay for DRG 424?

CMS reports a geometric mean length of stay of 4.4 days and an arithmetic mean of 5.7 days for FY2027. The geometric mean is used for transfer-payment calculations.

Which DRGs are in the same CC/MCC family as 424?

DRG 423 (Other Hepatobiliary or Pancreas O.R. Procedures with MCC, weight 4.1670); DRG 425 (Other Hepatobiliary or Pancreas O.R. Procedures without CC/MCC, weight 1.8820). The family's weights range from 1.8820 to 4.1670, so documented complications and comorbidities change payment materially.

What documentation supports the severity level of DRG 424?

DRG 424 is reached when the stay carries a secondary diagnosis from the CMS Complication or Comorbidity list but none from the MCC list. Common CC captures include chronic kidney disease stage 3 and above, uncontrolled diabetes with manifestations, malnutrition of specified severity and heart failure of a stated type. Each must be documented by the treating clinician and show clinical relevance in the record; a condition listed only in the problem list without assessment is the most frequent reason a CC is removed on audit and the stay drops to the base DRG.

Which codes group to DRG 424?

The v44 Definitions Manual lists 1106 operating room procedures codes for this group. Examples from the operating room procedures list: 008W0ZZ (Division of Cervical Spinal Cord, Open Approach); 008W3ZZ (Division of Cervical Spinal Cord, Percutaneous Approach); 008W4ZZ (Division of Cervical Spinal Cord, Percutaneous Endoscopic Approach); 008X0ZZ (Division of Thoracic Spinal Cord, Open Approach).

Is DRG 424 a post-acute transfer DRG?

No. DRG 424 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.