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MS-DRG 434 · MDC 07 · Medical

MS-DRG 434: Cirrhosis and Alcoholic Hepatitis without CC/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 434

FY2027 relative weight
0.6410
Higher than 2% of all MS-DRGs
Change vs FY2026
-10.1%
FY2026 weight 0.7130
Geometric mean LOS
2.1 days
Arithmetic mean 2.6 days
MDC
07
Diseases and Disorders of the Hepatobiliary System and Pancreas
Severity level
without CC or MCC
Transfer policy
Not a transfer DRG

TL;DR

MS-DRG 434 is a medical group in MDC 07 (Diseases and Disorders of the Hepatobiliary System and Pancreas) at the base severity level of its family. CMS assigns it a FY2027 relative weight of 0.6410 with a geometric mean length of stay of 2.1 days and an arithmetic mean of 2.6. Its weight moved down 10.1% from FY2026 (0.7130). That weight is higher than 2% of all medical and surgical MS-DRGs. Its CC/MCC family (DRG 432, DRG 433) spans weights 0.6410 to 1.9830. The v44 Definitions Manual assigns it through 17 principal diagnosis codes.

What changed from FY2026 to FY2027

CMS recalibrates every MS-DRG weight annually from the prior year's MedPAR claims. For DRG 434 the FY2027 relative weight is 0.6410 against 0.7130 in FY2026, a fall of 10.10%, which exceeds the 2% threshold worth re-checking in contract models.

FY2026 versus FY2027 payment factors for MS-DRG 434
MetricFY2026FY2027Change
Relative weight0.71300.6410-0.0720
Geometric mean LOS (days)2.32.1-0.2
Arithmetic mean LOS (days)3.02.6-0.4
Weights shown are the FY2027 final values after the 10% cap on year-over-year reductions where applicable.

CC and MCC family

DRG 434 shares its base definition with 2 other MS-DRGs split by severity. The family's weights span 0.6410 to 1.9830, a 3.09× spread, which is the payment effect of documenting qualifying complications and comorbidities.

MS-DRGs in the same base group as DRG 434
DRGTitleFY2027 weightGMLOS
432Cirrhosis and Alcoholic Hepatitis with MCC1.98304.9
433Cirrhosis and Alcoholic Hepatitis with CC1.04003.2
434Cirrhosis and Alcoholic Hepatitis without CC/MCC0.64102.1

Grouper logic (v44 Definitions Manual)

Principal Diagnosis: 17 ICD-10 codes drive assignment to this group; the first 12 are shown.

Principal Diagnosis codes assigned to DRG 434 (sample)
ICD-10 codeDescription
K7010Alcoholic hepatitis without ascites
K7011Alcoholic hepatitis with ascites
K702Alcoholic fibrosis and sclerosis of liver
K7030Alcoholic cirrhosis of liver without ascites
K7031Alcoholic cirrhosis of liver with ascites
K7040Alcoholic hepatic failure without coma
K7041Alcoholic hepatic failure with coma
K709Alcoholic liver disease, unspecified
K7400Hepatic fibrosis, unspecified
K7401Hepatic fibrosis, early fibrosis
K7402Hepatic fibrosis, advanced fibrosis
K740AHepatic fibrosis, moderate fibrosis

Documentation and denial exposure

As a medical DRG, assignment depends on the principal diagnosis sequenced from the attending's documentation; a secondary condition sequenced first, or a symptom code in place of the confirmed diagnosis, changes the MDC or the DRG. 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 434 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 434

What is MS-DRG 434?

MS-DRG 434 is "Cirrhosis and Alcoholic Hepatitis without CC/MCC", a medical 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 434?

The FY2027 relative weight is 0.6410 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 0.7130, a change of -10.1%.

What is the average length of stay for DRG 434?

CMS reports a geometric mean length of stay of 2.1 days and an arithmetic mean of 2.6 days for FY2027. The geometric mean is used for transfer-payment calculations.

Which DRGs are in the same CC/MCC family as 434?

DRG 432 (Cirrhosis and Alcoholic Hepatitis with MCC, weight 1.9830); DRG 433 (Cirrhosis and Alcoholic Hepatitis with CC, weight 1.0400). The family's weights range from 0.6410 to 1.9830, so documented complications and comorbidities change payment materially.

What documentation supports the severity level of DRG 434?

DRG 434 is the base-severity assignment: no secondary diagnosis on the CC or MCC lists was coded, or the only ones present are excluded for this principal diagnosis. Revenue-integrity review here looks for undercapture, meaning conditions treated during the stay (electrolyte disorders, specified anemia, acute blood loss, pressure injuries present on admission) that were never documented to the specificity the lists require. A compliant query to the attending, not a coder assumption, is the only way to move a stay to the CC or MCC sibling.

Which codes group to DRG 434?

The v44 Definitions Manual lists 17 principal diagnosis codes for this group. Examples from the principal diagnosis list: K7010 (Alcoholic hepatitis without ascites); K7011 (Alcoholic hepatitis with ascites); K702 (Alcoholic fibrosis and sclerosis of liver); K7030 (Alcoholic cirrhosis of liver without ascites).

Is DRG 434 a post-acute transfer DRG?

No. DRG 434 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.