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MS-DRG 463 · MDC 08 · Surgical

MS-DRG 463: Wound Debridement or Skin Graft Except Hand for Musculoskeletal and Connective Tissue Disorders with MCC or Insertion of Antibiotic-eluting Bone Void Filler

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 463

FY2027 relative weight
5.1300
Higher than 92% of all MS-DRGs
Change vs FY2026
-10.0%
FY2026 weight 5.6990
Geometric mean LOS
7.8 days
Arithmetic mean 10.9 days
MDC
08
Diseases and Disorders of the Musculoskeletal System and Connective Tissue
Severity level
with MCC (major complication or comorbidity)
Transfer policy
Post-acute transfer DRG
Special-pay DRG

TL;DR

MS-DRG 463 is a surgical group in MDC 08 (Diseases and Disorders of the Musculoskeletal System and Connective Tissue) at the highest-severity level of its family. CMS assigns it a FY2027 relative weight of 5.1300 with a geometric mean length of stay of 7.8 days and an arithmetic mean of 10.9. Its weight moved down 10.0% from FY2026 (5.6990). That weight is higher than 92% of all surgical and medical MS-DRGs. Its CC/MCC family (DRG 464, DRG 465) spans weights 2.4820 to 5.1300. The v44 Definitions Manual assigns it through 418 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 463 the FY2027 relative weight is 5.1300 against 5.6990 in FY2026, a fall of 9.98%, which exceeds the 2% threshold worth re-checking in contract models.

FY2026 versus FY2027 payment factors for MS-DRG 463
MetricFY2026FY2027Change
Relative weight5.69905.1300-0.5690
Geometric mean LOS (days)10.67.8-2.8
Arithmetic mean LOS (days)14.310.9-3.4
Weights shown are the FY2027 final values after the 10% cap on year-over-year reductions where applicable.

CC and MCC family

DRG 463 shares its base definition with 2 other MS-DRGs split by severity. The family's weights span 2.4820 to 5.1300, a 2.07× spread, which is the payment effect of documenting qualifying complications and comorbidities.

MS-DRGs in the same base group as DRG 463
DRGTitleFY2027 weightGMLOS
463Wound Debridement or Skin Graft Except Hand for Musculoskeletal and Connective Tissue Disorders with MCC or Insertion of Antibiotic-eluting Bone Void Filler5.13007.8
464Wound Debridement or Skin Graft Except Hand for Musculoskeletal and Connective Tissue Disorders with CC3.17603.0
465Wound Debridement or Skin Graft Except Hand for Musculoskeletal and Connective Tissue Disorders without CC/MCC2.48201.4

Grouper logic (v44 Definitions Manual)

Operating Room Procedures: 418 ICD-10 codes drive assignment to this group; the first 12 are shown.

Operating Room Procedures codes assigned to DRG 463 (sample)
ICD-10 codeDescription
0HR0X72Replacement of Scalp Skin with Autologous Tissue Substitute, Cell Suspension Technique, External Approach
0HR0X73Replacement of Scalp Skin with Autologous Tissue Substitute, Full Thickness, External Approach
0HR0X74Replacement of Scalp Skin with Autologous Tissue Substitute, Partial Thickness, External Approach
0HR0XJ3Replacement of Scalp Skin with Synthetic Substitute, Full Thickness, External Approach
0HR0XJ4Replacement of Scalp Skin with Synthetic Substitute, Partial Thickness, External Approach
0HR0XJZReplacement of Scalp Skin with Synthetic Substitute, External Approach
0HR0XK3Replacement of Scalp Skin with Nonautologous Tissue Substitute, Full Thickness, External Approach
0HR0XK4Replacement of Scalp Skin with Nonautologous Tissue Substitute, Partial Thickness, External Approach
0HR1X72Replacement of Face Skin with Autologous Tissue Substitute, Cell Suspension Technique, External Approach
0HR1X73Replacement of Face Skin with Autologous Tissue Substitute, Full Thickness, External Approach
0HR1X74Replacement of Face Skin with Autologous Tissue Substitute, Partial Thickness, External Approach
0HR1XJ3Replacement of Face Skin with Synthetic Substitute, Full Thickness, External 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 08 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 463 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 463

What is MS-DRG 463?

MS-DRG 463 is "Wound Debridement or Skin Graft Except Hand for Musculoskeletal and Connective Tissue Disorders with MCC or Insertion of Antibiotic-eluting Bone Void Filler", a surgical Medicare Severity Diagnosis-Related Group in MDC 08, Diseases and Disorders of the Musculoskeletal System and Connective Tissue. 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 463?

The FY2027 relative weight is 5.1300 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 5.6990, a change of -10.0%.

What is the average length of stay for DRG 463?

CMS reports a geometric mean length of stay of 7.8 days and an arithmetic mean of 10.9 days for FY2027. The geometric mean is used for transfer-payment calculations.

Which DRGs are in the same CC/MCC family as 463?

DRG 464 (Wound Debridement or Skin Graft Except Hand for Musculoskeletal and Connective Tissue Disorders with CC, weight 3.1760); DRG 465 (Wound Debridement or Skin Graft Except Hand for Musculoskeletal and Connective Tissue Disorders without CC/MCC, weight 2.4820). The family's weights range from 2.4820 to 5.1300, so documented complications and comorbidities change payment materially.

What documentation supports the severity level of DRG 463?

DRG 463 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 463?

The v44 Definitions Manual lists 418 operating room procedures codes for this group. Examples from the operating room procedures list: 0HR0X72 (Replacement of Scalp Skin with Autologous Tissue Substitute, Cell Suspension Technique, External Approach); 0HR0X73 (Replacement of Scalp Skin with Autologous Tissue Substitute, Full Thickness, External Approach); 0HR0X74 (Replacement of Scalp Skin with Autologous Tissue Substitute, Partial Thickness, External Approach); 0HR0XJ3 (Replacement of Scalp Skin with Synthetic Substitute, Full Thickness, External Approach).

Is DRG 463 a post-acute transfer DRG?

Yes. CMS flags DRG 463 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. It is also a special-pay DRG.

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.