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MS-DRG 480 · MDC 08 · Surgical

MS-DRG 480: Hip and Femur Procedures Except Major Joint 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 480

FY2027 relative weight
2.9200
Higher than 76% of all MS-DRGs
Change vs FY2026
+0.3%
FY2026 weight 2.9120
Geometric mean LOS
6.0 days
Arithmetic mean 7.1 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 480 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 2.9200 with a geometric mean length of stay of 6.0 days and an arithmetic mean of 7.1. Its weight moved up 0.3% from FY2026 (2.9120). That weight is higher than 76% of all surgical and medical MS-DRGs. Its CC/MCC family (DRG 481, DRG 482) spans weights 1.6400 to 2.9200. The v44 Definitions Manual assigns it through 604 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 480 the FY2027 relative weight is 2.9200 against 2.9120 in FY2026, a rise of 0.27%.

FY2026 versus FY2027 payment factors for MS-DRG 480
MetricFY2026FY2027Change
Relative weight2.91202.9200+0.0080
Geometric mean LOS (days)6.16.0-0.1
Arithmetic mean LOS (days)7.37.1-0.2
Weights shown are the FY2027 final values after the 10% cap on year-over-year reductions where applicable.

CC and MCC family

DRG 480 shares its base definition with 2 other MS-DRGs split by severity. The family's weights span 1.6400 to 2.9200, a 1.78× spread, which is the payment effect of documenting qualifying complications and comorbidities.

MS-DRGs in the same base group as DRG 480
DRGTitleFY2027 weightGMLOS
480Hip and Femur Procedures Except Major Joint with MCC or Insertion of Antibiotic-eluting Bone Void Filler2.92006.0
481Hip and Femur Procedures Except Major Joint with CC2.12704.3
482Hip and Femur Procedures Except Major Joint without CC/MCC1.64003.0

Grouper logic (v44 Definitions Manual)

Operating Room Procedures: 604 ICD-10 codes drive assignment to this group; the first 12 are shown.

Operating Room Procedures codes assigned to DRG 480 (sample)
ICD-10 codeDescription
0L8J0ZZDivision of Right Hip Tendon, Open Approach
0L8J3ZZDivision of Right Hip Tendon, Percutaneous Approach
0L8J4ZZDivision of Right Hip Tendon, Percutaneous Endoscopic Approach
0L8K0ZZDivision of Left Hip Tendon, Open Approach
0L8K3ZZDivision of Left Hip Tendon, Percutaneous Approach
0L8K4ZZDivision of Left Hip Tendon, Percutaneous Endoscopic Approach
0M9L4ZZDrainage of Right Hip Bursa and Ligament, Percutaneous Endoscopic Approach
0M9M4ZZDrainage of Left Hip Bursa and Ligament, Percutaneous Endoscopic Approach
0Q860ZZDivision of Right Upper Femur, Open Approach
0Q863ZZDivision of Right Upper Femur, Percutaneous Approach
0Q864ZZDivision of Right Upper Femur, Percutaneous Endoscopic Approach
0Q870ZZDivision of Left Upper Femur, 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 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 480 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 480

What is MS-DRG 480?

MS-DRG 480 is "Hip and Femur Procedures Except Major Joint 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 480?

The FY2027 relative weight is 2.9200 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 2.9120, a change of +0.3%.

What is the average length of stay for DRG 480?

CMS reports a geometric mean length of stay of 6.0 days and an arithmetic mean of 7.1 days for FY2027. The geometric mean is used for transfer-payment calculations.

Which DRGs are in the same CC/MCC family as 480?

DRG 481 (Hip and Femur Procedures Except Major Joint with CC, weight 2.1270); DRG 482 (Hip and Femur Procedures Except Major Joint without CC/MCC, weight 1.6400). The family's weights range from 1.6400 to 2.9200, so documented complications and comorbidities change payment materially.

What documentation supports the severity level of DRG 480?

DRG 480 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 480?

The v44 Definitions Manual lists 604 operating room procedures codes for this group. Examples from the operating room procedures list: 0L8J0ZZ (Division of Right Hip Tendon, Open Approach); 0L8J3ZZ (Division of Right Hip Tendon, Percutaneous Approach); 0L8J4ZZ (Division of Right Hip Tendon, Percutaneous Endoscopic Approach); 0L8K0ZZ (Division of Left Hip Tendon, Open Approach).

Is DRG 480 a post-acute transfer DRG?

Yes. CMS flags DRG 480 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.