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MS-DRG 506 · MDC 08 · Surgical

MS-DRG 506: Major Thumb or Joint Procedures

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 506

FY2027 relative weight
1.2140
Higher than 33% of all MS-DRGs
Change vs FY2026
-10.0%
FY2026 weight 1.3490
Geometric mean LOS
3.7 days
Arithmetic mean 4.4 days
MDC
08
Diseases and Disorders of the Musculoskeletal System and Connective Tissue
Severity level
single severity level
Transfer policy
Not a transfer DRG

TL;DR

MS-DRG 506 is a surgical group in MDC 08 (Diseases and Disorders of the Musculoskeletal System and Connective Tissue) at a single-severity group of its family. CMS assigns it a FY2027 relative weight of 1.2140 with a geometric mean length of stay of 3.7 days and an arithmetic mean of 4.4. Its weight moved down 10.0% from FY2026 (1.3490). That weight is higher than 33% of all surgical and medical MS-DRGs. CMS does not split this group by severity. The v44 Definitions Manual assigns it through 656 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 506 the FY2027 relative weight is 1.2140 against 1.3490 in FY2026, a fall of 10.01%, which exceeds the 2% threshold worth re-checking in contract models.

FY2026 versus FY2027 payment factors for MS-DRG 506
MetricFY2026FY2027Change
Relative weight1.34901.2140-0.1350
Geometric mean LOS (days)3.73.7+0.0
Arithmetic mean LOS (days)4.54.4-0.1
Weights shown are the FY2027 final values after the 10% cap on year-over-year reductions where applicable.

CC and MCC family

DRG 506 stands alone: CMS does not split this base group by CC or MCC severity, so complication documentation does not move the assignment, although it still affects quality and risk-adjustment reporting.

Grouper logic (v44 Definitions Manual)

Operating Room Procedures: 656 ICD-10 codes drive assignment to this group; the first 12 are shown.

Operating Room Procedures codes assigned to DRG 506 (sample)
ICD-10 codeDescription
0M9500ZDrainage of Right Wrist Bursa and Ligament with Drainage Device, Open Approach
0M950ZZDrainage of Right Wrist Bursa and Ligament, Open Approach
0M9540ZDrainage of Right Wrist Bursa and Ligament with Drainage Device, Percutaneous Endoscopic Approach
0M9600ZDrainage of Left Wrist Bursa and Ligament with Drainage Device, Open Approach
0M960ZZDrainage of Left Wrist Bursa and Ligament, Open Approach
0M9640ZDrainage of Left Wrist Bursa and Ligament with Drainage Device, Percutaneous Endoscopic Approach
0MC50ZZExtirpation of Matter from Right Wrist Bursa and Ligament, Open Approach
0MC53ZZExtirpation of Matter from Right Wrist Bursa and Ligament, Percutaneous Approach
0MC54ZZExtirpation of Matter from Right Wrist Bursa and Ligament, Percutaneous Endoscopic Approach
0MC60ZZExtirpation of Matter from Left Wrist Bursa and Ligament, Open Approach
0MC63ZZExtirpation of Matter from Left Wrist Bursa and Ligament, Percutaneous Approach
0MC64ZZExtirpation of Matter from Left Wrist Bursa and Ligament, Percutaneous Endoscopic 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 has no severity split, review risk concentrates on medical-necessity of the admission itself and on the two-midnight benchmark. 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 506 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 506

What is MS-DRG 506?

MS-DRG 506 is "Major Thumb or Joint Procedures", 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 506?

The FY2027 relative weight is 1.2140 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 1.3490, a change of -10.0%.

What is the average length of stay for DRG 506?

CMS reports a geometric mean length of stay of 3.7 days and an arithmetic mean of 4.4 days for FY2027. The geometric mean is used for transfer-payment calculations.

What documentation supports the severity level of DRG 506?

DRG 506 has no CC or MCC sibling, so secondary-diagnosis capture does not change the group or its weight. Review effort belongs instead on the principal diagnosis sequencing and the procedure codes that place the stay in this group, and on medical necessity of the inpatient admission itself under the two-midnight benchmark, which is where denials for single-severity groups concentrate.

Which codes group to DRG 506?

The v44 Definitions Manual lists 656 operating room procedures codes for this group. Examples from the operating room procedures list: 0M9500Z (Drainage of Right Wrist Bursa and Ligament with Drainage Device, Open Approach); 0M950ZZ (Drainage of Right Wrist Bursa and Ligament, Open Approach); 0M9540Z (Drainage of Right Wrist Bursa and Ligament with Drainage Device, Percutaneous Endoscopic Approach); 0M9600Z (Drainage of Left Wrist Bursa and Ligament with Drainage Device, Open Approach).

Is DRG 506 a post-acute transfer DRG?

No. DRG 506 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.