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MS-DRG 514 · MDC 08 · Surgical

MS-DRG 514: Hand or Wrist Procedures, Except Major Thumb or Joint Procedures 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 514

FY2027 relative weight
1.0200
Higher than 23% of all MS-DRGs
Change vs FY2026
-0.2%
FY2026 weight 1.0220
Geometric mean LOS
2.3 days
Arithmetic mean 2.7 days
MDC
08
Diseases and Disorders of the Musculoskeletal System and Connective Tissue
Severity level
without CC or MCC
Transfer policy
Not a transfer DRG

TL;DR

MS-DRG 514 is a surgical group in MDC 08 (Diseases and Disorders of the Musculoskeletal System and Connective Tissue) at the base severity level of its family. CMS assigns it a FY2027 relative weight of 1.0200 with a geometric mean length of stay of 2.3 days and an arithmetic mean of 2.7. Its weight moved down 0.2% from FY2026 (1.0220). That weight is higher than 23% of all surgical and medical MS-DRGs. Its CC/MCC family (DRG 513) spans weights 1.0200 to 1.5210. The v44 Definitions Manual assigns it through 1017 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 514 the FY2027 relative weight is 1.0200 against 1.0220 in FY2026, a fall of 0.20%.

FY2026 versus FY2027 payment factors for MS-DRG 514
MetricFY2026FY2027Change
Relative weight1.02201.0200-0.0020
Geometric mean LOS (days)2.12.3+0.2
Arithmetic mean LOS (days)2.62.7+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 514 shares its base definition with 1 other MS-DRG split by severity. The family's weights span 1.0200 to 1.5210, a 1.49× spread, which is the payment effect of documenting qualifying complications and comorbidities.

MS-DRGs in the same base group as DRG 514
DRGTitleFY2027 weightGMLOS
513Hand or Wrist Procedures, Except Major Thumb or Joint Procedures with CC/MCC1.52103.8
514Hand or Wrist Procedures, Except Major Thumb or Joint Procedures without CC/MCC1.02002.3

Grouper logic (v44 Definitions Manual)

Operating Room Procedures: 1017 ICD-10 codes drive assignment to this group; the first 12 are shown.

Operating Room Procedures codes assigned to DRG 514 (sample)
ICD-10 codeDescription
01N50ZZRelease Median Nerve, Open Approach
01N53ZZRelease Median Nerve, Percutaneous Approach
01N54ZZRelease Median Nerve, Percutaneous Endoscopic Approach
0HRFX72Replacement of Right Hand Skin with Autologous Tissue Substitute, Cell Suspension Technique, External Approach
0HRFX73Replacement of Right Hand Skin with Autologous Tissue Substitute, Full Thickness, External Approach
0HRFX74Replacement of Right Hand Skin with Autologous Tissue Substitute, Partial Thickness, External Approach
0HRFXJ3Replacement of Right Hand Skin with Synthetic Substitute, Full Thickness, External Approach
0HRFXJ4Replacement of Right Hand Skin with Synthetic Substitute, Partial Thickness, External Approach
0HRFXJZReplacement of Right Hand Skin with Synthetic Substitute, External Approach
0HRFXK3Replacement of Right Hand Skin with Nonautologous Tissue Substitute, Full Thickness, External Approach
0HRFXK4Replacement of Right Hand Skin with Nonautologous Tissue Substitute, Partial Thickness, External Approach
0HRGX72Replacement of Left Hand Skin with Autologous Tissue Substitute, Cell Suspension Technique, 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 514 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 514

What is MS-DRG 514?

MS-DRG 514 is "Hand or Wrist Procedures, Except Major Thumb or Joint Procedures without CC/MCC", 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 514?

The FY2027 relative weight is 1.0200 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 1.0220, a change of -0.2%.

What is the average length of stay for DRG 514?

CMS reports a geometric mean length of stay of 2.3 days and an arithmetic mean of 2.7 days for FY2027. The geometric mean is used for transfer-payment calculations.

Which DRGs are in the same CC/MCC family as 514?

DRG 513 (Hand or Wrist Procedures, Except Major Thumb or Joint Procedures with CC/MCC, weight 1.5210). The family's weights range from 1.0200 to 1.5210, so documented complications and comorbidities change payment materially.

What documentation supports the severity level of DRG 514?

DRG 514 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 514?

The v44 Definitions Manual lists 1017 operating room procedures codes for this group. Examples from the operating room procedures list: 01N50ZZ (Release Median Nerve, Open Approach); 01N53ZZ (Release Median Nerve, Percutaneous Approach); 01N54ZZ (Release Median Nerve, Percutaneous Endoscopic Approach); 0HRFX72 (Replacement of Right Hand Skin with Autologous Tissue Substitute, Cell Suspension Technique, External Approach).

Is DRG 514 a post-acute transfer DRG?

No. DRG 514 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.