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MS-DRG 544 · MDC 08 · Medical

MS-DRG 544: Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy 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 544

FY2027 relative weight
0.7400
Higher than 7% of all MS-DRGs
Change vs FY2026
-2.0%
FY2026 weight 0.7550
Geometric mean LOS
2.7 days
Arithmetic mean 3.1 days
MDC
08
Diseases and Disorders of the Musculoskeletal System and Connective Tissue
Severity level
without CC or MCC
Transfer policy
Post-acute transfer DRG

TL;DR

MS-DRG 544 is a medical 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 0.7400 with a geometric mean length of stay of 2.7 days and an arithmetic mean of 3.1. Its weight moved down 2.0% from FY2026 (0.7550). That weight is higher than 7% of all medical and surgical MS-DRGs. Its CC/MCC family (DRG 542, DRG 543) spans weights 0.7400 to 1.7210. The v44 Definitions Manual assigns it through 280 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 544 the FY2027 relative weight is 0.7400 against 0.7550 in FY2026, a fall of 1.99%.

FY2026 versus FY2027 payment factors for MS-DRG 544
MetricFY2026FY2027Change
Relative weight0.75500.7400-0.0150
Geometric mean LOS (days)2.72.7+0.0
Arithmetic mean LOS (days)3.13.1+0.0
Weights shown are the FY2027 final values after the 10% cap on year-over-year reductions where applicable.

CC and MCC family

DRG 544 shares its base definition with 2 other MS-DRGs split by severity. The family's weights span 0.7400 to 1.7210, a 2.33× spread, which is the payment effect of documenting qualifying complications and comorbidities.

MS-DRGs in the same base group as DRG 544
DRGTitleFY2027 weightGMLOS
542Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with MCC1.72104.9
543Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with CC1.00603.4
544Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy without CC/MCC0.74002.7

Grouper logic (v44 Definitions Manual)

Principal Diagnosis: 280 ICD-10 codes drive assignment to this group; the first 12 are shown.

Principal Diagnosis codes assigned to DRG 544 (sample)
ICD-10 codeDescription
C4000Malignant neoplasm of scapula and long bones of unspecified upper limb
C4001Malignant neoplasm of scapula and long bones of right upper limb
C4002Malignant neoplasm of scapula and long bones of left upper limb
C4010Malignant neoplasm of short bones of unspecified upper limb
C4011Malignant neoplasm of short bones of right upper limb
C4012Malignant neoplasm of short bones of left upper limb
C4020Malignant neoplasm of long bones of unspecified lower limb
C4021Malignant neoplasm of long bones of right lower limb
C4022Malignant neoplasm of long bones of left lower limb
C4030Malignant neoplasm of short bones of unspecified lower limb
C4031Malignant neoplasm of short bones of right lower limb
C4032Malignant neoplasm of short bones of left lower limb

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 544 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 544

What is MS-DRG 544?

MS-DRG 544 is "Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy without CC/MCC", a medical 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 544?

The FY2027 relative weight is 0.7400 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 0.7550, a change of -2.0%.

What is the average length of stay for DRG 544?

CMS reports a geometric mean length of stay of 2.7 days and an arithmetic mean of 3.1 days for FY2027. The geometric mean is used for transfer-payment calculations.

Which DRGs are in the same CC/MCC family as 544?

DRG 542 (Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with MCC, weight 1.7210); DRG 543 (Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with CC, weight 1.0060). The family's weights range from 0.7400 to 1.7210, so documented complications and comorbidities change payment materially.

What documentation supports the severity level of DRG 544?

DRG 544 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 544?

The v44 Definitions Manual lists 280 principal diagnosis codes for this group. Examples from the principal diagnosis list: C4000 (Malignant neoplasm of scapula and long bones of unspecified upper limb); C4001 (Malignant neoplasm of scapula and long bones of right upper limb); C4002 (Malignant neoplasm of scapula and long bones of left upper limb); C4010 (Malignant neoplasm of short bones of unspecified upper limb).

Is DRG 544 a post-acute transfer DRG?

Yes. CMS flags DRG 544 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.

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.