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MS-DRG 655 · MDC 11 · Surgical

MS-DRG 655: Major Bladder 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 655

FY2027 relative weight
2.0540
Higher than 64% of all MS-DRGs
Change vs FY2026
-3.0%
FY2026 weight 2.1170
Geometric mean LOS
2.9 days
Arithmetic mean 3.6 days
MDC
11
Assignment of Diagnosis Codes
Severity level
without CC or MCC
Transfer policy
Post-acute transfer DRG

TL;DR

MS-DRG 655 is a surgical group in MDC 11 (Assignment of Diagnosis Codes) at the base severity level of its family. CMS assigns it a FY2027 relative weight of 2.0540 with a geometric mean length of stay of 2.9 days and an arithmetic mean of 3.6. Its weight moved down 3.0% from FY2026 (2.1170). That weight is higher than 64% of all surgical and medical MS-DRGs. Its CC/MCC family (DRG 653, DRG 654) spans weights 2.0540 to 5.2140. The v44 Definitions Manual assigns it through 133 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 655 the FY2027 relative weight is 2.0540 against 2.1170 in FY2026, a fall of 2.98%, which exceeds the 2% threshold worth re-checking in contract models.

FY2026 versus FY2027 payment factors for MS-DRG 655
MetricFY2026FY2027Change
Relative weight2.11702.0540-0.0630
Geometric mean LOS (days)3.22.9-0.3
Arithmetic mean LOS (days)3.93.6-0.3
Weights shown are the FY2027 final values after the 10% cap on year-over-year reductions where applicable.

CC and MCC family

DRG 655 shares its base definition with 2 other MS-DRGs split by severity. The family's weights span 2.0540 to 5.2140, a 2.54× spread, which is the payment effect of documenting qualifying complications and comorbidities.

MS-DRGs in the same base group as DRG 655
DRGTitleFY2027 weightGMLOS
653Major Bladder Procedures with MCC5.21409.4
654Major Bladder Procedures with CC2.82005.0
655Major Bladder Procedures without CC/MCC2.05402.9

Grouper logic (v44 Definitions Manual)

Operating Room Procedures: 133 ICD-10 codes drive assignment to this group; the first 12 are shown.

Operating Room Procedures codes assigned to DRG 655 (sample)
ICD-10 codeDescription
0DX80ZBTransfer Small Intestine to Bladder, Open Approach
0DX84ZBTransfer Small Intestine to Bladder, Percutaneous Endoscopic Approach
0DXE0ZBTransfer Large Intestine to Bladder, Open Approach
0DXE4ZBTransfer Large Intestine to Bladder, Percutaneous Endoscopic Approach
0JUC07ZSupplement of Pelvic Region Subcutaneous Tissue and Fascia with Autologous Tissue Substitute, Open Approach
0JUC0JZSupplement of Pelvic Region Subcutaneous Tissue and Fascia with Synthetic Substitute, Open Approach
0JUC0KZSupplement of Pelvic Region Subcutaneous Tissue and Fascia with Nonautologous Tissue Substitute, Open Approach
0JUC37ZSupplement of Pelvic Region Subcutaneous Tissue and Fascia with Autologous Tissue Substitute, Percutaneous Approach
0JUC3JZSupplement of Pelvic Region Subcutaneous Tissue and Fascia with Synthetic Substitute, Percutaneous Approach
0JUC3KZSupplement of Pelvic Region Subcutaneous Tissue and Fascia with Nonautologous Tissue Substitute, Percutaneous Approach
0T1B079Bypass Bladder to Colocutaneous with Autologous Tissue Substitute, Open Approach
0T1B07CBypass Bladder to Ileocutaneous with Autologous Tissue Substitute, 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 11 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 655 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 655

What is MS-DRG 655?

MS-DRG 655 is "Major Bladder Procedures without CC/MCC", a surgical Medicare Severity Diagnosis-Related Group in MDC 11, Assignment of Diagnosis Codes. 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 655?

The FY2027 relative weight is 2.0540 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 2.1170, a change of -3.0%.

What is the average length of stay for DRG 655?

CMS reports a geometric mean length of stay of 2.9 days and an arithmetic mean of 3.6 days for FY2027. The geometric mean is used for transfer-payment calculations.

Which DRGs are in the same CC/MCC family as 655?

DRG 653 (Major Bladder Procedures with MCC, weight 5.2140); DRG 654 (Major Bladder Procedures with CC, weight 2.8200). The family's weights range from 2.0540 to 5.2140, so documented complications and comorbidities change payment materially.

What documentation supports the severity level of DRG 655?

DRG 655 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 655?

The v44 Definitions Manual lists 133 operating room procedures codes for this group. Examples from the operating room procedures list: 0DX80ZB (Transfer Small Intestine to Bladder, Open Approach); 0DX84ZB (Transfer Small Intestine to Bladder, Percutaneous Endoscopic Approach); 0DXE0ZB (Transfer Large Intestine to Bladder, Open Approach); 0DXE4ZB (Transfer Large Intestine to Bladder, Percutaneous Endoscopic Approach).

Is DRG 655 a post-acute transfer DRG?

Yes. CMS flags DRG 655 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.