Key facts for DRG 725
- FY2027 relative weight
- 1.1570
- Higher than 31% of all MS-DRGs
- Change vs FY2026
- -1.1%
- FY2026 weight 1.1700
- Geometric mean LOS
- 3.6 days
- Arithmetic mean 4.6 days
- MDC
- 12
- Assignment of Diagnosis Codes
- Severity level
- with MCC (major complication or comorbidity)
- Transfer policy
- Not a transfer DRG
TL;DR
MS-DRG 725 is a medical group in MDC 12 (Assignment of Diagnosis Codes) at the highest-severity level of its family. CMS assigns it a FY2027 relative weight of 1.1570 with a geometric mean length of stay of 3.6 days and an arithmetic mean of 4.6. Its weight moved down 1.1% from FY2026 (1.1700). That weight is higher than 31% of all medical and surgical MS-DRGs. Its CC/MCC family (DRG 726) spans weights 0.7250 to 1.1570. The v44 Definitions Manual assigns it through 5 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 725 the FY2027 relative weight is 1.1570 against 1.1700 in FY2026, a fall of 1.11%.
| Metric | FY2026 | FY2027 | Change |
|---|---|---|---|
| Relative weight | 1.1700 | 1.1570 | -0.0130 |
| Geometric mean LOS (days) | 3.8 | 3.6 | -0.2 |
| Arithmetic mean LOS (days) | 4.9 | 4.6 | -0.3 |
CC and MCC family
DRG 725 shares its base definition with 1 other MS-DRG split by severity. The family's weights span 0.7250 to 1.1570, a 1.60× spread, which is the payment effect of documenting qualifying complications and comorbidities.
| DRG | Title | FY2027 weight | GMLOS |
|---|---|---|---|
| 725 | Benign Prostatic Hypertrophy with MCC | 1.1570 | 3.6 |
| 726 | Benign Prostatic Hypertrophy without MCC | 0.7250 | 2.5 |
Grouper logic (v44 Definitions Manual)
Principal Diagnosis: 5 ICD-10 codes drive assignment to this group.
| ICD-10 code | Description |
|---|---|
| N400 | Benign prostatic hyperplasia without lower urinary tract symptoms |
| N401 | Benign prostatic hyperplasia with lower urinary tract symptoms |
| N402 | Nodular prostate without lower urinary tract symptoms |
| N403 | Nodular prostate with lower urinary tract symptoms |
| N4283 | Cyst of prostate |
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 725 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.
Frequently asked questions — DRG 725
What is MS-DRG 725?
MS-DRG 725 is "Benign Prostatic Hypertrophy with MCC", a medical Medicare Severity Diagnosis-Related Group in MDC 12, 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 725?
The FY2027 relative weight is 1.1570 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 1.1700, a change of -1.1%.
What is the average length of stay for DRG 725?
CMS reports a geometric mean length of stay of 3.6 days and an arithmetic mean of 4.6 days for FY2027. The geometric mean is used for transfer-payment calculations.
Which DRGs are in the same CC/MCC family as 725?
DRG 726 (Benign Prostatic Hypertrophy without MCC, weight 0.7250). The family's weights range from 0.7250 to 1.1570, so documented complications and comorbidities change payment materially.
What documentation supports the severity level of DRG 725?
DRG 725 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 725?
The v44 Definitions Manual lists 5 principal diagnosis codes for this group. Examples from the principal diagnosis list: N400 (Benign prostatic hyperplasia without lower urinary tract symptoms); N401 (Benign prostatic hyperplasia with lower urinary tract symptoms); N402 (Nodular prostate without lower urinary tract symptoms); N403 (Nodular prostate with lower urinary tract symptoms).
Is DRG 725 a post-acute transfer DRG?
No. DRG 725 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.
- IPPS FY2027 Final Rule Table 5 (CMS-1849-F)Version v44 FY2027 · effective 2026-10-01 · file CMS-1849-F Table 5.txtSHA-256 01003dd571c1e2f5…
- IPPS FY2026 Final Rule Table 5 (CMS-1833-F)Version v43 FY2026 · effective 2025-10-01 · file CMS-1833-F Table 5.txtSHA-256 bf8c390d14b3cd3e…
- ICD-10 MS-DRG Definitions Manual v44 (text)Version v44 · effective 2026-10-01 · file fy2027-fr-icd10-ms-drg-definitions-manual-files-v44.zipSHA-256 ae4f6c11727fe91f…
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.