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MS-DRG 812 · MDC 16 · Medical

MS-DRG 812: Red Blood Cell Disorders without 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 812

FY2027 relative weight
0.9240
Higher than 18% of all MS-DRGs
Change vs FY2026
+0.7%
FY2026 weight 0.9180
Geometric mean LOS
2.8 days
Arithmetic mean 3.6 days
MDC
16
Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders
Severity level
without MCC
Transfer policy
Not a transfer DRG

TL;DR

MS-DRG 812 is a medical group in MDC 16 (Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders) at the base severity level of its family. CMS assigns it a FY2027 relative weight of 0.9240 with a geometric mean length of stay of 2.8 days and an arithmetic mean of 3.6. Its weight moved up 0.7% from FY2026 (0.9180). That weight is higher than 18% of all medical and surgical MS-DRGs. Its CC/MCC family (DRG 811) spans weights 0.9240 to 1.3990. The v44 Definitions Manual assigns it through 134 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 812 the FY2027 relative weight is 0.9240 against 0.9180 in FY2026, a rise of 0.65%.

FY2026 versus FY2027 payment factors for MS-DRG 812
MetricFY2026FY2027Change
Relative weight0.91800.9240+0.0060
Geometric mean LOS (days)2.72.8+0.1
Arithmetic mean LOS (days)3.63.6+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 812 shares its base definition with 1 other MS-DRG split by severity. The family's weights span 0.9240 to 1.3990, a 1.51× spread, which is the payment effect of documenting qualifying complications and comorbidities.

MS-DRGs in the same base group as DRG 812
DRGTitleFY2027 weightGMLOS
811Red Blood Cell Disorders with MCC1.39903.7
812Red Blood Cell Disorders without MCC0.92402.8

Grouper logic (v44 Definitions Manual)

Principal Diagnosis: 134 ICD-10 codes drive assignment to this group; the first 12 are shown.

Principal Diagnosis codes assigned to DRG 812 (sample)
ICD-10 codeDescription
D460Refractory anemia without ring sideroblasts, so stated
D461Refractory anemia with ring sideroblasts
D4620Refractory anemia with excess of blasts, unspecified
D4621Refractory anemia with excess of blasts 1
D4622Refractory anemia with excess of blasts 2
D464Refractory anemia, unspecified
D469Myelodysplastic syndrome, unspecified
D46ARefractory cytopenia with multilineage dysplasia
D46BRefractory cytopenia with multilineage dysplasia and ring sideroblasts
D46CMyelodysplastic syndrome with isolated del(5q) chromosomal abnormality
D46ZOther myelodysplastic syndromes
D500Iron deficiency anemia secondary to blood loss (chronic)

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 812 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 812

What is MS-DRG 812?

MS-DRG 812 is "Red Blood Cell Disorders without MCC", a medical Medicare Severity Diagnosis-Related Group in MDC 16, Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders. 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 812?

The FY2027 relative weight is 0.9240 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 0.9180, a change of +0.7%.

What is the average length of stay for DRG 812?

CMS reports a geometric mean length of stay of 2.8 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 812?

DRG 811 (Red Blood Cell Disorders with MCC, weight 1.3990). The family's weights range from 0.9240 to 1.3990, so documented complications and comorbidities change payment materially.

What documentation supports the severity level of DRG 812?

DRG 812 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 812?

The v44 Definitions Manual lists 134 principal diagnosis codes for this group. Examples from the principal diagnosis list: D460 (Refractory anemia without ring sideroblasts, so stated); D461 (Refractory anemia with ring sideroblasts); D4620 (Refractory anemia with excess of blasts, unspecified); D4621 (Refractory anemia with excess of blasts 1).

Is DRG 812 a post-acute transfer DRG?

No. DRG 812 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.