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MS-DRG 854 · MDC 18 · Surgical

MS-DRG 854: Infectious and Parasitic Diseases with O.R. Procedures with CC

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 854

FY2027 relative weight
2.0090
Higher than 63% of all MS-DRGs
Change vs FY2026
+0.6%
FY2026 weight 1.9980
Geometric mean LOS
4.8 days
Arithmetic mean 6.1 days
MDC
18
Infectious and Parasitic Diseases, Systemic or Unspecified Sites
Severity level
with CC (complication or comorbidity)
Transfer policy
Post-acute transfer DRG

TL;DR

MS-DRG 854 is a surgical group in MDC 18 (Infectious and Parasitic Diseases, Systemic or Unspecified Sites) at the middle severity level of its family. CMS assigns it a FY2027 relative weight of 2.0090 with a geometric mean length of stay of 4.8 days and an arithmetic mean of 6.1. Its weight moved up 0.6% from FY2026 (1.9980). That weight is higher than 63% of all surgical and medical MS-DRGs. Its CC/MCC family (DRG 853, DRG 855) spans weights 1.4500 to 4.9310.

What changed from FY2026 to FY2027

CMS recalibrates every MS-DRG weight annually from the prior year's MedPAR claims. For DRG 854 the FY2027 relative weight is 2.0090 against 1.9980 in FY2026, a rise of 0.55%.

FY2026 versus FY2027 payment factors for MS-DRG 854
MetricFY2026FY2027Change
Relative weight1.99802.0090+0.0110
Geometric mean LOS (days)4.94.8-0.1
Arithmetic mean LOS (days)6.26.1-0.1
Weights shown are the FY2027 final values after the 10% cap on year-over-year reductions where applicable.

CC and MCC family

DRG 854 shares its base definition with 2 other MS-DRGs split by severity. The family's weights span 1.4500 to 4.9310, a 3.40× spread, which is the payment effect of documenting qualifying complications and comorbidities.

MS-DRGs in the same base group as DRG 854
DRGTitleFY2027 weightGMLOS
853Infectious and Parasitic Diseases with O.R. Procedures with MCC4.93109.2
854Infectious and Parasitic Diseases with O.R. Procedures with CC2.00904.8
855Infectious and Parasitic Diseases with O.R. Procedures without CC/MCC1.45003.2

Grouper logic (v44 Definitions Manual)

The Definitions Manual assigns DRG 854 through the MDC 18 principal-diagnosis table and the operating-room procedure hierarchy rather than a DRG-specific code list. See the manual chapter for MDC 18.

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 18 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 854 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 854

What is MS-DRG 854?

MS-DRG 854 is "Infectious and Parasitic Diseases with O.R. Procedures with CC", a surgical Medicare Severity Diagnosis-Related Group in MDC 18, Infectious and Parasitic Diseases, Systemic or Unspecified Sites. 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 854?

The FY2027 relative weight is 2.0090 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 1.9980, a change of +0.6%.

What is the average length of stay for DRG 854?

CMS reports a geometric mean length of stay of 4.8 days and an arithmetic mean of 6.1 days for FY2027. The geometric mean is used for transfer-payment calculations.

Which DRGs are in the same CC/MCC family as 854?

DRG 853 (Infectious and Parasitic Diseases with O.R. Procedures with MCC, weight 4.9310); DRG 855 (Infectious and Parasitic Diseases with O.R. Procedures without CC/MCC, weight 1.4500). The family's weights range from 1.4500 to 4.9310, so documented complications and comorbidities change payment materially.

What documentation supports the severity level of DRG 854?

DRG 854 is reached when the stay carries a secondary diagnosis from the CMS Complication or Comorbidity list but none from the MCC list. Common CC captures include chronic kidney disease stage 3 and above, uncontrolled diabetes with manifestations, malnutrition of specified severity and heart failure of a stated type. Each must be documented by the treating clinician and show clinical relevance in the record; a condition listed only in the problem list without assessment is the most frequent reason a CC is removed on audit and the stay drops to the base DRG.

Is DRG 854 a post-acute transfer DRG?

Yes. CMS flags DRG 854 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.