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MS-DRG 864 · MDC 18 · Medical

MS-DRG 864: Fever and Inflammatory Conditions

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 864

FY2027 relative weight
0.8550
Higher than 14% of all MS-DRGs
Change vs FY2026
-3.7%
FY2026 weight 0.8880
Geometric mean LOS
2.5 days
Arithmetic mean 3.2 days
MDC
18
Infectious and Parasitic Diseases, Systemic or Unspecified Sites
Severity level
single severity level
Transfer policy
Not a transfer DRG

TL;DR

MS-DRG 864 is a medical group in MDC 18 (Infectious and Parasitic Diseases, Systemic or Unspecified Sites) at a single-severity group of its family. CMS assigns it a FY2027 relative weight of 0.8550 with a geometric mean length of stay of 2.5 days and an arithmetic mean of 3.2. Its weight moved down 3.7% from FY2026 (0.8880). That weight is higher than 14% of all medical and surgical MS-DRGs. CMS does not split this group by severity. The v44 Definitions Manual assigns it through 8 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 864 the FY2027 relative weight is 0.8550 against 0.8880 in FY2026, a fall of 3.72%, which exceeds the 2% threshold worth re-checking in contract models.

FY2026 versus FY2027 payment factors for MS-DRG 864
MetricFY2026FY2027Change
Relative weight0.88800.8550-0.0330
Geometric mean LOS (days)2.62.5-0.1
Arithmetic mean LOS (days)3.23.2+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 864 stands alone: CMS does not split this base group by CC or MCC severity, so complication documentation does not move the assignment, although it still affects quality and risk-adjustment reporting.

Grouper logic (v44 Definitions Manual)

Principal Diagnosis: 8 ICD-10 codes drive assignment to this group.

Principal Diagnosis codes assigned to DRG 864 (sample)
ICD-10 codeDescription
R502Drug induced fever
R5081Fever presenting with conditions classified elsewhere
R5082Postprocedural fever
R5083Postvaccination fever
R5084Febrile nonhemolytic transfusion reaction
R509Fever, unspecified
R6510Systemic inflammatory response syndrome (SIRS) of non-infectious origin without acute organ dysfunction
R6511Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction

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 has no severity split, review risk concentrates on medical-necessity of the admission itself and on the two-midnight benchmark. 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 864 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 864

What is MS-DRG 864?

MS-DRG 864 is "Fever and Inflammatory Conditions", a medical 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 864?

The FY2027 relative weight is 0.8550 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 0.8880, a change of -3.7%.

What is the average length of stay for DRG 864?

CMS reports a geometric mean length of stay of 2.5 days and an arithmetic mean of 3.2 days for FY2027. The geometric mean is used for transfer-payment calculations.

What documentation supports the severity level of DRG 864?

DRG 864 has no CC or MCC sibling, so secondary-diagnosis capture does not change the group or its weight. Review effort belongs instead on the principal diagnosis sequencing and the procedure codes that place the stay in this group, and on medical necessity of the inpatient admission itself under the two-midnight benchmark, which is where denials for single-severity groups concentrate.

Which codes group to DRG 864?

The v44 Definitions Manual lists 8 principal diagnosis codes for this group. Examples from the principal diagnosis list: R502 (Drug induced fever); R5081 (Fever presenting with conditions classified elsewhere); R5082 (Postprocedural fever); R5083 (Postvaccination fever).

Is DRG 864 a post-acute transfer DRG?

No. DRG 864 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.