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MS-DRG 904 · MDC 21 · Surgical

MS-DRG 904: Skin Grafts for Injuries with 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 904

FY2027 relative weight
3.7090
Higher than 84% of all MS-DRGs
Change vs FY2026
+1.0%
FY2026 weight 3.6730
Geometric mean LOS
6.6 days
Arithmetic mean 9.6 days
MDC
21
Assignment of Diagnosis Codes
Severity level
with CC (complication or comorbidity)
Transfer policy
Not a transfer DRG

TL;DR

MS-DRG 904 is a surgical group in MDC 21 (Assignment of Diagnosis Codes) at the middle severity level of its family. CMS assigns it a FY2027 relative weight of 3.7090 with a geometric mean length of stay of 6.6 days and an arithmetic mean of 9.6. Its weight moved up 1.0% from FY2026 (3.6730). That weight is higher than 84% of all surgical and medical MS-DRGs. Its CC/MCC family (DRG 905) spans weights 1.5540 to 3.7090. The v44 Definitions Manual assigns it through 300 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 904 the FY2027 relative weight is 3.7090 against 3.6730 in FY2026, a rise of 0.98%.

FY2026 versus FY2027 payment factors for MS-DRG 904
MetricFY2026FY2027Change
Relative weight3.67303.7090+0.0360
Geometric mean LOS (days)6.66.6+0.0
Arithmetic mean LOS (days)10.29.6-0.6
Weights shown are the FY2027 final values after the 10% cap on year-over-year reductions where applicable.

CC and MCC family

DRG 904 shares its base definition with 1 other MS-DRG split by severity. The family's weights span 1.5540 to 3.7090, a 2.39× spread, which is the payment effect of documenting qualifying complications and comorbidities.

MS-DRGs in the same base group as DRG 904
DRGTitleFY2027 weightGMLOS
904Skin Grafts for Injuries with CC/MCC3.70906.6
905Skin Grafts for Injuries without CC/MCC1.55402.9

Grouper logic (v44 Definitions Manual)

Operating Room Procedures: 300 ICD-10 codes drive assignment to this group; the first 12 are shown.

Operating Room Procedures codes assigned to DRG 904 (sample)
ICD-10 codeDescription
0HR0X72Replacement of Scalp Skin with Autologous Tissue Substitute, Cell Suspension Technique, External Approach
0HR0X73Replacement of Scalp Skin with Autologous Tissue Substitute, Full Thickness, External Approach
0HR0X74Replacement of Scalp Skin with Autologous Tissue Substitute, Partial Thickness, External Approach
0HR0XJ3Replacement of Scalp Skin with Synthetic Substitute, Full Thickness, External Approach
0HR0XJ4Replacement of Scalp Skin with Synthetic Substitute, Partial Thickness, External Approach
0HR0XJZReplacement of Scalp Skin with Synthetic Substitute, External Approach
0HR0XK3Replacement of Scalp Skin with Nonautologous Tissue Substitute, Full Thickness, External Approach
0HR0XK4Replacement of Scalp Skin with Nonautologous Tissue Substitute, Partial Thickness, External Approach
0HR1X72Replacement of Face Skin with Autologous Tissue Substitute, Cell Suspension Technique, External Approach
0HR1X73Replacement of Face Skin with Autologous Tissue Substitute, Full Thickness, External Approach
0HR1X74Replacement of Face Skin with Autologous Tissue Substitute, Partial Thickness, External Approach
0HR1XJ3Replacement of Face Skin with Synthetic Substitute, Full Thickness, External 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 21 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 904 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 904

What is MS-DRG 904?

MS-DRG 904 is "Skin Grafts for Injuries with CC/MCC", a surgical Medicare Severity Diagnosis-Related Group in MDC 21, 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 904?

The FY2027 relative weight is 3.7090 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 3.6730, a change of +1.0%.

What is the average length of stay for DRG 904?

CMS reports a geometric mean length of stay of 6.6 days and an arithmetic mean of 9.6 days for FY2027. The geometric mean is used for transfer-payment calculations.

Which DRGs are in the same CC/MCC family as 904?

DRG 905 (Skin Grafts for Injuries without CC/MCC, weight 1.5540). The family's weights range from 1.5540 to 3.7090, so documented complications and comorbidities change payment materially.

What documentation supports the severity level of DRG 904?

DRG 904 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.

Which codes group to DRG 904?

The v44 Definitions Manual lists 300 operating room procedures codes for this group. Examples from the operating room procedures list: 0HR0X72 (Replacement of Scalp Skin with Autologous Tissue Substitute, Cell Suspension Technique, External Approach); 0HR0X73 (Replacement of Scalp Skin with Autologous Tissue Substitute, Full Thickness, External Approach); 0HR0X74 (Replacement of Scalp Skin with Autologous Tissue Substitute, Partial Thickness, External Approach); 0HR0XJ3 (Replacement of Scalp Skin with Synthetic Substitute, Full Thickness, External Approach).

Is DRG 904 a post-acute transfer DRG?

No. DRG 904 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.