MS-DRGs in MDC 04
Weights in this category range from 0.6060 (DRG 195) to 6.3970 (DRG 207); the change column compares FY2027 with FY2026.
| DRG | Title | Type | Weight | GMLOS | Change |
|---|---|---|---|---|---|
| 163 | Major Chest Procedures with MCC | Surgical | 4.4880 | 5.9 | +0.1% |
| 164 | Major Chest Procedures with CC | Surgical | 2.5150 | 3.2 | -0.4% |
| 165 | Major Chest Procedures without CC/MCC | Surgical | 1.9290 | 1.9 | +0.8% |
| 166 | Other Respiratory System O.R. Procedures with MCC | Surgical | 3.8730 | 7.6 | +3.6% |
| 167 | Other Respiratory System O.R. Procedures with CC | Surgical | 1.8240 | 3.3 | +1.2% |
| 168 | Other Respiratory System O.R. Procedures without CC/MCC | Surgical | 1.3890 | 1.8 | +1.7% |
| 173 | Ultrasound Accelerated and Other Thrombolysis with Principal Diagnosis Pulmonary Embolism | Surgical | 2.9550 | 3.7 | -0.7% |
| 175 | Pulmonary Embolism with MCC or Acute Cor Pulmonale | Medical | 1.3650 | 3.7 | -0.7% |
| 176 | Pulmonary Embolism without MCC | Medical | 0.8060 | 2.4 | +0.1% |
| 177 | Respiratory Infections and Inflammations with MCC | Medical | 1.6090 | 4.5 | +2.9% |
| 178 | Respiratory Infections and Inflammations with CC | Medical | 0.9740 | 3.1 | -0.2% |
| 179 | Respiratory Infections and Inflammations without CC/MCC | Medical | 0.7340 | 2.4 | -2.8% |
| 180 | Respiratory Neoplasms with MCC | Medical | 1.7800 | 4.7 | +0.8% |
| 181 | Respiratory Neoplasms with CC | Medical | 1.0930 | 3.1 | +2.1% |
| 182 | Respiratory Neoplasms without CC/MCC | Medical | 0.7440 | 2.0 | -1.3% |
| 183 | Major Chest Trauma with MCC | Medical | 1.4900 | 4.1 | -2.6% |
| 184 | Major Chest Trauma with CC | Medical | 1.0650 | 3.1 | +0.1% |
| 185 | Major Chest Trauma without CC/MCC | Medical | 0.7710 | 2.2 | -1.9% |
| 186 | Pleural Effusion with MCC | Medical | 1.5840 | 4.2 | +1.7% |
| 187 | Pleural Effusion with CC | Medical | 1.0000 | 3.0 | +1.1% |
| 188 | Pleural Effusion without CC/MCC | Medical | 0.6650 | 2.1 | -7.3% |
| 189 | Pulmonary Edema and Respiratory Failure | Medical | 1.2110 | 3.4 | -1.9% |
| 190 | Chronic Obstructive Pulmonary Disease with MCC | Medical | 1.0750 | 3.3 | -3.0% |
| 191 | Chronic Obstructive Pulmonary Disease with CC | Medical | 0.8260 | 2.6 | -2.0% |
| 192 | Chronic Obstructive Pulmonary Disease without CC/MCC | Medical | 0.6280 | 2.1 | -2.2% |
| 193 | Simple Pneumonia and Pleurisy with MCC | Medical | 1.2820 | 3.8 | -2.4% |
| 194 | Simple Pneumonia and Pleurisy with CC | Medical | 0.7890 | 2.7 | -2.1% |
| 195 | Simple Pneumonia and Pleurisy without CC/MCC | Medical | 0.6060 | 2.2 | -3.5% |
| 196 | Interstitial Lung Disease with MCC | Medical | 1.8330 | 4.8 | -2.9% |
| 197 | Interstitial Lung Disease with CC | Medical | 0.9490 | 2.8 | +0.0% |
| 198 | Interstitial Lung Disease without CC/MCC | Medical | 0.7260 | 2.2 | +1.4% |
| 199 | Pneumothorax with MCC | Medical | 1.7310 | 4.7 | -1.9% |
| 200 | Pneumothorax with CC | Medical | 1.0770 | 3.1 | -2.0% |
| 201 | Pneumothorax without CC/MCC | Medical | 0.6780 | 2.2 | -5.2% |
| 202 | Bronchitis and Asthma with CC/MCC | Medical | 0.9470 | 2.8 | -2.5% |
| 203 | Bronchitis and Asthma without CC/MCC | Medical | 0.6510 | 2.1 | -2.8% |
| 204 | Respiratory Signs and Symptoms | Medical | 0.8210 | 2.1 | +1.7% |
| 205 | Other Respiratory System Diagnoses with MCC | Medical | 1.8240 | 4.3 | -0.4% |
| 206 | Other Respiratory System Diagnoses without MCC | Medical | 0.9250 | 2.4 | -1.7% |
| 207 | Respiratory System Diagnosis with Ventilator Support >96 Hours | Medical | 6.3970 | 12.3 | -0.6% |
| 208 | Respiratory System Diagnosis with Ventilator Support <=96 Hours | Medical | 2.7510 | 4.8 | +0.1% |
How to read this table
The relative weight is the payment multiplier CMS applies to a hospital's wage-adjusted standardized amount; a weight of 2.0 pays roughly twice an average inpatient case before outliers and add-ons. Geometric mean length of stay is the figure used in post-acute transfer calculations, so stays shorter than it in a transfer DRG are paid per diem. The change column compares the FY2027 final weight with FY2026; moves larger than two percent usually come from code reassignments in the final rule's Table 6 series or from updated cost data, and are worth re-checking in contract models and budgets before October 1. Surgical DRGs require a qualifying operating-room procedure; medical DRGs are reached when no such procedure is coded.
Frequently asked questions
How many MS-DRGs are in MDC 04?
41 MS-DRGs are assigned to MDC 04 (Assignment of Diagnosis Codes) in the FY2027 v44 grouper: 7 surgical and 34 medical.
Which MDC 04 DRG has the highest weight?
DRG 207, Respiratory System Diagnosis with Ventilator Support >96 Hours, carries the highest FY2027 relative weight in this category at 6.3970; the lowest is DRG 195 at 0.6060.
How is a stay assigned to this MDC?
The grouper maps the principal diagnosis to MDC 04, then checks for a qualifying operating-room procedure to choose between the surgical and medical DRG partitions, and finally applies CC/MCC severity splits.
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…
Disclaimer
Operational reference compiled from CMS publications. Relative weights are national factors; actual payment depends on hospital-specific rates and adjustments. Not legal, clinical or billing advice.