MS-DRGs in MDC 05
Weights in this category range from 0.4940 (DRG 298) to 11.5160 (DRG 209); the change column compares FY2027 with FY2026.
| DRG | Title | Type | Weight | GMLOS | Change |
|---|---|---|---|---|---|
| 209 | Complex Aortic Arch Procedures | Surgical | 11.5160 | 6.0 | +1.7% |
| 210 | Cardiac Pacemaker Revision or Device Replacement with MCC | Surgical | 3.2660 | 5.4 | new |
| 211 | Cardiac Pacemaker Revision or Device Replacement without MCC | Surgical | 1.8100 | 2.6 | new |
| 212 | Concomitant Aortic and Mitral Valve Procedures | Surgical | 11.4420 | 12.8 | +5.2% |
| 213 | Endovascular Abdominal Aorta with Iliac Branch Procedures | Surgical | 5.8480 | 1.7 | +2.5% |
| 215 | Other Heart Assist System Implant | Surgical | 10.1420 | 4.5 | +1.9% |
| 216 | Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with MCC | Surgical | 9.8820 | 10.5 | +1.0% |
| 217 | Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with CC | Surgical | 6.8050 | 3.9 | +3.5% |
| 218 | Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization without CC/MCC | Surgical | 6.8050 | 3.9 | +3.5% |
| 219 | Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization with MCC | Surgical | 7.6400 | 8.0 | -0.5% |
| 220 | Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization with CC | Surgical | 5.5060 | 5.3 | +3.2% |
| 221 | Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization without CC/MCC | Surgical | 4.7130 | 2.5 | -6.5% |
| 228 | Other Cardiothoracic Procedures with MCC | Surgical | 4.9660 | 5.9 | +0.4% |
| 229 | Other Cardiothoracic Procedures without MCC | Surgical | 3.4400 | 2.5 | +9.2% |
| 231 | Coronary Bypass with PTCA with MCC | Surgical | 8.7750 | 10.3 | +4.1% |
| 232 | Coronary Bypass with PTCA without MCC | Surgical | 6.2270 | 7.7 | +2.7% |
| 233 | Coronary Bypass with Cardiac Catheterization or Open Ablation with MCC | Surgical | 8.0160 | 11.2 | +4.9% |
| 234 | Coronary Bypass with Cardiac Catheterization or Open Ablation without MCC | Surgical | 5.5040 | 8.3 | +0.8% |
| 235 | Coronary Bypass without Cardiac Catheterization with MCC | Surgical | 5.8530 | 7.7 | -0.3% |
| 236 | Coronary Bypass without Cardiac Catheterization without MCC | Surgical | 4.3380 | 5.7 | +3.6% |
| 239 | Amputation for Circulatory System Disorders Except Upper Limb and Toe with MCC | Surgical | 5.0010 | 11.0 | +1.6% |
| 240 | Amputation for Circulatory System Disorders Except Upper Limb and Toe with CC | Surgical | 2.9470 | 7.3 | +3.4% |
| 241 | Amputation for Circulatory System Disorders Except Upper Limb and Toe without CC/MCC | Surgical | 1.4820 | 4.3 | +7.1% |
| 242 | Permanent Cardiac Pacemaker Implant with MCC | Surgical | 3.1230 | 4.8 | -2.2% |
| 243 | Permanent Cardiac Pacemaker Implant with CC | Surgical | 2.1080 | 2.8 | -1.1% |
| 244 | Permanent Cardiac Pacemaker Implant without CC/MCC | Surgical | 1.7640 | 2.1 | -2.4% |
| 245 | AICD Generator Procedures | Surgical | 4.6460 | 4.4 | +1.8% |
| 250 | Percutaneous Cardiovascular Procedures without Intraluminal Device with MCC | Surgical | 2.3390 | 3.1 | +7.2% |
| 251 | Percutaneous Cardiovascular Procedures without Intraluminal Device without MCC | Surgical | 1.6640 | 1.9 | +11.4% |
| 252 | Other Vascular Procedures with MCC | Surgical | 3.4820 | 5.3 | -0.2% |
| 253 | Other Vascular Procedures with CC | Surgical | 2.6270 | 3.6 | +1.2% |
| 254 | Other Vascular Procedures without CC/MCC | Surgical | 1.7960 | 1.7 | +0.8% |
| 255 | Upper Limb and Toe Amputation for Circulatory System Disorders with MCC | Surgical | 2.8290 | 6.9 | +4.9% |
| 256 | Upper Limb and Toe Amputation for Circulatory System Disorders with CC | Surgical | 1.6710 | 5.0 | -1.6% |
| 257 | Upper Limb and Toe Amputation for Circulatory System Disorders without CC/MCC | Surgical | 1.0450 | 3.2 | -4.3% |
| 263 | Vein Ligation and Stripping | Surgical | 3.2420 | 4.9 | +6.1% |
| 265 | AICD Lead Procedures | Surgical | 3.2560 | 4.1 | -10.0% |
| 266 | Endovascular Cardiac Valve Replacement and Supplement Procedures with MCC | Surgical | 5.9370 | 2.3 | -3.1% |
| 267 | Endovascular Cardiac Valve Replacement and Supplement Procedures without MCC | Surgical | 4.7210 | 1.3 | -0.8% |
| 268 | Aortic and Heart Assist Procedures Except Pulsation Balloon with MCC | Surgical | 7.1660 | 6.2 | +4.2% |
| 269 | Aortic and Heart Assist Procedures Except Pulsation Balloon without MCC | Surgical | 4.2590 | 1.5 | +0.9% |
| 270 | Other Major Cardiovascular Procedures with MCC | Surgical | 5.2660 | 6.1 | -0.2% |
| 271 | Other Major Cardiovascular Procedures with CC | Surgical | 3.5970 | 3.6 | +1.2% |
| 272 | Other Major Cardiovascular Procedures without CC/MCC | Surgical | 2.4850 | 1.7 | -2.7% |
| 273 | Percutaneous and Other Intracardiac Procedures with MCC | Surgical | 4.2980 | 3.7 | +4.2% |
| 274 | Percutaneous and Other Intracardiac Procedures without MCC | Surgical | 3.3320 | 1.2 | +1.2% |
| 275 | Cardiac Defibrillator Implant with Cardiac Catheterization and MCC | Surgical | 7.1570 | 8.2 | +0.4% |
| 276 | Cardiac Defibrillator Implant with MCC or Carotid Sinus Neurostimulator | Surgical | 6.2020 | 6.3 | +3.3% |
| 277 | Cardiac Defibrillator Implant without MCC | Surgical | 4.6910 | 3.4 | +1.6% |
| 278 | Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures with MCC | Surgical | 6.3480 | 7.9 | +14.1% |
| 279 | Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures without MCC | Surgical | 4.1310 | 3.6 | +14.6% |
| 280 | Acute Myocardial Infarction, Discharged Alive with MCC | Medical | 1.6110 | 4.0 | +0.4% |
| 281 | Acute Myocardial Infarction, Discharged Alive with CC | Medical | 0.9180 | 2.3 | -0.1% |
| 282 | Acute Myocardial Infarction, Discharged Alive without CC/MCC | Medical | 0.7380 | 1.7 | +2.1% |
| 283 | Acute Myocardial Infarction, Expired with MCC | Medical | 1.9620 | 3.2 | -1.0% |
| 284 | Acute Myocardial Infarction, Expired with CC | Medical | 0.7530 | 1.6 | +8.8% |
| 285 | Acute Myocardial Infarction, Expired without CC/MCC | Medical | 0.5390 | 1.2 | -10.0% |
| 286 | Circulatory Disorders Except AMI, with Cardiac Catheterization with MCC | Medical | 2.2180 | 5.4 | +0.2% |
| 287 | Circulatory Disorders Except AMI, with Cardiac Catheterization without MCC | Medical | 1.0790 | 2.1 | +0.8% |
| 288 | Acute and Subacute Endocarditis with MCC | Medical | 2.6300 | 7.3 | -2.8% |
| 289 | Acute and Subacute Endocarditis with CC | Medical | 1.5360 | 5.0 | -10.0% |
| 290 | Acute and Subacute Endocarditis without CC/MCC | Medical | 0.8370 | 2.4 | -10.0% |
| 291 | Heart Failure and Shock with MCC | Medical | 1.2680 | 3.8 | -1.3% |
| 292 | Heart Failure and Shock with CC | Medical | 0.8610 | 2.9 | +1.4% |
| 293 | Heart Failure and Shock without CC/MCC | Medical | 0.5460 | 2.1 | -3.5% |
| 296 | Cardiac Arrest, Unexplained with MCC | Medical | 1.4990 | 2.1 | -4.0% |
| 297 | Cardiac Arrest, Unexplained with CC | Medical | 0.7770 | 1.3 | +22.6% |
| 298 | Cardiac Arrest, Unexplained without CC/MCC | Medical | 0.4940 | 1.0 | +8.6% |
| 299 | Peripheral Vascular Disorders with MCC | Medical | 1.5840 | 3.9 | -3.0% |
| 300 | Peripheral Vascular Disorders with CC | Medical | 1.0460 | 3.0 | -2.0% |
| 301 | Peripheral Vascular Disorders without CC/MCC | Medical | 0.7130 | 2.0 | -1.0% |
| 302 | Atherosclerosis with MCC | Medical | 1.1990 | 2.8 | +0.2% |
| 303 | Atherosclerosis without MCC | Medical | 0.6610 | 1.8 | -1.8% |
| 304 | Hypertension with MCC | Medical | 1.2010 | 3.1 | +0.9% |
| 305 | Hypertension without MCC | Medical | 0.7580 | 2.1 | +0.4% |
| 306 | Cardiac Congenital and Valvular Disorders with MCC | Medical | 1.5460 | 3.8 | -1.9% |
| 307 | Cardiac Congenital and Valvular Disorders without MCC | Medical | 0.9150 | 2.1 | +0.2% |
| 308 | Cardiac Arrhythmia and Conduction Disorders with MCC | Medical | 1.1810 | 3.3 | -1.9% |
| 309 | Cardiac Arrhythmia and Conduction Disorders with CC | Medical | 0.7320 | 2.2 | -0.5% |
| 310 | Cardiac Arrhythmia and Conduction Disorders without CC/MCC | Medical | 0.5690 | 1.8 | +0.5% |
| 311 | Angina Pectoris | Medical | 0.6680 | 1.9 | -4.8% |
| 312 | Syncope and Collapse | Medical | 0.8660 | 2.4 | -0.7% |
| 313 | Chest Pain | Medical | 0.7110 | 1.7 | -1.3% |
| 314 | Other Circulatory System Diagnoses with MCC | Medical | 2.0870 | 4.8 | +0.1% |
| 315 | Other Circulatory System Diagnoses with CC | Medical | 0.9510 | 2.6 | -1.3% |
| 316 | Other Circulatory System Diagnoses without CC/MCC | Medical | 0.6680 | 1.8 | -2.1% |
| 317 | Concomitant Left Atrial Appendage Closure and Cardiac Ablation | Surgical | 7.0890 | 2.1 | +6.0% |
| 318 | Percutaneous Coronary Atherectomy without Intraluminal Device | Surgical | 2.6180 | 2.7 | +8.1% |
| 319 | Other Endovascular Cardiac Valve Procedures with MCC | Surgical | 4.2660 | 7.1 | -4.4% |
| 320 | Other Endovascular Cardiac Valve Procedures without MCC | Surgical | 2.1650 | 1.9 | -10.0% |
| 321 | Percutaneous Cardiovascular Procedures with Intraluminal Device with MCC or 4+ Arteries/Intraluminal Devices | Surgical | 2.7150 | 3.6 | -0.2% |
| 322 | Percutaneous Cardiovascular Procedures with Intraluminal Device without MCC | Surgical | 1.7750 | 2.0 | +0.7% |
| 323 | Coronary Intravascular Lithotripsy with Intraluminal Device with MCC | Surgical | 4.4350 | 4.6 | +2.5% |
| 324 | Coronary Intravascular Lithotripsy with Intraluminal Device without MCC | Surgical | 3.1910 | 2.3 | +1.3% |
| 325 | Coronary Intravascular Lithotripsy without Intraluminal Device | Surgical | 3.3350 | 2.7 | +3.9% |
| 359 | Percutaneous Coronary Atherectomy with Intraluminal Device with MCC | Surgical | 3.3780 | 3.8 | -1.8% |
| 360 | Percutaneous Coronary Atherectomy with Intraluminal Device without MCC | Surgical | 2.3400 | 2.1 | -3.1% |
| 361 | Other Circulatory System O.R. Procedures with MCC | Surgical | 3.7580 | 7.6 | new |
| 362 | Other Circulatory System O.R. Procedures without MCC | Surgical | 2.1970 | 4.9 | new |
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 05?
99 MS-DRGs are assigned to MDC 05 (Assignment of Diagnosis Codes) in the FY2027 v44 grouper: 64 surgical and 35 medical.
Which MDC 05 DRG has the highest weight?
DRG 209, Complex Aortic Arch Procedures, carries the highest FY2027 relative weight in this category at 11.5160; the lowest is DRG 298 at 0.4940.
How is a stay assigned to this MDC?
The grouper maps the principal diagnosis to MDC 05, 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.