MS-DRGs in MDC 08
Weights in this category range from 0.7120 (DRG 538) to 13.7380 (DRG 523); the change column compares FY2027 with FY2026.
| DRG | Title | Type | Weight | GMLOS | Change |
|---|---|---|---|---|---|
| 400 | Knee Procedures with Principal Diagnosis of Infection | Surgical | 2.0250 | 5.8 | new |
| 402 | Single Level Combined Anterior and Posterior Spinal Fusion Except Cervical | Surgical | 4.0950 | 2.4 | +1.8% |
| 403 | Hip or Knee Procedures with Principal Diagnosis of Periprosthetic Joint Infection with MCC or Insertion of Antibiotic-eluting Bone Void Filler | Surgical | 5.0050 | 9.0 | new |
| 404 | Hip or Knee Procedures with Principal Diagnosis of Periprosthetic Joint Infection without MCC | Surgical | 3.2520 | 4.6 | new |
| 426 | Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with MCC | Surgical | 9.9190 | 6.7 | -10.0% |
| 427 | Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with CC | Surgical | 6.7020 | 3.7 | -7.2% |
| 428 | Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical without CC/MCC | Surgical | 5.9200 | 2.5 | +5.3% |
| 429 | Combined Anterior and Posterior Cervical Spinal Fusion with MCC | Surgical | 8.8410 | 9.5 | -1.9% |
| 430 | Combined Anterior and Posterior Cervical Spinal Fusion without MCC | Surgical | 5.8940 | 3.5 | +2.2% |
| 447 | Multiple Level Spinal Fusion Except Cervical with MCC | Surgical | 6.9660 | 8.1 | +4.3% |
| 448 | Multiple Level Spinal Fusion Except Cervical without MCC | Surgical | 4.3500 | 3.3 | +2.6% |
| 449 | Revision of Hip or Knee Prosthesis | Surgical | 3.3000 | 3.1 | new |
| 450 | Single Level Spinal Fusion Except Cervical with MCC | Surgical | 5.2340 | 6.3 | -1.8% |
| 451 | Single Level Spinal Fusion Except Cervical without MCC | Surgical | 3.2600 | 2.4 | +0.9% |
| 456 | Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, or Infection with MCC | Surgical | 7.6210 | 9.9 | -9.3% |
| 457 | Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, or Infection with CC | Surgical | 5.3670 | 4.5 | -10.0% |
| 458 | Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, or Infection without CC/MCC | Surgical | 4.0370 | 2.1 | -3.3% |
| 461 | Bilateral or Multiple Major Joint Procedures of Lower Extremity with MCC | Surgical | 4.9710 | 6.2 | -10.0% |
| 462 | Bilateral or Multiple Major Joint Procedures of Lower Extremity without MCC | Surgical | 2.8530 | 2.2 | +7.3% |
| 463 | Wound Debridement or Skin Graft Except Hand for Musculoskeletal and Connective Tissue Disorders with MCC or Insertion of Antibiotic-eluting Bone Void Filler | Surgical | 5.1300 | 7.8 | -10.0% |
| 464 | Wound Debridement or Skin Graft Except Hand for Musculoskeletal and Connective Tissue Disorders with CC | Surgical | 3.1760 | 3.0 | +2.0% |
| 465 | Wound Debridement or Skin Graft Except Hand for Musculoskeletal and Connective Tissue Disorders without CC/MCC | Surgical | 2.4820 | 1.4 | +36.1% |
| 469 | Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity with MCC or Total Ankle Replacement | Surgical | 3.1080 | 3.3 | +2.5% |
| 470 | Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC | Surgical | 1.9560 | 2.0 | +1.4% |
| 471 | Cervical Spinal Fusion with MCC | Surgical | 4.9360 | 7.0 | +2.2% |
| 472 | Cervical Spinal Fusion with CC | Surgical | 2.9810 | 2.5 | +1.2% |
| 473 | Cervical Spinal Fusion without CC/MCC | Surgical | 2.4530 | 1.6 | +0.5% |
| 474 | Amputation for Musculoskeletal System and Connective Tissue Disorders with MCC or Insertion of Antibiotic-eluting Bone Void Filler | Surgical | 4.2130 | 9.7 | -1.9% |
| 475 | Amputation for Musculoskeletal System and Connective Tissue Disorders with CC | Surgical | 2.2250 | 6.0 | -2.2% |
| 476 | Amputation for Musculoskeletal System and Connective Tissue Disorders without CC/MCC | Surgical | 1.1350 | 2.6 | -3.8% |
| 477 | Biopsies of Musculoskeletal System and Connective Tissue with MCC or Insertion of Antibiotic-eluting Bone Void Filler | Surgical | 3.4030 | 8.1 | -1.5% |
| 478 | Biopsies of Musculoskeletal System and Connective Tissue with CC | Surgical | 2.4340 | 5.3 | -1.0% |
| 479 | Biopsies of Musculoskeletal System and Connective Tissue without CC/MCC | Surgical | 1.8530 | 3.3 | -0.3% |
| 480 | Hip and Femur Procedures Except Major Joint with MCC or Insertion of Antibiotic-eluting Bone Void Filler | Surgical | 2.9200 | 6.0 | +0.3% |
| 481 | Hip and Femur Procedures Except Major Joint with CC | Surgical | 2.1270 | 4.3 | +1.5% |
| 482 | Hip and Femur Procedures Except Major Joint without CC/MCC | Surgical | 1.6400 | 3.0 | +0.6% |
| 483 | Major Joint or Limb Reattachment Procedures of Upper Extremities | Surgical | 2.8960 | 2.1 | +4.5% |
| 488 | Knee Procedures without Principal Diagnosis of Infection with CC/MCC | Surgical | 2.2200 | 4.6 | +25.5% |
| 489 | Knee Procedures without Principal Diagnosis of Infection without CC/MCC | Surgical | 1.3120 | 2.0 | +17.5% |
| 492 | Lower Extremity and Humerus Procedures Except Hip, Foot and Femur with MCC or Insertion of Antibiotic-eluting Bone Void Filler | Surgical | 3.6920 | 6.4 | +0.5% |
| 493 | Lower Extremity and Humerus Procedures Except Hip, Foot and Femur with CC | Surgical | 2.5530 | 4.2 | +0.7% |
| 494 | Lower Extremity and Humerus Procedures Except Hip, Foot and Femur without CC/MCC | Surgical | 2.0250 | 2.8 | +1.0% |
| 495 | Local Excision and Removal of Internal Fixation Devices Except Hip and Femur with MCC | Surgical | 3.3360 | 7.0 | -8.0% |
| 496 | Local Excision and Removal of Internal Fixation Devices Except Hip and Femur with CC | Surgical | 1.7780 | 2.8 | -1.4% |
| 497 | Local Excision and Removal of Internal Fixation Devices Except Hip and Femur without CC/MCC | Surgical | 1.1710 | 1.4 | -3.1% |
| 498 | Local Excision and Removal of Internal Fixation Devices of Hip and Femur with CC/MCC | Surgical | 3.1880 | 4.4 | +5.7% |
| 499 | Local Excision and Removal of Internal Fixation Devices of Hip and Femur without CC/MCC | Surgical | 2.1670 | 1.8 | +7.5% |
| 500 | Soft Tissue Procedures with MCC | Surgical | 3.3600 | 7.8 | +6.2% |
| 501 | Soft Tissue Procedures with CC | Surgical | 1.8660 | 4.1 | +6.8% |
| 502 | Soft Tissue Procedures without CC/MCC | Surgical | 1.4330 | 2.3 | +6.5% |
| 503 | Foot Procedures with MCC | Surgical | 2.7760 | 6.9 | -0.5% |
| 504 | Foot Procedures with CC | Surgical | 1.7750 | 4.0 | -5.0% |
| 505 | Foot Procedures without CC/MCC | Surgical | 1.7750 | 4.0 | -1.0% |
| 506 | Major Thumb or Joint Procedures | Surgical | 1.2140 | 3.7 | -10.0% |
| 507 | Major Shoulder or Elbow Joint Procedures with CC/MCC | Surgical | 1.8570 | 5.1 | +2.8% |
| 508 | Major Shoulder or Elbow Joint Procedures without CC/MCC | Surgical | 1.3630 | 2.9 | -10.0% |
| 510 | Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures with MCC | Surgical | 3.1280 | 5.2 | +3.5% |
| 511 | Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures with CC | Surgical | 2.1180 | 3.5 | +1.9% |
| 512 | Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures without CC/MCC | Surgical | 1.7040 | 2.2 | +3.0% |
| 513 | Hand or Wrist Procedures, Except Major Thumb or Joint Procedures with CC/MCC | Surgical | 1.5210 | 3.8 | -3.4% |
| 514 | Hand or Wrist Procedures, Except Major Thumb or Joint Procedures without CC/MCC | Surgical | 1.0200 | 2.3 | -0.2% |
| 515 | Other Musculoskeletal System and Connective Tissue O.R. Procedures with MCC | Surgical | 3.1890 | 6.7 | +0.1% |
| 516 | Other Musculoskeletal System and Connective Tissue O.R. Procedures with CC | Surgical | 2.1180 | 4.0 | +1.9% |
| 517 | Other Musculoskeletal System and Connective Tissue O.R. Procedures without CC/MCC | Surgical | 1.5730 | 2.3 | +2.3% |
| 518 | Back and Neck Procedures Except Spinal Fusion with MCC or Disc Device or Neurostimulator | Surgical | 3.7310 | 5.1 | -0.2% |
| 519 | Back and Neck Procedures Except Spinal Fusion with CC | Surgical | 2.0360 | 3.2 | +1.8% |
| 520 | Back and Neck Procedures Except Spinal Fusion without CC/MCC | Surgical | 1.5560 | 2.1 | +4.2% |
| 521 | Hip Replacement with Principal Diagnosis of Hip Fracture with MCC | Surgical | 2.8520 | 5.9 | -0.6% |
| 522 | Hip Replacement with Principal Diagnosis of Hip Fracture without MCC | Surgical | 2.1160 | 4.0 | -0.1% |
| 523 | Extensive or Complex Spinal Fusion Procedures Except Cervical with MCC | Surgical | 13.7380 | 9.2 | new |
| 524 | Extensive or Complex Spinal Fusion Procedures Except Cervical with CC | Surgical | 9.8320 | 5.6 | new |
| 525 | Extensive or Complex Spinal Fusion Procedures Except Cervical without CC/MCC | Surgical | 7.2950 | 3.2 | new |
| 533 | Fractures of Femur with MCC | Medical | 1.4640 | 4.2 | -6.6% |
| 534 | Fractures of Femur without MCC | Medical | 0.8400 | 3.0 | +4.2% |
| 535 | Fractures of Hip and Pelvis with MCC | Medical | 1.2720 | 3.9 | -0.8% |
| 536 | Fractures of Hip and Pelvis without MCC | Medical | 0.8070 | 2.9 | -0.1% |
| 537 | Sprains, Strains, and Dislocations of Hip, Pelvis and Thigh with CC/MCC | Medical | 0.9150 | 3.1 | -4.1% |
| 538 | Sprains, Strains, and Dislocations of Hip, Pelvis and Thigh without CC/MCC | Medical | 0.7120 | 2.4 | -1.1% |
| 539 | Osteomyelitis with MCC | Medical | 1.9380 | 6.1 | -1.6% |
| 540 | Osteomyelitis with CC | Medical | 1.3080 | 4.3 | +0.9% |
| 541 | Osteomyelitis without CC/MCC | Medical | 0.8290 | 2.8 | +5.3% |
| 542 | Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with MCC | Medical | 1.7210 | 4.9 | -2.6% |
| 543 | Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with CC | Medical | 1.0060 | 3.4 | -2.1% |
| 544 | Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy without CC/MCC | Medical | 0.7400 | 2.7 | -2.0% |
| 545 | Connective Tissue Disorders with MCC | Medical | 2.3900 | 5.3 | -3.7% |
| 546 | Connective Tissue Disorders with CC | Medical | 1.1730 | 3.3 | +1.7% |
| 547 | Connective Tissue Disorders without CC/MCC | Medical | 0.7530 | 2.3 | -9.9% |
| 548 | Septic Arthritis with MCC | Medical | 1.9510 | 6.0 | +1.0% |
| 549 | Septic Arthritis with CC | Medical | 1.1430 | 3.7 | -5.3% |
| 550 | Septic Arthritis without CC/MCC | Medical | 0.8600 | 2.8 | -1.6% |
| 551 | Medical Back Problems with MCC | Medical | 1.6350 | 4.4 | -2.5% |
| 552 | Medical Back Problems without MCC | Medical | 0.9580 | 2.9 | -0.3% |
| 553 | Bone Diseases and Arthropathies with MCC | Medical | 1.2490 | 3.9 | -3.6% |
| 554 | Bone Diseases and Arthropathies without MCC | Medical | 0.8330 | 2.8 | +0.4% |
| 555 | Signs and Symptoms of Musculoskeletal System and Connective Tissue with MCC | Medical | 1.2910 | 3.7 | -2.3% |
| 556 | Signs and Symptoms of Musculoskeletal System and Connective Tissue without MCC | Medical | 0.8210 | 2.7 | -1.2% |
| 557 | Tendonitis, Myositis and Bursitis with MCC | Medical | 1.4880 | 4.6 | +0.1% |
| 558 | Tendonitis, Myositis and Bursitis without MCC | Medical | 0.8870 | 3.1 | -0.7% |
| 559 | Aftercare, Musculoskeletal System and Connective Tissue with MCC | Medical | 1.8090 | 4.9 | -3.0% |
| 560 | Aftercare, Musculoskeletal System and Connective Tissue with CC | Medical | 1.1230 | 3.8 | -0.3% |
| 561 | Aftercare, Musculoskeletal System and Connective Tissue without CC/MCC | Medical | 0.8260 | 3.0 | +2.7% |
| 562 | Fracture, Sprain, Strain and Dislocation Except Femur, Hip, Pelvis and Thigh with MCC | Medical | 1.3980 | 4.1 | -1.9% |
| 563 | Fracture, Sprain, Strain and Dislocation Except Femur, Hip, Pelvis and Thigh without MCC | Medical | 0.8980 | 3.0 | +0.3% |
| 564 | Other Musculoskeletal System and Connective Tissue Diagnoses with MCC | Medical | 1.4910 | 4.6 | -3.4% |
| 565 | Other Musculoskeletal System and Connective Tissue Diagnoses with CC | Medical | 0.9780 | 3.3 | +0.4% |
| 566 | Other Musculoskeletal System and Connective Tissue Diagnoses without CC/MCC | Medical | 0.7370 | 2.4 | -1.6% |
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 08?
106 MS-DRGs are assigned to MDC 08 (Diseases and Disorders of the Musculoskeletal System and Connective Tissue) in the FY2027 v44 grouper: 72 surgical and 34 medical.
Which MDC 08 DRG has the highest weight?
DRG 523, Extensive or Complex Spinal Fusion Procedures Except Cervical with MCC, carries the highest FY2027 relative weight in this category at 13.7380; the lowest is DRG 538 at 0.7120.
How is a stay assigned to this MDC?
The grouper maps the principal diagnosis to MDC 08, 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.