Headline numbers
- DRGs compared
- 752
- Weights up
- 346
- Weights down
- 404
- Moved ≥ 2%
- 411
- Average change
- -0.10%
- New DRGs
- 14
25 largest weight increases
These groups pay materially more per discharge in FY2027 than in FY2026 at the same base rate; most increases reflect higher reported costs or the migration of costlier cases into the group through code reassignment.
| DRG | Title | FY2027 weight | Change |
|---|---|---|---|
| 465 | Wound Debridement or Skin Graft Except Hand for Musculoskeletal and Connective Tissue Disorders without CC/MCC | 2.4820 | +36.07% |
| 927 | Extensive Burns or Full Thickness Burns with MV >96 Hours with Skin Graft | 27.8340 | +30.36% |
| 488 | Knee Procedures without Principal Diagnosis of Infection with CC/MCC | 2.2200 | +25.49% |
| 425 | Other Hepatobiliary or Pancreas O.R. Procedures without CC/MCC | 1.8820 | +25.47% |
| 761 | Menstrual and Other Female Reproductive System Disorders without CC/MCC | 0.7040 | +23.29% |
| 297 | Cardiac Arrest, Unexplained with CC | 0.7770 | +22.56% |
| 950 | Aftercare without CC/MCC | 0.7660 | +21.97% |
| 779 | Abortion without D&C | 1.0200 | +21.28% |
| 970 | HIV with Extensive O.R. Procedures without MCC | 3.1460 | +19.30% |
| 935 | Non-Extensive Burns | 2.4230 | +17.62% |
| 489 | Knee Procedures without Principal Diagnosis of Infection without CC/MCC | 1.3120 | +17.46% |
| 969 | HIV with Extensive O.R. Procedures with MCC | 7.1740 | +17.20% |
| 816 | Reticuloendothelial and Immunity Disorders without CC/MCC | 0.7380 | +16.77% |
| 759 | Infections, Female Reproductive System without CC/MCC | 0.7690 | +15.81% |
| 801 | Splenic Procedures without CC/MCC | 2.1930 | +14.88% |
| 007 | Lung Transplant | 14.8700 | +14.83% |
| 279 | Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures without MCC | 4.1310 | +14.56% |
| 278 | Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures with MCC | 6.3480 | +14.05% |
| 800 | Splenic Procedures with CC | 3.1490 | +12.10% |
| 099 | Non-Bacterial Infection of Nervous System Except Viral Meningitis without CC/MCC | 1.5250 | +11.97% |
| 818 | Other Antepartum Diagnoses with O.R. Procedures with CC | 1.2940 | +11.65% |
| 623 | Skin Grafts and Wound Debridement for Endocrine, Nutritional and Metabolic Disorders with CC | 2.0030 | +11.65% |
| 251 | Percutaneous Cardiovascular Procedures without Intraluminal Device without MCC | 1.6640 | +11.38% |
| 410 | Biliary Tract Procedures Except Only Cholecystectomy with or without C.D.E. without CC/MCC | 1.7660 | +11.21% |
| 835 | Acute Leukemia with CC | 2.3030 | +10.40% |
25 largest weight decreases
Decreases are capped at 10% a year, so groups near the cap signal sustained cost declines or case-mix shifts that carry into FY2028; budgets built on FY2026 weights overstate revenue for these discharges.
| DRG | Title | FY2027 weight | Change |
|---|---|---|---|
| 434 | Cirrhosis and Alcoholic Hepatitis without CC/MCC | 0.6410 | -10.10% |
| 976 | HIV with Major Related Condition without CC/MCC | 0.8120 | -10.08% |
| 724 | Malignancy, Male Reproductive System without CC/MCC | 0.5900 | -10.06% |
| 081 | Nontraumatic Stupor and Coma without MCC | 0.8060 | -10.04% |
| 817 | Other Antepartum Diagnoses with O.R. Procedures with MCC | 2.0530 | -10.04% |
| 594 | Skin Ulcers without CC/MCC | 0.7800 | -10.03% |
| 285 | Acute Myocardial Infarction, Expired without CC/MCC | 0.5390 | -10.02% |
| 289 | Acute and Subacute Endocarditis with CC | 1.5360 | -10.02% |
| 697 | Urethral Stricture | 0.9700 | -10.02% |
| 116 | Intraocular Procedures with CC/MCC | 1.6270 | -10.01% |
| 265 | AICD Lead Procedures | 3.2560 | -10.01% |
| 420 | Hepatobiliary Diagnostic Procedures with MCC | 3.0660 | -10.01% |
| 506 | Major Thumb or Joint Procedures | 1.2140 | -10.01% |
| 618 | Amputation of Lower Limb for Endocrine, Nutritional and Metabolic Disorders without CC/MCC | 1.2760 | -10.01% |
| 709 | Penis Procedures with CC/MCC | 2.0940 | -10.01% |
| 017 | Autologous Bone Marrow Transplant without CC/MCC | 4.8890 | -10.00% |
| 096 | Bacterial and Tuberculous Infections of Nervous System without CC/MCC | 2.3210 | -10.00% |
| 290 | Acute and Subacute Endocarditis without CC/MCC | 0.8370 | -10.00% |
| 426 | Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with MCC | 9.9190 | -10.00% |
| 734 | Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy with CC/MCC | 1.9170 | -10.00% |
| 819 | Other Antepartum Diagnoses with O.R. Procedures without CC/MCC | 0.7740 | -10.00% |
| 934 | Full Thickness Burn without Skin Graft or Inhalation Injury | 1.9900 | -10.00% |
| 411 | Cholecystectomy with C.D.E. with MCC | 2.9730 | -9.99% |
| 457 | Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, or Infection with CC | 5.3670 | -9.99% |
| 461 | Bilateral or Multiple Major Joint Procedures of Lower Extremity with MCC | 4.9710 | -9.99% |
New MS-DRGs for FY2027
| DRG | Title | FY2027 weight |
|---|---|---|
| 210 | Cardiac Pacemaker Revision or Device Replacement with MCC | 3.2660 |
| 211 | Cardiac Pacemaker Revision or Device Replacement without MCC | 1.8100 |
| 361 | Other Circulatory System O.R. Procedures with MCC | 3.7580 |
| 362 | Other Circulatory System O.R. Procedures without MCC | 2.1970 |
| 400 | Knee Procedures with Principal Diagnosis of Infection | 2.0250 |
| 403 | Hip or Knee Procedures with Principal Diagnosis of Periprosthetic Joint Infection with MCC or Insertion of Antibiotic-eluting Bone Void Filler | 5.0050 |
| 404 | Hip or Knee Procedures with Principal Diagnosis of Periprosthetic Joint Infection without MCC | 3.2520 |
| 449 | Revision of Hip or Knee Prosthesis | 3.3000 |
| 523 | Extensive or Complex Spinal Fusion Procedures Except Cervical with MCC | 13.7380 |
| 524 | Extensive or Complex Spinal Fusion Procedures Except Cervical with CC | 9.8320 |
| 525 | Extensive or Complex Spinal Fusion Procedures Except Cervical without CC/MCC | 7.2950 |
| 731 | Uterine and Adnexa Procedures for Malignancy with MCC | 3.5460 |
| 732 | Uterine and Adnexa Procedures for Malignancy with CC | 1.9200 |
| 733 | Uterine and Adnexa Procedures for Malignancy without CC/MCC | 1.4320 |
Method and reuse
Weights are the final values after the 10% reduction cap from each year's Table 5; percentage change is over the FY2026 weight. The full per-DRG comparison is on each MS-DRG page, and the computation is described in the reference methodology. Figures may be reused with attribution to QuickIntell and a link to this page.
Frequently asked questions
How many MS-DRG weights changed for FY2027?
Of 752 MS-DRGs with weights in both years, 346 increased and 404 decreased; 411 moved by at least 2%. The average change is -0.10%.
Why do DRG weights change every year?
CMS recalibrates weights from the prior year's MedPAR claims and cost reports, so shifts in reported costs, case mix and coding move each group's weight. Code reassignments in the final rule's Table 6 series also move patients between groups. Decreases are capped at 10% per year.
What should a hospital do with this list?
Re-run contract models and budgets on the FY2027 weights for the groups it discharges most, check that the encoder loaded the v44 grouper on October 1, and review documentation programmes for families whose MCC or CC sibling gained the most.
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-02. 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
Relative weights are national factors; actual payment depends on hospital-specific rates and adjustments. Operational reference, not legal, clinical or billing advice.