Key facts for DRG 470
- FY2027 relative weight
- 1.9563
- Higher than 61% of all MS-DRGs
- Change vs FY2026
- +1.4%
- FY2026 weight 1.9289
- Geometric mean LOS
- 2.0 days
- Arithmetic mean 2.3 days
- MDC
- 08
- Diseases and Disorders of the Musculoskeletal System and Connective Tissue
- Severity level
- without MCC
- National unadjusted operating payment
- $13,396.74
- Weight × $6,848.00 FY2027 standardized amount; capital adds $1,056.30
- Transfer policy
- Post-acute transfer DRG
TL;DR
MS-DRG 470 is a surgical group in MDC 08 (Diseases and Disorders of the Musculoskeletal System and Connective Tissue), at the lower of two severity levels (no MCC present). CMS assigns it a FY2027 relative weight of 1.9563 with a geometric mean length of stay of 2.0 days and an arithmetic mean of 2.3. Its weight moved up 1.4% from FY2026 (1.9289). That weight is higher than 61% of all MS-DRGs. Its weight sits 37.1% below DRG 469 (with MCC, 3.1085). The v44 Definitions Manual assigns it through 178 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 470 the FY2027 relative weight is 1.9563 against 1.9289 in FY2026, a rise of 1.42%.
| Metric | FY2026 | FY2027 | Change |
|---|---|---|---|
| Relative weight | 1.9289 | 1.9563 | +0.0274 |
| Geometric mean LOS (days) | 1.9 | 2.0 | +0.1 |
| Arithmetic mean LOS (days) | 2.2 | 2.3 | +0.1 |
CC and MCC family
DRG 470 shares its base definition with 1 other MS-DRG split by severity. The family's weights span 1.9563 to 3.1085, a 1.59× spread, which is the payment effect of documenting qualifying complications and comorbidities.
| DRG | Title | FY2027 weight | GMLOS | National operating payment |
|---|---|---|---|---|
| 469 | Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity with MCC or Total Ankle Replacement | 3.1085 | 3.3 | $21,287.01 |
| 470 | Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC | 1.9563 | 2.0 | $13,396.74 |
At the national rate, documenting the family's top severity level (DRG 469, $21,287.01) instead of its base level (DRG 470, $13,396.74) changes the operating payment by $7,890.27, the amount at stake when a qualifying secondary diagnosis goes undocumented. The figures are national operating amounts before the hospital-specific adjustments described below.
National unadjusted payment for DRG 470
Multiplying the FY2027 relative weight (1.9563) by the national rates in IPPS Tables 1A and 1D, as corrected by notice CMS-1849-CN3, gives the base amounts below. Across the CC/MCC family the operating amount spans $7,890.27.
| Component | National rate | DRG 470 |
|---|---|---|
| Operating (labor and nonlabor share) | $4,519.68 + $2,328.32 = $6,848.00 | $13,396.74 |
| Capital (federal rate) | $539.95 | $1,056.30 |
| Operating plus capital | $14,453.04 |
These are national, unadjusted figures, not what a given hospital is paid. The labor share is multiplied by the hospital's wage index (Table 1A applies when the wage index is above 1.0 and Table 1B otherwise), and teaching (IME), disproportionate share (DSH), outlier, transfer and new-technology add-on rules then change the amount for each stay. Because DRG 470 is on the post-acute transfer list, a qualifying early discharge to post-acute care is paid per diem against the 2.0-day geometric mean instead of the full amount. Use the figures to compare groups and to size a documentation finding, not to forecast a remittance; the DRG payment calculator applies a hospital's own wage index and teaching and DSH factors to DRG 470.
Grouper logic (v44 Definitions Manual)
The manual's split table for Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity or Total Ankle Replacement gives one row per combination of criteria and the MS-DRG it assigns. DRG 470 is the row where Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity is Yes, Total Ankle Replacement is No, MCC is No.
Criteria stated in the manual
- Without Total Ankle Replacement
Operating Room Procedures: 178 ICD-10-PCS codes in this DRG's assignment logic; the first 12 are shown.
| ICD-10-PCS code | Description |
|---|---|
| 0SR9019 | Replacement of Right Hip Joint with Metal Synthetic Substitute, Cemented, Open Approach |
| 0SR901A | Replacement of Right Hip Joint with Metal Synthetic Substitute, Uncemented, Open Approach |
| 0SR901Z | Replacement of Right Hip Joint with Metal Synthetic Substitute, Open Approach |
| 0SR9029 | Replacement of Right Hip Joint with Metal on Polyethylene Synthetic Substitute, Cemented, Open Approach |
| 0SR902A | Replacement of Right Hip Joint with Metal on Polyethylene Synthetic Substitute, Uncemented, Open Approach |
| 0SR902Z | Replacement of Right Hip Joint with Metal on Polyethylene Synthetic Substitute, Open Approach |
| 0SR9039 | Replacement of Right Hip Joint with Ceramic Synthetic Substitute, Cemented, Open Approach |
| 0SR903A | Replacement of Right Hip Joint with Ceramic Synthetic Substitute, Uncemented, Open Approach |
| 0SR903Z | Replacement of Right Hip Joint with Ceramic Synthetic Substitute, Open Approach |
| 0SR9049 | Replacement of Right Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Cemented, Open Approach |
| 0SR904A | Replacement of Right Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Uncemented, Open Approach |
| 0SR904Z | Replacement of Right Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Open Approach |
Code editor, HAC and CC/MCC exclusion notes for DRG 470
162 procedure codes in this DRG's logic are on the procedure list of HAC 10 (Deep Vein Thrombosis (DVT) / Pulmonary Embolism (PE) with Total Knee or Hip Replacement), for example 0SR9019. When the condition that category tracks is coded as a secondary diagnosis with a present-on-admission indicator of N or U after one of these procedures, the grouper does not count it as a CC or MCC. The FY2027 HAC list gives the diagnoses and procedures of each category.
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 08 with a lower weight. The inpatient claim reports that procedure in ICD-10-PCS, which NCCI does not edit; the surgeon's professional claim for the same operation carries CPT and HCPCS codes, and the NCCI pair checker for those professional codes shows whether two of them bundle. 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).
For teams evaluating QuickIntell software
Evaluate a documentation and coding workflow for DRG 470
Explore QuickCode for qualified coder review and documentation clarification, or QuickScribe for clinician-reviewed visit documentation. Confirm inpatient scope, the supported grouper version and reviewer responsibilities during evaluation. This public reference is not a production grouper and does not determine a claim's reimbursement.
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Frequently asked questions — DRG 470
What is MS-DRG 470?
MS-DRG 470 is "Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC", a surgical Medicare Severity Diagnosis-Related Group in MDC 08 (Diseases and Disorders of the Musculoskeletal System and Connective Tissue). 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 470?
The FY2027 relative weight is 1.9563 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 1.9289, a change of +1.4%.
What is the Medicare base payment for MS-DRG 470?
$13,396.74 for operating costs plus $1,056.30 for capital, $14,453.04 together, at the FY2027 national rates: weight 1.9563 times the $6,848.00 operating standardized amount and the $539.95 capital rate (IPPS Tables 1A and 1D as corrected by CMS-1849-CN3). DRG 469 (with MCC) comes to $21,287.01 operating on the same basis. The hospital's wage index, IME, DSH, outlier and transfer adjustments change what a given stay is paid.
What is the average length of stay for DRG 470?
CMS reports a geometric mean length of stay of 2.0 days and an arithmetic mean of 2.3 days for FY2027. The geometric mean is used for transfer-payment calculations.
Which DRGs are in the same CC/MCC family as 470?
DRG 469 (with MCC, weight 3.1085, GMLOS 3.3 days). Together with DRG 470 the family spans 1.9563 to 3.1085, a 1.59x spread, so documented complications and comorbidities change payment materially.
What documentation supports the severity level of DRG 470?
DRG 470 is the lower level of a two-way MCC split: no secondary diagnosis on the CMS MCC list was coded, and CCs alone do not change the group. Review here looks for MCC-level conditions treated during the stay but not documented to the required specificity, such as acute respiratory failure, severe protein-calorie malnutrition or septic shock; a compliant query to the attending is the only way to move the stay to the MCC sibling.
Which codes group to DRG 470?
The v44 Definitions Manual lists 178 operating room procedures codes for this group. Examples from the operating room procedures list, 0SR9019 (Replacement of Right Hip Joint with Metal Synthetic Substitute, Cemented, Open Approach); 0SR901A (Replacement of Right Hip Joint with Metal Synthetic Substitute, Uncemented, Open Approach); 0SR901Z (Replacement of Right Hip Joint with Metal Synthetic Substitute, Open Approach); 0SR9029 (Replacement of Right Hip Joint with Metal on Polyethylene Synthetic Substitute, Cemented, Open Approach).
Is DRG 470 a post-acute transfer DRG?
Yes. CMS flags DRG 470 under the post-acute care transfer policy, so a discharge to a qualifying post-acute setting before the geometric mean length of stay is paid a per-diem amount rather than the full DRG payment.
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.
- IPPS FY2027 Table 5 as corrected by correction notice CMS-1849-CN3Version v44 FY2027 (final rule + CN3) · effective 2026-10-01 · file CMS-1849-CN Table 5.txtSHA-256 2cc4e0b083e62e40…
- 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…
- ICD-10 MS-DRG Definitions Manual v44 (text)Version v44 · effective 2026-10-01 · file fy2027-fr-icd10-ms-drg-definitions-manual-files-v44.zipSHA-256 ae4f6c11727fe91f…
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.
Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.