MS-DRG 458: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, OR INFECTION WITHOUT CC/MCC
MS-DRG 458 is spinal fusion except cervical with spinal curvature, malignancy, or infection without cc/mcc, in MDC 08 (a surgical DRG), at the without-CC/MCC level. Its FY2027 relative weight is 4.0388, so a case here pays more than the average Medicare inpatient stay (weight 1.0), with a geometric mean length of stay of 2.10 days. 163 ICD-10-CM principal diagnoses group into MS-DRGs 456–458 under the CMS definitions manual; the most-searched are listed below.
FY2027 payment factors
- Relative weight
- 4.0388
- Geometric mean LOS
- 2.10
- Arithmetic mean LOS
- 2.50
- Post-acute transfer
- Yes
This DRG is subject to the post-acute care transfer policy: a discharge to a qualifying setting below the mean length of stay is paid per diem rather than in full.
Principal diagnoses that group to MS-DRGs 456–458
From the CMS MS-DRG definitions manual’s principal-diagnosis index: 163 ICD-10-CM codes route here, and the CC/MCC status of the secondary diagnoses decides which of 456–458 the case lands in. The 24 most-searched:
- C79.51Secondary malignant neoplasm of bone
- D49.2Neoplasm of unspecified behavior of bone, soft tissue, and skin
- M86.9Osteomyelitis, unspecified
- M41.9Scoliosis, unspecified
- D48.0Neoplasm of uncertain behavior of bone and articular cartilage
- C41.2Malignant neoplasm of vertebral column
- C79.52Secondary malignant neoplasm of bone marrow
- M41.125Adolescent idiopathic scoliosis, thoracolumbar region
- M41.86Other forms of scoliosis, lumbar region
- M43.9Deforming dorsopathy, unspecified
- M46.26Osteomyelitis of vertebra, lumbar region
- M46.28Osteomyelitis of vertebra, sacral and sacrococcygeal region
- Q78.0Osteogenesis imperfecta
- A18.01Tuberculosis of spine
- M40.209Unspecified kyphosis, site unspecified
- M41.26Other idiopathic scoliosis, lumbar region
- M84.58XAPathological fracture in neoplastic disease, other specified site, initial encounter for fracture
- Q67.5Congenital deformity of spine
- T84.69XAInfection and inflammatory reaction due to internal fixation device of other site, initial encounter
- A02.24Salmonella osteomyelitis
- A54.40Gonococcal infection of musculoskeletal system, unspecified
- A54.41Gonococcal spondylopathy
- A54.43Gonococcal osteomyelitis
- A54.49Gonococcal infection of other musculoskeletal tissue
139 more codes group here. Open any code above for its full hierarchy, or check a whole claim in the free DRG calculator.
The severity splits
Same base DRG, split by whether a secondary diagnosis is a CC or MCC. The last column is the weight change from MS-DRG 458.
| 456 | SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, OR INFECTION WITH MCC | 7.6244 | +3.5856 |
| 457 | SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, OR INFECTION WITH CC | 5.3668 | +1.3280 |
| 458 | SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, OR INFECTION WITHOUT CC/MCC | 4.0388 |
All FY2027 MS-DRGs · MDC 08