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521

MS-DRG 521: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC

DRGSurgicalMDC 08

MS-DRG 521 is hip replacement with principal diagnosis of hip fracture with mcc, in MDC 08 (a surgical DRG), at the with-MCC (major complication or comorbidity) level. Its FY2027 relative weight is 2.8515, so a case here pays more than the average Medicare inpatient stay (weight 1.0), with a geometric mean length of stay of 5.90 days. 1,232 ICD-10-CM principal diagnoses group into MS-DRGs 521–522 under the CMS definitions manual; the most-searched are listed below.

FY2027 payment factors

Relative weight
2.8515
Geometric mean LOS
5.90
Arithmetic mean LOS
6.90
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 521–522

From the CMS MS-DRG definitions manual’s principal-diagnosis index: 1,232 ICD-10-CM codes route here, and the CC/MCC status of the secondary diagnoses decides which of 521–522 the case lands in. The 24 most-searched:

  • S72.001AFracture of unspecified part of neck of right femur, initial encounter for closed fracture
  • S72.002AFracture of unspecified part of neck of left femur, initial encounter for closed fracture
  • S72.141ADisplaced intertrochanteric fracture of right femur, initial encounter for closed fracture
  • S72.142ADisplaced intertrochanteric fracture of left femur, initial encounter for closed fracture
  • S72.009AFracture of unspecified part of neck of unspecified femur, initial encounter for closed fracture
  • M80.051AAge-related osteoporosis with current pathological fracture, right femur, initial encounter for fracture
  • M84.459APathological fracture, hip, unspecified, initial encounter for fracture
  • S72.111ADisplaced fracture of greater trochanter of right femur, initial encounter for closed fracture
  • M80.051GAge-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with delayed healing
  • M80.051KAge-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with nonunion
  • M80.051PAge-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with malunion
  • M80.052AAge-related osteoporosis with current pathological fracture, left femur, initial encounter for fracture
  • M80.052GAge-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with delayed healing
  • M80.052KAge-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with nonunion
  • M80.052PAge-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with malunion
  • M80.059AAge-related osteoporosis with current pathological fracture, unspecified femur, initial encounter for fracture
  • M80.059GAge-related osteoporosis with current pathological fracture, unspecified femur, subsequent encounter for fracture with delayed healing
  • M80.059KAge-related osteoporosis with current pathological fracture, unspecified femur, subsequent encounter for fracture with nonunion
  • M80.059PAge-related osteoporosis with current pathological fracture, unspecified femur, subsequent encounter for fracture with malunion
  • M80.0AXAAge-related osteoporosis with current pathological fracture, other site, initial encounter for fracture
  • M80.0AXDAge-related osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with routine healing
  • M80.0AXGAge-related osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with delayed healing
  • M80.0AXKAge-related osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with nonunion
  • M80.0AXPAge-related osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with malunion

1,208 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 521.

521HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC2.8515
522HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC2.1158-0.7357

All FY2027 MS-DRGs · MDC 08

MS-DRG (IPPS Table 5)FY2027