MS-DRG 522: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC
MS-DRG 522 is hip replacement with principal diagnosis of hip fracture without mcc, in MDC 08 (a surgical DRG), at the without-CC/MCC level. Its FY2027 relative weight is 2.1158, so a case here pays more than the average Medicare inpatient stay (weight 1.0), with a geometric mean length of stay of 4.00 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
- 2.1158
- Geometric mean LOS
- 4.00
- Arithmetic mean LOS
- 4.40
- 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 522.
| 521 | HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC | 2.8515 | +0.7357 |
| 522 | HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 2.1158 |
All FY2027 MS-DRGs · MDC 08