MS-DRG 543: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC
MS-DRG 543 is pathological fractures and musculoskeletal and connective tissue malignancy with cc, in MDC 08 (a medical DRG), at the with-CC (complication or comorbidity) level. Its FY2027 relative weight is 1.0060, so a case here pays more than the average Medicare inpatient stay (weight 1.0), with a geometric mean length of stay of 3.40 days. 280 ICD-10-CM principal diagnoses group into MS-DRGs 542–544 under the CMS definitions manual; the most-searched are listed below.
FY2027 payment factors
- Relative weight
- 1.0060
- Geometric mean LOS
- 3.40
- Arithmetic mean LOS
- 4.20
- 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 542–544
From the CMS MS-DRG definitions manual’s principal-diagnosis index: 280 ICD-10-CM codes route here, and the CC/MCC status of the secondary diagnoses decides which of 542–544 the case lands in. The 24 most-searched:
- C79.51Secondary malignant neoplasm of bone
- C49.9Malignant neoplasm of connective and soft tissue, unspecified
- C41.9Malignant neoplasm of bone and articular cartilage, unspecified
- M80.08XAAge-related osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture
- C41.1Malignant neoplasm of mandible
- C49.0Malignant neoplasm of connective and soft tissue of head, face and neck
- C49.22Malignant neoplasm of connective and soft tissue of left lower limb, including hip
- C49.4Malignant neoplasm of connective and soft tissue of abdomen
- D48.0Neoplasm of uncertain behavior of bone and articular cartilage
- C41.2Malignant neoplasm of vertebral column
- C49.21Malignant neoplasm of connective and soft tissue of right lower limb, including hip
- C49.3Malignant neoplasm of connective and soft tissue of thorax
- C49.5Malignant neoplasm of connective and soft tissue of pelvis
- C79.52Secondary malignant neoplasm of bone marrow
- M30.1Polyarteritis with lung involvement [Churg-Strauss]
- M31.30Wegener's granulomatosis without renal involvement
- M48.56XACollapsed vertebra, not elsewhere classified, lumbar region, initial encounter for fracture
- M80.00XAAge-related osteoporosis with current pathological fracture, unspecified site, initial encounter for fracture
- C41.0Malignant neoplasm of bones of skull and face
- C41.4Malignant neoplasm of pelvic bones, sacrum and coccyx
- M48.54XACollapsed vertebra, not elsewhere classified, thoracic region, initial encounter for fracture
- M80.051AAge-related osteoporosis with current pathological fracture, right femur, initial encounter for fracture
- M84.459APathological fracture, hip, unspecified, initial encounter for fracture
- M84.48XAPathological fracture, other site, initial encounter for fracture
256 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 543.
| 542 | PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC | 1.7211 | +0.7151 |
| 543 | PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC | 1.0060 | |
| 544 | PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC | 0.7406 | -0.2654 |
All FY2027 MS-DRGs · MDC 08