MS-DRG 559: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
MS-DRG 559 is aftercare, musculoskeletal system and connective tissue with mcc, in MDC 08 (a medical DRG), at the with-MCC (major complication or comorbidity) level. Its FY2027 relative weight is 1.8088, so a case here pays more than the average Medicare inpatient stay (weight 1.0), with a geometric mean length of stay of 4.90 days. 7,892 ICD-10-CM principal diagnoses group into MS-DRGs 559–561 under the CMS definitions manual; the most-searched are listed below.
FY2027 payment factors
- Relative weight
- 1.8088
- Geometric mean LOS
- 4.90
- Arithmetic mean LOS
- 6.60
- 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 559–561
From the CMS MS-DRG definitions manual’s principal-diagnosis index: 7,892 ICD-10-CM codes route here, and the CC/MCC status of the secondary diagnoses decides which of 559–561 the case lands in. The 24 most-searched:
- Z47.89Encounter for other orthopedic aftercare
- Z47.1Aftercare following joint replacement surgery
- T84.84XAPain due to internal orthopedic prosthetic devices, implants and grafts, initial encounter
- Z47.81Encounter for orthopedic aftercare following surgical amputation
- M96.0Pseudarthrosis after fusion or arthrodesis
- S72.001DFracture of unspecified part of neck of right femur, subsequent encounter for closed fracture with routine healing
- S72.002DFracture of unspecified part of neck of left femur, subsequent encounter for closed fracture with routine healing
- M80.08XDAge-related osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with routine healing
- S72.141DDisplaced intertrochanteric fracture of right femur, subsequent encounter for closed fracture with routine healing
- S72.142DDisplaced intertrochanteric fracture of left femur, subsequent encounter for closed fracture with routine healing
- T84.53XAInfection and inflammatory reaction due to internal right knee prosthesis, initial encounter
- T84.54XAInfection and inflammatory reaction due to internal left knee prosthesis, initial encounter
- Z47.2Encounter for removal of internal fixation device
- S32.010DWedge compression fracture of first lumbar vertebra, subsequent encounter for fracture with routine healing
- S52.502DUnspecified fracture of the lower end of left radius, subsequent encounter for closed fracture with routine healing
- S72.91XDUnspecified fracture of right femur, subsequent encounter for closed fracture with routine healing
- M84.48XDPathological fracture, other site, subsequent encounter for fracture with routine healing
- S22.42XDMultiple fractures of ribs, left side, subsequent encounter for fracture with routine healing
- S42.202DUnspecified fracture of upper end of left humerus, subsequent encounter for fracture with routine healing
- S62.101GFracture of unspecified carpal bone, right wrist, subsequent encounter for fracture with delayed healing
- S82.841DDisplaced bimalleolar fracture of right lower leg, subsequent encounter for closed fracture with routine healing
- S82.852EDisplaced trimalleolar fracture of left lower leg, subsequent encounter for open fracture type I or II with routine healing
- S82.892DOther fracture of left lower leg, subsequent encounter for closed fracture with routine healing
- T84.418ABreakdown (mechanical) of other internal orthopedic devices, implants and grafts, initial encounter
7,868 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 559.
| 559 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC | 1.8088 | |
| 560 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC | 1.1238 | -0.6850 |
| 561 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC | 0.8258 | -0.9830 |
All FY2027 MS-DRGs · MDC 08