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MS-DRG 562: FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC

DRGMedicalMDC 08

MS-DRG 562 is fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with mcc, in MDC 08 (a medical DRG), at the with-MCC (major complication or comorbidity) level. Its FY2027 relative weight is 1.3980, so a case here pays more than the average Medicare inpatient stay (weight 1.0), with a geometric mean length of stay of 4.10 days. 4,649 ICD-10-CM principal diagnoses group into MS-DRGs 562–563 under the CMS definitions manual; the most-searched are listed below.

FY2027 payment factors

Relative weight
1.3980
Geometric mean LOS
4.10
Arithmetic mean LOS
5.10
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 562–563

From the CMS MS-DRG definitions manual’s principal-diagnosis index: 4,649 ICD-10-CM codes route here, and the CC/MCC status of the secondary diagnoses decides which of 562–563 the case lands in. The 24 most-searched:

  • S39.012AStrain of muscle, fascia and tendon of lower back, initial encounter
  • S93.402ASprain of unspecified ligament of left ankle, initial encounter
  • S46.011AStrain of muscle(s) and tendon(s) of the rotator cuff of right shoulder, initial encounter
  • S93.401ASprain of unspecified ligament of right ankle, initial encounter
  • M22.2X1Patellofemoral disorders, right knee
  • S46.012AStrain of muscle(s) and tendon(s) of the rotator cuff of left shoulder, initial encounter
  • S52.501AUnspecified fracture of the lower end of right radius, initial encounter for closed fracture
  • S83.241AOther tear of medial meniscus, current injury, right knee, initial encounter
  • S83.511ASprain of anterior cruciate ligament of right knee, initial encounter
  • M22.2X2Patellofemoral disorders, left knee
  • M22.41Chondromalacia patellae, right knee
  • M22.42Chondromalacia patellae, left knee
  • M23.91Unspecified internal derangement of right knee
  • M23.92Unspecified internal derangement of left knee
  • S43.431ASuperior glenoid labrum lesion of right shoulder, initial encounter
  • S43.432ASuperior glenoid labrum lesion of left shoulder, initial encounter
  • S83.242AOther tear of medial meniscus, current injury, left knee, initial encounter
  • S83.512ASprain of anterior cruciate ligament of left knee, initial encounter
  • S83.92XASprain of unspecified site of left knee, initial encounter
  • S29.011AStrain of muscle and tendon of front wall of thorax, initial encounter
  • S29.012AStrain of muscle and tendon of back wall of thorax, initial encounter
  • S43.401AUnspecified sprain of right shoulder joint, initial encounter
  • S46.911AStrain of unspecified muscle, fascia and tendon at shoulder and upper arm level, right arm, initial encounter
  • S52.502AUnspecified fracture of the lower end of left radius, initial encounter for closed fracture

4,625 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 562.

562FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC1.3980
563FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC0.8985-0.4995

All FY2027 MS-DRGs · MDC 08

MS-DRG (IPPS Table 5)FY2027