MS-DRG 563 — FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC

DRGMedicalMDC 08

FY2026 payment factors

Relative weight: 0.8955
Geometric mean LOS: 3.00
Arithmetic mean LOS: 3.50
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.

Other DRGs in MDC 08

The with-MCC, with-CC and without-CC/MCC splits usually sit next to each other here. Those are what a documentation query is actually deciding between, and the weight gap between them is why the query is worth raising.

402SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL4.0205
426MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE11.0212
427MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC7.2186
428MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC5.6220
429COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC9.0096
430COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC5.7671
447MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE6.6816
448MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC4.2408
450SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE5.3296
451SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC3.2304
456SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC8.4034
457SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC5.9631
458SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC4.1726
461BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC5.5230
462BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC2.6600
463WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC5.6995
464WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC3.1147
465WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC1.8237
466REVISION OF HIP OR KNEE REPLACEMENT WITH MCC5.2054
467REVISION OF HIP OR KNEE REPLACEMENT WITH CC3.5266
468REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC2.7480
469MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT3.0332
470MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC1.9289
471CERVICAL SPINAL FUSION WITH MCC4.8287
472CERVICAL SPINAL FUSION WITH CC2.9461
473CERVICAL SPINAL FUSION WITHOUT CC/MCC2.4413
474AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC4.2929
475AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC2.2757
476AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC1.1802
477BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC3.4546
478BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC2.4592
479BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC1.8589
480HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC2.9123
481HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC2.0945
482HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC1.6310
483MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES2.7719
485KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC3.2271
486KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC2.0911
487KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC1.5662
488KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC1.7689