FY 2026 MS-DRG Grouper Changes: CMS Updates

The Centers for Medicare & Medicaid Services (CMS) has released updates to the Medicare Severity Diagnosis Related Group (MS-DRG) classification system for Fiscal Year 2026. These changes include deletions, additions, and revisions to existing MS-DRG codes.

Deleted MS-DRGs

Six MS-DRG codes have been removed from the classification system:

MS-DRG 077-079 - Hypertensive Encephalopathy series (with MCC, with CC, and without CC/MCC)
MS-DRG 294-295 - Deep Vein Thrombophlebitis (with CC/MCC and without CC/MCC)
MS-DRG 509 - Arthroscopy

New MS-DRGs

Five new MS-DRG codes have been added:

MS-DRG 209 - Complex Aortic Arch Procedures
MS-DRG 213 - Endovascular Abdominal Aorta with Iliac Branch Procedures
MS-DRG 318 - Percutaneous Coronary Atherectomy without Intraluminal Device
MS-DRG 359 - Percutaneous Coronary Atherectomy with Intraluminal Device with MCC
MS-DRG 360 - Percutaneous Coronary Atherectomy with Intraluminal Device without MCC

Revised Title Descriptions

Six existing MS-DRGs have updated title descriptions:

MS-DRG 023 - Craniotomy with Major Device Implant or Acute Complex CNS Principal Diagnosis with MCC or Antineoplastic Implant or Epilepsy with Neurostimulator
MS-DRG 067-068 - Precerebral Occlusion without Infarction (with MCC and without MCC)
MS-DRG 070-072 - Other Cerebrovascular Disorders (with MCC, with CC, and without CC/MCC)

Impact on Healthcare Facilities

Healthcare facilities and billing departments should review these changes and update their systems accordingly for FY 2026 implementation. Our DRG Grouper tool has been updated to support v43.0 (FY 2026) to help you test and validate these new classifications.

Key Takeaways

Review deleted codes - Ensure your coding teams are aware of the six deleted MS-DRGs and have alternative classifications ready
Adopt new codes - The five new MS-DRGs primarily focus on cardiovascular procedures and require accurate procedure code documentation
Update documentation - Revised descriptions may affect how cases are classified, particularly for neurological and cerebrovascular cases

Testing the New Grouper

You can test these changes using our free online DRG Grouper tool. Simply select FY 2026 V43.0 from the grouper version dropdown and input your diagnosis and procedure codes to see how cases will be classified under the new system.

Stay tuned for more updates on CMS policy changes and DRG grouper modifications.