Extensive O.R. Procedures Unrelated to Principal Diagnosis with CC
Assigned before MDC logic runs, so it is driven by the procedure rather than the principal diagnosis. The grouper still reports the principal diagnosis's own MDC on a grouped claim.
CMS publishes classification in the Definitions Manual and weights in Table 5 of the IPPS rule, one spreadsheet per year. These are the 9 versions this grouper supports.
| Version | Fiscal year | Effective | Relative weight |
|---|---|---|---|
| V44.0 | FY 2027 | 2026-10-01 | 2.4249 |
| V43.1 | FY 2026 (Apr-Sep) | 2026-04-01 | 2.4585 |
| V43.0 | FY 2026 (Oct-Mar) | 2025-10-01 | 2.4585 |
| V42.1 | FY 2025 (Apr-Sep) | 2025-04-01 | 2.4483 |
| V42.0 | FY 2025 (Oct-Mar) | 2024-10-01 | 2.4483 |
| V41.1 | FY 2024 (Apr-Sep) | 2024-04-01 | 2.4860 |
| V41.0 | FY 2024 (Oct-Mar) | 2023-10-01 | 2.4860 |
| V40.1 | FY 2023 (Apr-Sep) | 2023-04-01 | 2.5082 |
| V40.0 | FY 2023 (Oct-Mar) | 2022-10-01 | 2.5082 |
Range 2.4249 to 2.5082. A dash means the DRG did not exist in that version.
Relative weight is not payment: actual reimbursement also applies wage index, capital, DSH and IME adjustments, and outliers. Group an encounter to see which DRG it actually lands in.
Open the MS-DRG grouper