ICD-10 MS-DRG v42 (2025)

Medicare Severity Diagnosis Related Group

MDC 08: DISEASES & DISORDERS OF THE MUSCULOSKELETAL SYSTEM & CONN TISSUE

ICD10CM Code Assignment

Surgical DRGs

426   MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE
427   MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC
428   MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC
402   SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL
429   COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC
430   COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC
456   SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC
457   SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC
458   SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC
447   MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE
448   MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC
450   SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE
451   SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC
461   BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC
462   BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC
463   WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC
464   WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC
465   WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
466   REVISION OF HIP OR KNEE REPLACEMENT WITH MCC
467   REVISION OF HIP OR KNEE REPLACEMENT WITH CC
468   REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC
521   HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC
522   HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC
469   MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT
470   MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC
471   CERVICAL SPINAL FUSION WITH MCC
472   CERVICAL SPINAL FUSION WITH CC
473   CERVICAL SPINAL FUSION WITHOUT CC/MCC
474   AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC
475   AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC
476   AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
477   BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
478   BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC
479   BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC
480   HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC
481   HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC
482   HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC
483   MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES
485   KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC
486   KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC
487   KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC
488   KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC
489   KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC
518   BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR
519   BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC
520   BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC
492   LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC
493   LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC
494   LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC
495   LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC
496   LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC
497   LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC
498   LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC
499   LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC
500   SOFT TISSUE PROCEDURES WITH MCC
501   SOFT TISSUE PROCEDURES WITH CC
502   SOFT TISSUE PROCEDURES WITHOUT CC/MCC
503   FOOT PROCEDURES WITH MCC
504   FOOT PROCEDURES WITH CC
505   FOOT PROCEDURES WITHOUT CC/MCC
506   MAJOR THUMB OR JOINT PROCEDURES
507   MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC
508   MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC
509   ARTHROSCOPY
510   SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC
511   SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC
512   SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC
513   HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC
514   HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC
515   OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC
516   OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC
517   OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC

If the Principal Diagnosis designated a DRG should be selected from this MDC, AND an O.R. (Operating Room) procedure was performed but does not match the Surgical DRGs listed above, see the Unrelated Operating Room Procedures DRGs.


Medical DRGs

533   FRACTURES OF FEMUR WITH MCC
534   FRACTURES OF FEMUR WITHOUT MCC
535   FRACTURES OF HIP AND PELVIS WITH MCC
536   FRACTURES OF HIP AND PELVIS WITHOUT MCC
537   SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC
538   SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC
539   OSTEOMYELITIS WITH MCC
540   OSTEOMYELITIS WITH CC
541   OSTEOMYELITIS WITHOUT CC/MCC
542   PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC
543   PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC
544   PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC
545   CONNECTIVE TISSUE DISORDERS WITH MCC
546   CONNECTIVE TISSUE DISORDERS WITH CC
547   CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
548   SEPTIC ARTHRITIS WITH MCC
549   SEPTIC ARTHRITIS WITH CC
550   SEPTIC ARTHRITIS WITHOUT CC/MCC
551   MEDICAL BACK PROBLEMS WITH MCC
552   MEDICAL BACK PROBLEMS WITHOUT MCC
553   BONE DISEASES AND ARTHROPATHIES WITH MCC
554   BONE DISEASES AND ARTHROPATHIES WITHOUT MCC
555   SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
556   SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC
557   TENDONITIS, MYOSITIS AND BURSITIS WITH MCC
558   TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC
559   AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
560   AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC
561   AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC
562   FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC
563   FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC
564   OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC
565   OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC
566   OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC
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