ICD-10-CM/PCS MS-DRG v42.0 Definitions Manual
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MS-DRG Surgical Hierarchy by MDC and MS-DRG
Surgical HierarchyMS-DRG
Pre-MDC
018Chimeric Antigen Receptor (CAR) T-cell and Other Immunotherapies
001-002Heart transplant or implant of heart assist system
003-004ECMO or tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck
005-006Liver or intestinal transplant
014Allogeneic bone marrow transplant
007Lung transplant
019Simultaneous pancreas and kidney transplant with hemodialysis
008Simultaneous pancreas and kidney transplant
016-017Autologous bone marrow transplant
010Pancreas transplant
011-013Tracheostomy for face, mouth and neck diagnoses or laryngectomy
MDC 01 Diseases and disorders of the nervous system
020-022Intracranial vascular procedures with principal diagnosis hemorrhage
023-024Craniotomy with major device implant or acute complex CNS principal diagnosis
025-027Craniotomy and endovascular intracranial procedures
028-030Spinal procedures
031-033Ventricular shunt procedures
034-036Carotid artery stent procedures
037-039Extracranial procedures
040-042Peripheral, cranial nerve and other nervous system procedures
MDC 02 Diseases and disorders of the eye
113-114Orbital procedures
115Extraocular procedures except orbit
116-117Intraocular procedures
MDC 03 Diseases and disorders of the ear, nose, mouth and throat
140-142Major head and neck procedures
143-145Other ear, nose, mouth and throat O.R. procedures
135-136Sinus and mastoid procedures
137-138Mouth procedures
139Salivary gland procedures
MDC 04 Diseases and disorders of the respiratory system
163-165Major chest procedures
173Ultrasound accelerated and other thrombolysis with principal diagnosis pulmonary embolism
166-168Other respiratory system O.R. procedures
MDC 05 Diseases and disorders of the circulatory system
215Other heart assist system implant
212Concomitant Aortic and Mitral Valve Procedures
216-221Cardiac valve and other major cardiothoracic procedures
231-236Coronary bypass
317Concomitant left atrial appendage closure and cardiac ablation
275-277Cardiac defibrillator implant or carotid sinus neurostimulator
266-267Endovascular cardiac valve replacement and supplement procedures
268-269Aortic and heart assist procedures except pulsation balloon
228-229Other cardiothoracic procedures
319-320Other endovascular cardiac valve procedures
270-272Other major cardiovascular procedures
239-241Amputation for circulatory system disorders except upper limb and toe
242-244Permanent cardiac pacemaker implant
245AICD generator procedures
265AICD lead procedures
273-274Percutaneous intracardiac procedures
323-325Coronary intravascular lithotripsy
321-322Percutaneous cardiovascular procedures with intraluminal device
250-251Percutaneous cardiovascular procedures without intraluminal device
278-279Ultrasound accelerated and other thrombolysis
252-254Other vascular procedures
255-257Upper limb and toe amputation for circulatory system disorders
258-259Cardiac pacemaker device replacement
260-262Cardiac pacemaker revision except device replacement
263Vein ligation and stripping
264Other circulatory system O.R. procedures
MDC 06 Diseases and disorders of the digestive system
326-328Stomach, esophageal and duodenal procedures
329-331Major small and large bowel procedures
332-334Rectal resection
335-337Peritoneal adhesiolysis
397-399Appendix Procedures
344-346Minor small and large bowel procedures
347-349Anal and stomal procedures
350-355Hernia procedures
356-358Other digestive system O.R. procedures
MDC 07 Diseases and disorders of the hepatobiliary system and pancreas
405-407Pancreas, liver and shunt procedures
408-410Biliary tract procedures except only cholecystectomy with or without C.D.E.
411-419Cholecystectomy
420-422Hepatobiliary diagnostic procedures
423-425Other hepatobiliary or pancreas O.R. procedures
MDC 08 Diseases and disorders of the musculoskeletal system and connective tissue
426-428Multiple level combined anterior and posterior spinal fusion except cervical
402Single level combined anterior and posterior spinal fusion except cervical
429-430Combined anterior and posterior cervical spinal fusion
456-458Spinal fusion except cervical with spinal curvature, malignancy, infection or extensive fusions
447-448Multiple level spinal fusion except cervical
459-460Single level spinal fusion except cervical
461-462Bilateral or multiple major joint procedures of lower extremity
463-465Wound debridement and skin graft except hand for musculoskeletal and connective tissue disorders
466-468Revision of hip or knee replacement
521-522Hip replacement with principal diagnosis of hip fracture
469-470Major hip and knee joint replacement or reattachment of lower extremity
471-473Cervical spinal fusion
474-476Amputation for musculoskeletal system and connective tissue disorders
477-479Biopsies of musculoskeletal system and connective tissue
480-482Hip and femur procedures except major joint
483Major joint or limb reattachment procedures of upper extremities
485-489Knee procedures
518-520Back and neck procedures except spinal fusion
492-494Lower extremity and humerus procedures except hip, foot and femur
495-497Local excision and removal of internal fixation devices except hip and femur
498-499Local excision and removal of internal fixation devices of hip and femur
500-502Soft tissue procedures
503-505Foot procedures
506Major thumb or joint procedures
507-508Major shoulder or elbow joint procedures
509Arthroscopy
510-512Shoulder, elbow or forearm procedures, except major joint procedures
513-514Hand or wrist procedures, except major thumb or joint procedures
515-517Other musculoskeletal system and connective tissue O.R. procedures
MDC 09 Diseases and disorders of the skin, subcutaneous tissue and breast
573-578Skin graft
570-572Skin debridement
579-581Other skin, subcutaneous tissue and breast procedures
582-583Mastectomy for malignancy
584-585Breast biopsy, local excision and other breast procedures
MDC 10 Endocrine, nutritional and metabolic diseases and disorders
616-618Amputation of lower limb for endocrine, nutritional and metabolic disorders
619-621O.R. procedures for obesity
614-615Adrenal and pituitary procedures
622-624Skin grafts and wound debridement for endocrine, nutritional and metabolic disorders
625-627Thyroid, parathyroid and thyroglossal procedures
628-630Other endocrine, nutritional and metabolic O.R. procedures
MDC 11 Diseases and disorders of the kidney and urinary tract
650-651Kidney transplant with hemodialysis
652Kidney transplant
653-655Major bladder procedures
656-661Kidney and ureter procedures
662-664Minor bladder procedures
665-667Prostatectomy
668-670Transurethral procedures
671-672Urethral procedures
673-675Other kidney and urinary tract procedures
MDC 12 Diseases and disorders of the male reproductive system
707-708Major male pelvic procedures
709-710Penis procedures
711-712Testes procedures
713-714Transurethral prostatectomy
715-718Other male reproductive system O.R. procedures
MDC 13 Diseases and disorders of the female reproductive system
734-735Pelvic evisceration, radical hysterectomy and radical vulvectomy
736-741Uterine and adnexa procedures
742-743Uterine and adnexa procedures for non-malignancy
744-745D&C, conization, laparoscopy and tubal interruption
746-747Vagina, cervix and vulva procedures
748Female reproductive system reconstructive procedures
749-750Other female reproductive system O.R. procedures
MDC 14 Pregnancy, childbirth and the puerperium
783-785Cesarean section with sterilization
786-788Cesarean section without sterilization
768Vaginal delivery with O.R. procedures except sterilization and/or D&C
796-798Vaginal delivery with sterilization and/or D&C
770Abortion with D&C, aspiration curettage or hysterotomy
817-819Other antepartum diagnoses with O.R. procedures
769Postpartum and post abortion diagnoses with O.R. procedures
MDC 16 Diseases and disorders of blood, blood forming organs and immunologic disorders
799-801Splenic Procedures
802-804Other O.R. procedures of the blood and blood forming organs
MDC 17 Myeloproliferative diseases and disorders, poorly differentiated neoplasms
820-822Lymphoma and leukemia with major O.R. procedures
850Acute leukemia with other procedures
823-825Lymphoma and non-acute leukemia with other procedures
826-828Myeloproliferative disorders or poorly differentiated neoplasms with major O.R. procedures
829-830Myeloproliferative disorders or poorly differentiated neoplasms with other procedures
MDC 18 Infectious and parasitic diseases, systemic or unspecified sites
856-858Postoperative or post-traumatic infections with O.R. procedures
853-855Infectious and parasitic diseases with O.R. procedures
MDC 19 Mental diseases and disorders
876O.R. procedures with principal diagnosis of mental illness
MDC 21 Injuries, poisonings and toxic effects of drugs
901-903Wound debridements for injuries
904-905Skin grafts for injuries
906Hand procedures for injuries
907-909Other O.R. procedures for injuries
MDC 22 Burns
927Extensive burns or full thickness burns with MV >96 hours
928-929Full thickness burn
MDC 23 Factors influencing health status and other contacts with health services
939-941O.R. procedures with diagnoses of other contact with health services
MDC 24 Multiple significant trauma
955Craniotomy for multiple significant trauma
956Limb reattachment, hip and femur procedures for multiple significant trauma
957-959Other O.R. procedures for multiple significant trauma
MDC 25 Human immunodeficiency virus infections
969-970HIV with extensive O.R. procedures



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