MS-DRG v44.0 · MDC 04: Diseases and Disorders of the Respiratory System
194 — Simple Pneumonia and Pleurisy with CC
- Relative weight
- 0.7888
- Geometric mean LOS
- 2.7 days
- Arithmetic mean LOS
- 3.3 days
- Type
- Medical
About MS-DRG 194
MS-DRG 194, Simple Pneumonia and Pleurisy with CC, is a medical DRG in MDC 04 (Diseases and Disorders of the Respiratory System) under MS-DRG version 44.0, which applies to inpatient discharges from October 1, 2026 through September 30, 2027.
Its FY2027 relative weight is 0.7888, so Medicare's base payment for this DRG is about 0.79 times the average inpatient case (below average), before hospital-specific adjustments. The geometric mean length of stay is 2.7 days and the arithmetic mean is 3.3 days.
It belongs to a 3-level severity family: DRG 193 (with MCC, weight 1.2825), DRG 194 (with CC, weight 0.7888) and DRG 195 (without CC/MCC, weight 0.6063). The highest-severity level carries 2.1 times the weight of the lowest, which is why documenting CC and MCC conditions matters.
It is subject to Medicare's post-acute care transfer policy, so payment can be reduced when a patient with a shorter-than-average stay is discharged to a skilled nursing facility, home health or another post-acute setting.
34 ICD-10-CM diagnosis codes are part of this DRG's grouping logic; they are listed below.
ICD-10-CM codes that group to DRG 194 (34)
Chapter 1: Certain infectious and parasitic diseases
Chapter 10: Diseases of the respiratory system
- J09.X1Influenza due to identified novel influenza A virus with pneumonia
- J09.X2Influenza due to identified novel influenza A virus with other respiratory manifestations
- J10.00Influenza due to other identified influenza virus with unspecified type of pneumonia
- J10.01Influenza due to other identified influenza virus with the same other identified influenza virus pneumonia
- J10.08Influenza due to other identified influenza virus with other specified pneumonia
- J10.1Influenza due to other identified influenza virus with other respiratory manifestations
- J11.00Influenza due to unidentified influenza virus with unspecified type of pneumonia
- J11.08Influenza due to unidentified influenza virus with specified pneumonia
- J12.0Adenoviral pneumonia
- J12.1Respiratory syncytial virus pneumonia
- J12.2Parainfluenza virus pneumonia
- J12.3Human metapneumovirus pneumonia
- J12.81Pneumonia due to SARS-associated coronavirus
- J12.82Pneumonia due to coronavirus disease 2019
- J12.89Other viral pneumonia
- J12.9Viral pneumonia, unspecified
- J13Pneumonia due to Streptococcus pneumoniae
- J14Pneumonia due to Hemophilus influenzae
- J15.3Pneumonia due to streptococcus, group B
- J15.4Pneumonia due to other streptococci
- J15.7Pneumonia due to Mycoplasma pneumoniae
- J15.9Unspecified bacterial pneumonia
- J16.0Chlamydial pneumonia
- J16.8Pneumonia due to other specified infectious organisms
- J18.0Bronchopneumonia, unspecified organism
- J18.1Lobar pneumonia, unspecified organism
- J18.8Other pneumonia, unspecified organism
- J18.9Pneumonia, unspecified organism
- J92.0Pleural plaque with presence of asbestos
- J92.9Pleural plaque without asbestos
- J94.1Fibrothorax
- J94.9Pleural condition, unspecified
Chapter 18: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
Common questions about DRG 194
What is the relative weight of DRG 194?
- 0.7888 for FY2027 (MS-DRG v44.0), from the IPPS final rule Table 5.
What is the average length of stay for DRG 194?
- The geometric mean length of stay is 2.7 days; the arithmetic mean is 3.3 days.
Is DRG 194 medical or surgical?
- DRG 194 is a medical DRG.