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MS-DRG v44.0 · MDC 04: Diseases and Disorders of the Respiratory System

194 — Simple Pneumonia and Pleurisy with CC

This DRG is subject to the post-acute care transfer policy.
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

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.