MS-DRG v44.0 · MDC 08: Diseases and Disorders of the Musculoskeletal System and Connective Tissue
542 — Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with MCC
- Relative weight
- 1.7211
- Geometric mean LOS
- 4.9 days
- Arithmetic mean LOS
- 6.6 days
- Type
- Medical
About MS-DRG 542
MS-DRG 542, Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with MCC, is a medical DRG in MDC 08 (Diseases and Disorders of the Musculoskeletal System and Connective Tissue) under MS-DRG version 44.0, which applies to inpatient discharges from October 1, 2026 through September 30, 2027.
Its FY2027 relative weight is 1.7211, so Medicare's base payment for this DRG is about 1.72 times the average inpatient case, before hospital-specific adjustments. The geometric mean length of stay is 4.9 days and the arithmetic mean is 6.6 days.
It belongs to a 3-level severity family: DRG 542 (with MCC, weight 1.7211), DRG 543 (with CC, weight 1.006) and DRG 544 (without CC/MCC, weight 0.7406). The highest-severity level carries 2.3 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.
280 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 542 (280)
Chapter 2: Neoplasms
- C40.00Malignant neoplasm of scapula and long bones of unspecified upper limb
- C40.01Malignant neoplasm of scapula and long bones of right upper limb
- C40.02Malignant neoplasm of scapula and long bones of left upper limb
- C40.10Malignant neoplasm of short bones of unspecified upper limb
- C40.11Malignant neoplasm of short bones of right upper limb
- C40.12Malignant neoplasm of short bones of left upper limb
- C40.20Malignant neoplasm of long bones of unspecified lower limb
- C40.21Malignant neoplasm of long bones of right lower limb
- C40.22Malignant neoplasm of long bones of left lower limb
- C40.30Malignant neoplasm of short bones of unspecified lower limb
- C40.31Malignant neoplasm of short bones of right lower limb
- C40.32Malignant neoplasm of short bones of left lower limb
- C40.80Malignant neoplasm of overlapping sites of bone and articular cartilage of unspecified limb
- C40.81Malignant neoplasm of overlapping sites of bone and articular cartilage of right limb
- C40.82Malignant neoplasm of overlapping sites of bone and articular cartilage of left limb
- C40.90Malignant neoplasm of unspecified bones and articular cartilage of unspecified limb
- C40.91Malignant neoplasm of unspecified bones and articular cartilage of right limb
- C40.92Malignant neoplasm of unspecified bones and articular cartilage of left limb
- C41.0Malignant neoplasm of bones of skull and face
- C41.1Malignant neoplasm of mandible
- C41.2Malignant neoplasm of vertebral column
- C41.3Malignant neoplasm of ribs, sternum and clavicle
- C41.4Malignant neoplasm of pelvic bones, sacrum and coccyx
- C41.9Malignant neoplasm of bone and articular cartilage, unspecified
- C47.0Malignant neoplasm of peripheral nerves of head, face and neck
- C47.10Malignant neoplasm of peripheral nerves of unspecified upper limb, including shoulder
- C47.11Malignant neoplasm of peripheral nerves of right upper limb, including shoulder
- C47.12Malignant neoplasm of peripheral nerves of left upper limb, including shoulder
- C47.20Malignant neoplasm of peripheral nerves of unspecified lower limb, including hip
- C47.21Malignant neoplasm of peripheral nerves of right lower limb, including hip
- C47.22Malignant neoplasm of peripheral nerves of left lower limb, including hip
- C47.3Malignant neoplasm of peripheral nerves of thorax
- C47.4Malignant neoplasm of peripheral nerves of abdomen
- C47.5Malignant neoplasm of peripheral nerves of pelvis
- C47.6Malignant neoplasm of peripheral nerves of trunk, unspecified
- C47.8Malignant neoplasm of overlapping sites of peripheral nerves and autonomic nervous system
- C47.9Malignant neoplasm of peripheral nerves and autonomic nervous system, unspecified
- C49.0Malignant neoplasm of connective and soft tissue of head, face and neck
- C49.10Malignant neoplasm of connective and soft tissue of unspecified upper limb, including shoulder
- C49.11Malignant neoplasm of connective and soft tissue of right upper limb, including shoulder
- C49.12Malignant neoplasm of connective and soft tissue of left upper limb, including shoulder
- C49.20Malignant neoplasm of connective and soft tissue of unspecified lower limb, including hip
- C49.21Malignant neoplasm of connective and soft tissue of right lower limb, including hip
- C49.22Malignant neoplasm of connective and soft tissue of left lower limb, including hip
- C49.3Malignant neoplasm of connective and soft tissue of thorax
- C49.4Malignant neoplasm of connective and soft tissue of abdomen
- C49.5Malignant neoplasm of connective and soft tissue of pelvis
- C49.6Malignant neoplasm of connective and soft tissue of trunk, unspecified
- C49.8Malignant neoplasm of overlapping sites of connective and soft tissue
- C49.9Malignant neoplasm of connective and soft tissue, unspecified
- C79.51Secondary malignant neoplasm of bone
- C79.52Secondary malignant neoplasm of bone marrow
- C7B.03Secondary carcinoid tumors of bone
- D48.0Neoplasm of uncertain behavior of bone and articular cartilage
Chapter 13: Diseases of the musculoskeletal system and connective tissue
- M30.1Polyarteritis with lung involvement [Churg-Strauss]
- M31.2Lethal midline granuloma
- M31.30Wegener's granulomatosis without renal involvement
- M31.31Wegener's granulomatosis with renal involvement
- M48.40XAFatigue fracture of vertebra, site unspecified, initial encounter for fracture
- M48.41XAFatigue fracture of vertebra, occipito-atlanto-axial region, initial encounter for fracture
- M48.42XAFatigue fracture of vertebra, cervical region, initial encounter for fracture
- M48.43XAFatigue fracture of vertebra, cervicothoracic region, initial encounter for fracture
- M48.44XAFatigue fracture of vertebra, thoracic region, initial encounter for fracture
- M48.45XAFatigue fracture of vertebra, thoracolumbar region, initial encounter for fracture
- M48.46XAFatigue fracture of vertebra, lumbar region, initial encounter for fracture
- M48.47XAFatigue fracture of vertebra, lumbosacral region, initial encounter for fracture
- M48.48XAFatigue fracture of vertebra, sacral and sacrococcygeal region, initial encounter for fracture
- M48.50XACollapsed vertebra, not elsewhere classified, site unspecified, initial encounter for fracture
- M48.51XACollapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, initial encounter for fracture
- M48.52XACollapsed vertebra, not elsewhere classified, cervical region, initial encounter for fracture
- M48.53XACollapsed vertebra, not elsewhere classified, cervicothoracic region, initial encounter for fracture
- M48.54XACollapsed vertebra, not elsewhere classified, thoracic region, initial encounter for fracture
- M48.55XACollapsed vertebra, not elsewhere classified, thoracolumbar region, initial encounter for fracture
- M48.56XACollapsed vertebra, not elsewhere classified, lumbar region, initial encounter for fracture
- M48.57XACollapsed vertebra, not elsewhere classified, lumbosacral region, initial encounter for fracture
- M48.58XACollapsed vertebra, not elsewhere classified, sacral and sacrococcygeal region, initial encounter for fracture
- M80.00XAAge-related osteoporosis with current pathological fracture, unspecified site, initial encounter for fracture
- M80.011AAge-related osteoporosis with current pathological fracture, right shoulder, initial encounter for fracture
- M80.012AAge-related osteoporosis with current pathological fracture, left shoulder, initial encounter for fracture
- M80.019AAge-related osteoporosis with current pathological fracture, unspecified shoulder, initial encounter for fracture
- M80.021AAge-related osteoporosis with current pathological fracture, right humerus, initial encounter for fracture
- M80.022AAge-related osteoporosis with current pathological fracture, left humerus, initial encounter for fracture
- M80.029AAge-related osteoporosis with current pathological fracture, unspecified humerus, initial encounter for fracture
- M80.031AAge-related osteoporosis with current pathological fracture, right forearm, initial encounter for fracture
- M80.032AAge-related osteoporosis with current pathological fracture, left forearm, initial encounter for fracture
- M80.039AAge-related osteoporosis with current pathological fracture, unspecified forearm, initial encounter for fracture
- M80.041AAge-related osteoporosis with current pathological fracture, right hand, initial encounter for fracture
- M80.042AAge-related osteoporosis with current pathological fracture, left hand, initial encounter for fracture
- M80.049AAge-related osteoporosis with current pathological fracture, unspecified hand, initial encounter for fracture
- M80.051AAge-related osteoporosis with current pathological fracture, right femur, initial encounter for fracture
- M80.052AAge-related osteoporosis with current pathological fracture, left femur, initial encounter for fracture
- M80.059AAge-related osteoporosis with current pathological fracture, unspecified femur, initial encounter for fracture
- M80.061AAge-related osteoporosis with current pathological fracture, right lower leg, initial encounter for fracture
- M80.062AAge-related osteoporosis with current pathological fracture, left lower leg, initial encounter for fracture
- M80.069AAge-related osteoporosis with current pathological fracture, unspecified lower leg, initial encounter for fracture
- M80.071AAge-related osteoporosis with current pathological fracture, right ankle and foot, initial encounter for fracture
- M80.072AAge-related osteoporosis with current pathological fracture, left ankle and foot, initial encounter for fracture
- M80.079AAge-related osteoporosis with current pathological fracture, unspecified ankle and foot, initial encounter for fracture
- M80.08XAAge-related osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture
- M80.0AXAAge-related osteoporosis with current pathological fracture, other site, initial encounter for fracture
- M80.0B1AAge-related osteoporosis with current pathological fracture, right pelvis, initial encounter for fracture
- M80.0B2AAge-related osteoporosis with current pathological fracture, left pelvis, initial encounter for fracture
- M80.0B9AAge-related osteoporosis with current pathological fracture, unspecified pelvis, initial encounter for fracture
- M80.80XAOther osteoporosis with current pathological fracture, unspecified site, initial encounter for fracture
- M80.811AOther osteoporosis with current pathological fracture, right shoulder, initial encounter for fracture
- M80.812AOther osteoporosis with current pathological fracture, left shoulder, initial encounter for fracture
- M80.819AOther osteoporosis with current pathological fracture, unspecified shoulder, initial encounter for fracture
- M80.821AOther osteoporosis with current pathological fracture, right humerus, initial encounter for fracture
- M80.822AOther osteoporosis with current pathological fracture, left humerus, initial encounter for fracture
- M80.829AOther osteoporosis with current pathological fracture, unspecified humerus, initial encounter for fracture
- M80.831AOther osteoporosis with current pathological fracture, right forearm, initial encounter for fracture
- M80.832AOther osteoporosis with current pathological fracture, left forearm, initial encounter for fracture
- M80.839AOther osteoporosis with current pathological fracture, unspecified forearm, initial encounter for fracture
- M80.841AOther osteoporosis with current pathological fracture, right hand, initial encounter for fracture
- M80.842AOther osteoporosis with current pathological fracture, left hand, initial encounter for fracture
- M80.849AOther osteoporosis with current pathological fracture, unspecified hand, initial encounter for fracture
- M80.851AOther osteoporosis with current pathological fracture, right femur, initial encounter for fracture
- M80.852AOther osteoporosis with current pathological fracture, left femur, initial encounter for fracture
- M80.859AOther osteoporosis with current pathological fracture, unspecified femur, initial encounter for fracture
- M80.861AOther osteoporosis with current pathological fracture, right lower leg, initial encounter for fracture
- M80.862AOther osteoporosis with current pathological fracture, left lower leg, initial encounter for fracture
- M80.869AOther osteoporosis with current pathological fracture, unspecified lower leg, initial encounter for fracture
- M80.871AOther osteoporosis with current pathological fracture, right ankle and foot, initial encounter for fracture
- M80.872AOther osteoporosis with current pathological fracture, left ankle and foot, initial encounter for fracture
- M80.879AOther osteoporosis with current pathological fracture, unspecified ankle and foot, initial encounter for fracture
- M80.88XAOther osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture
- M80.8AXAOther osteoporosis with current pathological fracture, other site, initial encounter for fracture
- M80.8B1AOther osteoporosis with current pathological fracture, right pelvis, initial encounter for fracture
- M80.8B2AOther osteoporosis with current pathological fracture, left pelvis, initial encounter for fracture
- M80.8B9AOther osteoporosis with current pathological fracture, unspecified pelvis, initial encounter for fracture
- M84.30XAStress fracture, unspecified site, initial encounter for fracture
- M84.311AStress fracture, right shoulder, initial encounter for fracture
- M84.312AStress fracture, left shoulder, initial encounter for fracture
- M84.319AStress fracture, unspecified shoulder, initial encounter for fracture
- M84.321AStress fracture, right humerus, initial encounter for fracture
- M84.322AStress fracture, left humerus, initial encounter for fracture
- M84.329AStress fracture, unspecified humerus, initial encounter for fracture
- M84.331AStress fracture, right ulna, initial encounter for fracture
- M84.332AStress fracture, left ulna, initial encounter for fracture
- M84.333AStress fracture, right radius, initial encounter for fracture
- M84.334AStress fracture, left radius, initial encounter for fracture
- M84.339AStress fracture, unspecified ulna and radius, initial encounter for fracture
- M84.341AStress fracture, right hand, initial encounter for fracture
- M84.342AStress fracture, left hand, initial encounter for fracture
- M84.343AStress fracture, unspecified hand, initial encounter for fracture
- M84.344AStress fracture, right finger(s), initial encounter for fracture
- M84.345AStress fracture, left finger(s), initial encounter for fracture
- M84.346AStress fracture, unspecified finger(s), initial encounter for fracture
- M84.350AStress fracture, pelvis, initial encounter for fracture
- M84.351AStress fracture, right femur, initial encounter for fracture
- M84.352AStress fracture, left femur, initial encounter for fracture
- M84.353AStress fracture, unspecified femur, initial encounter for fracture
- M84.359AStress fracture, hip, unspecified, initial encounter for fracture
- M84.361AStress fracture, right tibia, initial encounter for fracture
- M84.362AStress fracture, left tibia, initial encounter for fracture
- M84.363AStress fracture, right fibula, initial encounter for fracture
- M84.364AStress fracture, left fibula, initial encounter for fracture
- M84.369AStress fracture, unspecified tibia and fibula, initial encounter for fracture
- M84.371AStress fracture, right ankle, initial encounter for fracture
- M84.372AStress fracture, left ankle, initial encounter for fracture
- M84.373AStress fracture, unspecified ankle, initial encounter for fracture
- M84.374AStress fracture, right foot, initial encounter for fracture
- M84.375AStress fracture, left foot, initial encounter for fracture
- M84.376AStress fracture, unspecified foot, initial encounter for fracture
- M84.377AStress fracture, right toe(s), initial encounter for fracture
- M84.378AStress fracture, left toe(s), initial encounter for fracture
- M84.379AStress fracture, unspecified toe(s), initial encounter for fracture
- M84.38XAStress fracture, other site, initial encounter for fracture
- M84.40XAPathological fracture, unspecified site, initial encounter for fracture
- M84.411APathological fracture, right shoulder, initial encounter for fracture
- M84.412APathological fracture, left shoulder, initial encounter for fracture
- M84.419APathological fracture, unspecified shoulder, initial encounter for fracture
- M84.421APathological fracture, right humerus, initial encounter for fracture
- M84.422APathological fracture, left humerus, initial encounter for fracture
- M84.429APathological fracture, unspecified humerus, initial encounter for fracture
- M84.431APathological fracture, right ulna, initial encounter for fracture
- M84.432APathological fracture, left ulna, initial encounter for fracture
- M84.433APathological fracture, right radius, initial encounter for fracture
- M84.434APathological fracture, left radius, initial encounter for fracture
- M84.439APathological fracture, unspecified ulna and radius, initial encounter for fracture
- M84.441APathological fracture, right hand, initial encounter for fracture
- M84.442APathological fracture, left hand, initial encounter for fracture
- M84.443APathological fracture, unspecified hand, initial encounter for fracture
- M84.444APathological fracture, right finger(s), initial encounter for fracture
- M84.445APathological fracture, left finger(s), initial encounter for fracture
- M84.446APathological fracture, unspecified finger(s), initial encounter for fracture
- M84.451APathological fracture, right femur, initial encounter for fracture
- M84.452APathological fracture, left femur, initial encounter for fracture
- M84.453APathological fracture, unspecified femur, initial encounter for fracture
- M84.454APathological fracture, pelvis, initial encounter for fracture
- M84.459APathological fracture, hip, unspecified, initial encounter for fracture
- M84.461APathological fracture, right tibia, initial encounter for fracture
- M84.462APathological fracture, left tibia, initial encounter for fracture
- M84.463APathological fracture, right fibula, initial encounter for fracture
- M84.464APathological fracture, left fibula, initial encounter for fracture
- M84.469APathological fracture, unspecified tibia and fibula, initial encounter for fracture
- M84.471APathological fracture, right ankle, initial encounter for fracture
- M84.472APathological fracture, left ankle, initial encounter for fracture
- M84.473APathological fracture, unspecified ankle, initial encounter for fracture
- M84.474APathological fracture, right foot, initial encounter for fracture
- M84.475APathological fracture, left foot, initial encounter for fracture
- M84.476APathological fracture, unspecified foot, initial encounter for fracture
- M84.477APathological fracture, right toe(s), initial encounter for fracture
- M84.478APathological fracture, left toe(s), initial encounter for fracture
- M84.479APathological fracture, unspecified toe(s), initial encounter for fracture
- M84.48XAPathological fracture, other site, initial encounter for fracture
- M84.50XAPathological fracture in neoplastic disease, unspecified site, initial encounter for fracture
- M84.511APathological fracture in neoplastic disease, right shoulder, initial encounter for fracture
- M84.512APathological fracture in neoplastic disease, left shoulder, initial encounter for fracture
- M84.519APathological fracture in neoplastic disease, unspecified shoulder, initial encounter for fracture
- M84.521APathological fracture in neoplastic disease, right humerus, initial encounter for fracture
- M84.522APathological fracture in neoplastic disease, left humerus, initial encounter for fracture
- M84.529APathological fracture in neoplastic disease, unspecified humerus, initial encounter for fracture
- M84.531APathological fracture in neoplastic disease, right ulna, initial encounter for fracture
- M84.532APathological fracture in neoplastic disease, left ulna, initial encounter for fracture
- M84.533APathological fracture in neoplastic disease, right radius, initial encounter for fracture
- M84.534APathological fracture in neoplastic disease, left radius, initial encounter for fracture
- M84.539APathological fracture in neoplastic disease, unspecified ulna and radius, initial encounter for fracture
- M84.541APathological fracture in neoplastic disease, right hand, initial encounter for fracture
- M84.542APathological fracture in neoplastic disease, left hand, initial encounter for fracture
- M84.549APathological fracture in neoplastic disease, unspecified hand, initial encounter for fracture
- M84.550APathological fracture in neoplastic disease, pelvis, initial encounter for fracture
- M84.551APathological fracture in neoplastic disease, right femur, initial encounter for fracture
- M84.552APathological fracture in neoplastic disease, left femur, initial encounter for fracture
- M84.553APathological fracture in neoplastic disease, unspecified femur, initial encounter for fracture
- M84.559APathological fracture in neoplastic disease, hip, unspecified, initial encounter for fracture
- M84.561APathological fracture in neoplastic disease, right tibia, initial encounter for fracture
- M84.562APathological fracture in neoplastic disease, left tibia, initial encounter for fracture
- M84.563APathological fracture in neoplastic disease, right fibula, initial encounter for fracture
- M84.564APathological fracture in neoplastic disease, left fibula, initial encounter for fracture
- M84.569APathological fracture in neoplastic disease, unspecified tibia and fibula, initial encounter for fracture
- M84.571APathological fracture in neoplastic disease, right ankle, initial encounter for fracture
- M84.572APathological fracture in neoplastic disease, left ankle, initial encounter for fracture
- M84.573APathological fracture in neoplastic disease, unspecified ankle, initial encounter for fracture
- M84.574APathological fracture in neoplastic disease, right foot, initial encounter for fracture
- M84.575APathological fracture in neoplastic disease, left foot, initial encounter for fracture
- M84.576APathological fracture in neoplastic disease, unspecified foot, initial encounter for fracture
- M84.58XAPathological fracture in neoplastic disease, other specified site, initial encounter for fracture
- M84.60XAPathological fracture in other disease, unspecified site, initial encounter for fracture
- M84.611APathological fracture in other disease, right shoulder, initial encounter for fracture
- M84.612APathological fracture in other disease, left shoulder, initial encounter for fracture
- M84.619APathological fracture in other disease, unspecified shoulder, initial encounter for fracture
- M84.621APathological fracture in other disease, right humerus, initial encounter for fracture
- M84.622APathological fracture in other disease, left humerus, initial encounter for fracture
- M84.629APathological fracture in other disease, unspecified humerus, initial encounter for fracture
- M84.631APathological fracture in other disease, right ulna, initial encounter for fracture
- M84.632APathological fracture in other disease, left ulna, initial encounter for fracture
- M84.633APathological fracture in other disease, right radius, initial encounter for fracture
- M84.634APathological fracture in other disease, left radius, initial encounter for fracture
- M84.639APathological fracture in other disease, unspecified ulna and radius, initial encounter for fracture
- M84.641APathological fracture in other disease, right hand, initial encounter for fracture
- M84.642APathological fracture in other disease, left hand, initial encounter for fracture
- M84.649APathological fracture in other disease, unspecified hand, initial encounter for fracture
- M84.650APathological fracture in other disease, pelvis, initial encounter for fracture
- M84.651APathological fracture in other disease, right femur, initial encounter for fracture
- M84.652APathological fracture in other disease, left femur, initial encounter for fracture
- M84.653APathological fracture in other disease, unspecified femur, initial encounter for fracture
- M84.659APathological fracture in other disease, hip, unspecified, initial encounter for fracture
- M84.661APathological fracture in other disease, right tibia, initial encounter for fracture
- M84.662APathological fracture in other disease, left tibia, initial encounter for fracture
- M84.663APathological fracture in other disease, right fibula, initial encounter for fracture
- M84.664APathological fracture in other disease, left fibula, initial encounter for fracture
- M84.669APathological fracture in other disease, unspecified tibia and fibula, initial encounter for fracture
- M84.671APathological fracture in other disease, right ankle, initial encounter for fracture
- M84.672APathological fracture in other disease, left ankle, initial encounter for fracture
- M84.673APathological fracture in other disease, unspecified ankle, initial encounter for fracture
- M84.674APathological fracture in other disease, right foot, initial encounter for fracture
- M84.675APathological fracture in other disease, left foot, initial encounter for fracture
- M84.676APathological fracture in other disease, unspecified foot, initial encounter for fracture
- M84.68XAPathological fracture in other disease, other site, initial encounter for fracture
- M84.750AAtypical femoral fracture, unspecified, initial encounter for fracture
- M84.751AIncomplete atypical femoral fracture, right leg, initial encounter for fracture
- M84.752AIncomplete atypical femoral fracture, left leg, initial encounter for fracture
- M84.753AIncomplete atypical femoral fracture, unspecified leg, initial encounter for fracture
- M84.754AComplete transverse atypical femoral fracture, right leg, initial encounter for fracture
- M84.755AComplete transverse atypical femoral fracture, left leg, initial encounter for fracture
- M84.756AComplete transverse atypical femoral fracture, unspecified leg, initial encounter for fracture
- M84.757AComplete oblique atypical femoral fracture, right leg, initial encounter for fracture
- M84.758AComplete oblique atypical femoral fracture, left leg, initial encounter for fracture
- M84.759AComplete oblique atypical femoral fracture, unspecified leg, initial encounter for fracture
Common questions about DRG 542
What is the relative weight of DRG 542?
- 1.7211 for FY2027 (MS-DRG v44.0), from the IPPS final rule Table 5.
What is the average length of stay for DRG 542?
- The geometric mean length of stay is 4.9 days; the arithmetic mean is 6.6 days.
Is DRG 542 medical or surgical?
- DRG 542 is a medical DRG.