MS-DRG v44.0 · MDC 11: Diseases and Disorders of the Kidney and Urinary Tract
656 — Kidney and Ureter Procedures for Neoplasm with MCC
Source: CMS MS-DRG v44.0 and FY2027 IPPS final rule. Page updated September 29, 2026.
- Relative weight
- 3.2786
- Geometric mean LOS
- 4.9 days
- Arithmetic mean LOS
- 7.2 days
- Type
- Surgical
About MS-DRG 656
MS-DRG 656, Kidney and Ureter Procedures for Neoplasm with MCC, is a surgical DRG in MDC 11 (Diseases and Disorders of the Kidney and Urinary Tract) under MS-DRG version 44.0, which applies to inpatient discharges from October 1, 2026 through September 30, 2027.
Its FY2027 relative weight is 3.2786, so Medicare's base payment for this DRG is about 3.28 times the average inpatient case, before hospital-specific adjustments. The geometric mean length of stay is 4.9 days and the arithmetic mean is 7.2 days.
It belongs to a 3-level severity family: DRG 656 (with MCC, weight 3.2786), DRG 657 (with CC, weight 1.8365) and DRG 658 (without CC/MCC, weight 1.538). The highest-severity level carries 2.1 times the weight of the lowest, which is why documenting CC and MCC conditions matters.
67 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 656 (67)
Chapter 2: Neoplasms
- C64.1Malignant neoplasm of right kidney, except renal pelvis
- C64.2Malignant neoplasm of left kidney, except renal pelvis
- C64.9Malignant neoplasm of unspecified kidney, except renal pelvis
- C65.1Malignant neoplasm of right renal pelvis
- C65.2Malignant neoplasm of left renal pelvis
- C65.9Malignant neoplasm of unspecified renal pelvis
- C66.1Malignant neoplasm of right ureter
- C66.2Malignant neoplasm of left ureter
- C66.9Malignant neoplasm of unspecified ureter
- C67.0Malignant neoplasm of trigone of bladder
- C67.1Malignant neoplasm of dome of bladder
- C67.2Malignant neoplasm of lateral wall of bladder
- C67.3Malignant neoplasm of anterior wall of bladder
- C67.4Malignant neoplasm of posterior wall of bladder
- C67.5Malignant neoplasm of bladder neck
- C67.6Malignant neoplasm of ureteric orifice
- C67.7Malignant neoplasm of urachus
- C67.8Malignant neoplasm of overlapping sites of bladder
- C67.9Malignant neoplasm of bladder, unspecified
- C68.0Malignant neoplasm of urethra
- C68.1Malignant neoplasm of paraurethral glands
- C68.8Malignant neoplasm of overlapping sites of urinary organs
- C68.9Malignant neoplasm of urinary organ, unspecified
- C79.00Secondary malignant neoplasm of unspecified kidney and renal pelvis
- C79.01Secondary malignant neoplasm of right kidney and renal pelvis
- C79.02Secondary malignant neoplasm of left kidney and renal pelvis
- C79.10Secondary malignant neoplasm of unspecified urinary organs
- C79.11Secondary malignant neoplasm of bladder
- C79.19Secondary malignant neoplasm of other urinary organs
- C7A.093Malignant carcinoid tumor of the kidney
- D09.0Carcinoma in situ of bladder
- D09.10Carcinoma in situ of unspecified urinary organ
- D09.19Carcinoma in situ of other urinary organs
- D17.71Benign lipomatous neoplasm of kidney
- D17.72Benign lipomatous neoplasm of other genitourinary organ
- D30.00Benign neoplasm of unspecified kidney
- D30.01Benign neoplasm of right kidney
- D30.02Benign neoplasm of left kidney
- D30.10Benign neoplasm of unspecified renal pelvis
- D30.11Benign neoplasm of right renal pelvis
- D30.12Benign neoplasm of left renal pelvis
- D30.20Benign neoplasm of unspecified ureter
- D30.21Benign neoplasm of right ureter
- D30.22Benign neoplasm of left ureter
- D30.3Benign neoplasm of bladder
- D30.4Benign neoplasm of urethra
- D30.8Benign neoplasm of other specified urinary organs
- D30.9Benign neoplasm of urinary organ, unspecified
- D3A.093Benign carcinoid tumor of the kidney
- D41.00Neoplasm of uncertain behavior of unspecified kidney
- D41.01Neoplasm of uncertain behavior of right kidney
- D41.02Neoplasm of uncertain behavior of left kidney
- D41.10Neoplasm of uncertain behavior of unspecified renal pelvis
- D41.11Neoplasm of uncertain behavior of right renal pelvis
- D41.12Neoplasm of uncertain behavior of left renal pelvis
- D41.20Neoplasm of uncertain behavior of unspecified ureter
- D41.21Neoplasm of uncertain behavior of right ureter
- D41.22Neoplasm of uncertain behavior of left ureter
- D41.3Neoplasm of uncertain behavior of urethra
- D41.4Neoplasm of uncertain behavior of bladder
- D41.8Neoplasm of uncertain behavior of other specified urinary organs
- D41.9Neoplasm of uncertain behavior of unspecified urinary organ
- D49.4Neoplasm of unspecified behavior of bladder
- D49.511Neoplasm of unspecified behavior of right kidney
- D49.512Neoplasm of unspecified behavior of left kidney
- D49.519Neoplasm of unspecified behavior of unspecified kidney
- D49.59Neoplasm of unspecified behavior of other genitourinary organ
Common questions about DRG 656
What is the relative weight of DRG 656?
- 3.2786 for FY2027 (MS-DRG v44.0), from the IPPS final rule Table 5.
What is the average length of stay for DRG 656?
- The geometric mean length of stay is 4.9 days; the arithmetic mean is 7.2 days.
Is DRG 656 medical or surgical?
- DRG 656 is a surgical DRG.