MS-DRG v44.0 · MDC 16: Diseases and Disorders of the Blood and Blood Forming Organs and Immunological Disorders
816 — Reticuloendothelial and Immunity Disorders without CC/MCC
- Relative weight
- 0.7381
- Geometric mean LOS
- 2.1 days
- Arithmetic mean LOS
- 2.6 days
- Type
- Medical
About MS-DRG 816
MS-DRG 816, Reticuloendothelial and Immunity Disorders without CC/MCC, is a medical DRG in MDC 16 (Diseases and Disorders of the Blood and Blood Forming Organs and Immunological Disorders) under MS-DRG version 44.0, which applies to inpatient discharges from October 1, 2026 through September 30, 2027.
Its FY2027 relative weight is 0.7381, so Medicare's base payment for this DRG is about 0.74 times the average inpatient case (below average), before hospital-specific adjustments. The geometric mean length of stay is 2.1 days and the arithmetic mean is 2.6 days.
It belongs to a 3-level severity family: DRG 814 (with MCC, weight 2.0729), DRG 815 (with CC, weight 1.0444) and DRG 816 (without CC/MCC, weight 0.7381). The highest-severity level carries 2.8 times the weight of the lowest, which is why documenting CC and MCC conditions matters.
137 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 816 (137)
Chapter 1: Certain infectious and parasitic diseases
Chapter 2: Neoplasms
Chapter 3: Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- D68.312Antiphospholipid antibody with hemorrhagic disorder
- D68.51Activated protein C resistance
- D68.52Prothrombin gene mutation
- D68.59Other primary thrombophilia
- D68.61Antiphospholipid syndrome
- D68.62Lupus anticoagulant syndrome
- D68.69Other thrombophilia
- D72.10Eosinophilia, unspecified
- D72.110Idiopathic hypereosinophilic syndrome [IHES]
- D72.111Lymphocytic Variant Hypereosinophilic Syndrome [LHES]
- D72.118Other hypereosinophilic syndrome
- D72.119Hypereosinophilic syndrome [HES], unspecified
- D72.12Drug rash with eosinophilia and systemic symptoms syndrome
- D72.18Eosinophilia in diseases classified elsewhere
- D72.19Other eosinophilia
- D72.810Lymphocytopenia
- D72.818Other decreased white blood cell count
- D72.819Decreased white blood cell count, unspecified
- D72.820Lymphocytosis (symptomatic)
- D72.821Monocytosis (symptomatic)
- D72.822Plasmacytosis
- D72.823Leukemoid reaction
- D72.824Basophilia
- D72.825Bandemia
- D72.828Other elevated white blood cell count
- D72.829Elevated white blood cell count, unspecified
- D72.89Other specified disorders of white blood cells
- D72.9Disorder of white blood cells, unspecified
- D73.0Hyposplenism
- D73.1Hypersplenism
- D73.2Chronic congestive splenomegaly
- D73.3Abscess of spleen
- D73.4Cyst of spleen
- D73.5Infarction of spleen
- D73.81Neutropenic splenomegaly
- D73.89Other diseases of spleen
- D73.9Disease of spleen, unspecified
- D75.0Familial erythrocytosis
- D75.1Secondary polycythemia
- D75.838Other thrombocytosis
- D75.839Thrombocytosis, unspecified
- D75.89Other specified diseases of blood and blood-forming organs
- D75.9Disease of blood and blood-forming organs, unspecified
- D75.AGlucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
- D76.1Hemophagocytic lymphohistiocytosis
- D76.2Hemophagocytic syndrome, infection-associated
- D76.3Other histiocytosis syndromes
- D77Other disorders of blood and blood-forming organs in diseases classified elsewhere
- D80.0Hereditary hypogammaglobulinemia
- D80.1Nonfamilial hypogammaglobulinemia
- D80.2Selective deficiency of immunoglobulin A [IgA]
- D80.3Selective deficiency of immunoglobulin G [IgG] subclasses
- D80.4Selective deficiency of immunoglobulin M [IgM]
- D80.5Immunodeficiency with increased immunoglobulin M [IgM]
- D80.7Transient hypogammaglobulinemia of infancy
- D82.2Immunodeficiency with short-limbed stature
- D82.3Immunodeficiency following hereditary defective response to Epstein-Barr virus
- D82.4Hyperimmunoglobulin E [IgE] syndrome
- D82.8Immunodeficiency associated with other specified major defects
- D82.9Immunodeficiency associated with major defect, unspecified
- D83.0Common variable immunodeficiency with predominant abnormalities of B-cell numbers and function
- D83.1Common variable immunodeficiency with predominant immunoregulatory T-cell disorders
- D83.2Common variable immunodeficiency with autoantibodies to B- or T-cells
- D83.8Other common variable immunodeficiencies
- D83.9Common variable immunodeficiency, unspecified
- D84.0Lymphocyte function antigen-1 [LFA-1] defect
- D84.81Immunodeficiency due to conditions classified elsewhere
- D84.821Immunodeficiency due to drugs
- D84.822Immunodeficiency due to external causes
- D84.89Other immunodeficiencies
- D84.9Immunodeficiency, unspecified
- D89.0Polyclonal hypergammaglobulinemia
- D89.2Hypergammaglobulinemia, unspecified
- D89.3Immune reconstitution syndrome
- D89.40Mast cell activation, unspecified
- D89.41Monoclonal mast cell activation syndrome
- D89.42Idiopathic mast cell activation syndrome
- D89.43Secondary mast cell activation
- D89.44Hereditary alpha tryptasemia
- D89.49Other mast cell activation disorder
- D89.831Cytokine release syndrome, grade 1
- D89.832Cytokine release syndrome, grade 2
- D89.833Cytokine release syndrome, grade 3
- D89.834Cytokine release syndrome, grade 4
- D89.835Cytokine release syndrome, grade 5
- D89.839Cytokine release syndrome, grade unspecified
- D89.84IgG4-related disease
- D89.89Other specified disorders involving the immune mechanism, not elsewhere classified
- D89.9Disorder involving the immune mechanism, unspecified
Chapter 4: Endocrine, nutritional and metabolic diseases
Chapter 9: Diseases of the circulatory system
Chapter 12: Diseases of the skin and subcutaneous tissue
Chapter 17: Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
Chapter 18: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
- R16.1Splenomegaly, not elsewhere classified
- R59.0Localized enlarged lymph nodes
- R59.1Generalized enlarged lymph nodes
- R59.9Enlarged lymph nodes, unspecified
- R75Inconclusive laboratory evidence of human immunodeficiency virus [HIV]
- R76.0Raised antibody titer
- R76.81Abnormal rheumatoid factor and anti-citrullinated protein antibody without rheumatoid arthritis
- R76.89Other specified abnormal immunological findings in serum
- R76.9Abnormal immunological finding in serum, unspecified
Chapter 19: Injury, poisoning and certain other consequences of external causes
- S36.00XAUnspecified injury of spleen, initial encounter
- S36.020AMinor contusion of spleen, initial encounter
- S36.021AMajor contusion of spleen, initial encounter
- S36.029AUnspecified contusion of spleen, initial encounter
- S36.030ASuperficial (capsular) laceration of spleen, initial encounter
- S36.031AModerate laceration of spleen, initial encounter
- S36.032AMajor laceration of spleen, initial encounter
- S36.039AUnspecified laceration of spleen, initial encounter
- S36.09XAOther injury of spleen, initial encounter
- T80.82XAComplication of immune effector cellular therapy, initial encounter
Chapter 21: Factors influencing health status and contact with health services
Common questions about DRG 816
What is the relative weight of DRG 816?
- 0.7381 for FY2027 (MS-DRG v44.0), from the IPPS final rule Table 5.
What is the average length of stay for DRG 816?
- The geometric mean length of stay is 2.1 days; the arithmetic mean is 2.6 days.
Is DRG 816 medical or surgical?
- DRG 816 is a medical DRG.