MS-DRG · FY 2026 v43.0

MS-DRG 421 – Hepatobiliary Diagnostic Procedures with CC

A Surgical DRG in MDC 07 (Diseases & Disorders of the Hepatobiliary System & Pancreas). Inpatient cases group to DRG 421 when one of the 112 ICD-10-PCS operating-room procedures listed below is reported. Its FY 2026 relative weight is 1.7375 with a geometric mean length of stay of 3.4 days.

Surgical DRG – assigned by operating-room procedure✓ Official CMS v43.0 dataset

1.7375

Relative Weight

3.4

Geometric Mean LOS (days)

4.5

Arithmetic Mean LOS (days)

112

Procedure Codes

Severity family

DRG 420with MCCWeight 3.4071 · GMLOS 6.9 daysDRG 421with CCWeight 1.7375 · GMLOS 3.4 daysDRG 422without CC/MCCWeight 1.3995 · GMLOS 2.3 days

How a case is assigned to DRG 421

The grouper first assigns the case to MDC 07 from the principal diagnosis, then matches a qualifying operating-room procedure from the ICD-10-PCS list below (this is a Surgical DRG), then applies the severity split from secondary diagnoses: with MCC → 420; with CC → 421; without CC/MCC → 422.

ICD-10-PCS

Procedure Codes 112 codes · 72 categories

112 of 112 shown

07JP Lymphatic and Hemic Systems, Inspection1 code

07JP0ZZ Inspection of Spleen, Open Approach

0D9U Gastrointestinal System, Drainage2 codes

0D9U0ZX Drainage of Omentum, Open Approach, Diagnostic
0D9U4ZX Drainage of Omentum, Percutaneous Endoscopic Approach, Diagnostic

0D9V Gastrointestinal System, Drainage2 codes

0D9V0ZX Drainage of Mesentery, Open Approach, Diagnostic
0D9V4ZX Drainage of Mesentery, Percutaneous Endoscopic Approach, Diagnostic

0D9W Gastrointestinal System, Drainage2 codes

0D9W0ZX Drainage of Peritoneum, Open Approach, Diagnostic
0D9W4ZX Drainage of Peritoneum, Percutaneous Endoscopic Approach, Diagnostic

0DBU Gastrointestinal System, Excision1 code

0DBU0ZX Excision of Omentum, Open Approach, Diagnostic

0DBV Gastrointestinal System, Excision1 code

0DBV0ZX Excision of Mesentery, Open Approach, Diagnostic

0DBW Gastrointestinal System, Excision1 code

0DBW0ZX Excision of Peritoneum, Open Approach, Diagnostic

0DJ0 Gastrointestinal System, Inspection1 code

0DJ00ZZ Inspection of Upper Intestinal Tract, Open Approach

0DJ6 Gastrointestinal System, Inspection2 codes

0DJ60ZZ Inspection of Stomach, Open Approach
0DJ64ZZ Inspection of Stomach, Percutaneous Endoscopic Approach

0DJD Gastrointestinal System, Inspection1 code

0DJD0ZZ Inspection of Lower Intestinal Tract, Open Approach

0DJU Gastrointestinal System, Inspection2 codes

0DJU0ZZ Inspection of Omentum, Open Approach
0DJU4ZZ Inspection of Omentum, Percutaneous Endoscopic Approach

0DJV Gastrointestinal System, Inspection2 codes

0DJV0ZZ Inspection of Mesentery, Open Approach
0DJV4ZZ Inspection of Mesentery, Percutaneous Endoscopic Approach

0DJW Gastrointestinal System, Inspection2 codes

0DJW0ZZ Inspection of Peritoneum, Open Approach
0DJW4ZZ Inspection of Peritoneum, Percutaneous Endoscopic Approach

0F90 Hepatobiliary System and Pancreas, Drainage1 code

0F900ZX Drainage of Liver, Open Approach, Diagnostic

0F91 Hepatobiliary System and Pancreas, Drainage1 code

0F910ZX Drainage of Right Lobe Liver, Open Approach, Diagnostic

0F92 Hepatobiliary System and Pancreas, Drainage1 code

0F920ZX Drainage of Left Lobe Liver, Open Approach, Diagnostic

0F94 Hepatobiliary System and Pancreas, Drainage2 codes

0F940ZX Drainage of Gallbladder, Open Approach, Diagnostic
0F944ZX Drainage of Gallbladder, Percutaneous Endoscopic Approach, Diagnostic

0F95 Hepatobiliary System and Pancreas, Drainage1 code

0F950ZX Drainage of Right Hepatic Duct, Open Approach, Diagnostic

0F96 Hepatobiliary System and Pancreas, Drainage1 code

0F960ZX Drainage of Left Hepatic Duct, Open Approach, Diagnostic

0F97 Hepatobiliary System and Pancreas, Drainage1 code

0F970ZX Drainage of Common Hepatic Duct, Open Approach, Diagnostic

0F98 Hepatobiliary System and Pancreas, Drainage1 code

0F980ZX Drainage of Cystic Duct, Open Approach, Diagnostic

0F99 Hepatobiliary System and Pancreas, Drainage1 code

0F990ZX Drainage of Common Bile Duct, Open Approach, Diagnostic

0F9C Hepatobiliary System and Pancreas, Drainage1 code

0F9C0ZX Drainage of Ampulla of Vater, Open Approach, Diagnostic

0F9D Hepatobiliary System and Pancreas, Drainage1 code

0F9D0ZX Drainage of Pancreatic Duct, Open Approach, Diagnostic

0F9F Hepatobiliary System and Pancreas, Drainage1 code

0F9F0ZX Drainage of Accessory Pancreatic Duct, Open Approach, Diagnostic

0F9G Hepatobiliary System and Pancreas, Drainage1 code

0F9G0ZX Drainage of Pancreas, Open Approach, Diagnostic

0FB0 Hepatobiliary System and Pancreas, Excision2 codes

0FB00ZX Excision of Liver, Open Approach, Diagnostic
0FB04ZX Excision of Liver, Percutaneous Endoscopic Approach, Diagnostic

0FB1 Hepatobiliary System and Pancreas, Excision2 codes

0FB10ZX Excision of Right Lobe Liver, Open Approach, Diagnostic
0FB14ZX Excision of Right Lobe Liver, Percutaneous Endoscopic Approach, Diagnostic

0FB2 Hepatobiliary System and Pancreas, Excision2 codes

0FB20ZX Excision of Left Lobe Liver, Open Approach, Diagnostic
0FB24ZX Excision of Left Lobe Liver, Percutaneous Endoscopic Approach, Diagnostic

0FB4 Hepatobiliary System and Pancreas, Excision1 code

0FB40ZX Excision of Gallbladder, Open Approach, Diagnostic

0FB5 Hepatobiliary System and Pancreas, Excision1 code

0FB50ZX Excision of Right Hepatic Duct, Open Approach, Diagnostic

0FB6 Hepatobiliary System and Pancreas, Excision1 code

0FB60ZX Excision of Left Hepatic Duct, Open Approach, Diagnostic

0FB7 Hepatobiliary System and Pancreas, Excision1 code

0FB70ZX Excision of Common Hepatic Duct, Open Approach, Diagnostic

0FB8 Hepatobiliary System and Pancreas, Excision1 code

0FB80ZX Excision of Cystic Duct, Open Approach, Diagnostic

0FB9 Hepatobiliary System and Pancreas, Excision1 code

0FB90ZX Excision of Common Bile Duct, Open Approach, Diagnostic

0FBC Hepatobiliary System and Pancreas, Excision1 code

0FBC0ZX Excision of Ampulla of Vater, Open Approach, Diagnostic

0FBD Hepatobiliary System and Pancreas, Excision1 code

0FBD0ZX Excision of Pancreatic Duct, Open Approach, Diagnostic

0FBF Hepatobiliary System and Pancreas, Excision1 code

0FBF0ZX Excision of Accessory Pancreatic Duct, Open Approach, Diagnostic

0FBG Hepatobiliary System and Pancreas, Excision1 code

0FBG0ZX Excision of Pancreas, Open Approach, Diagnostic

0FD0 Hepatobiliary System and Pancreas, Extraction1 code

0FD04ZX Extraction of Liver, Percutaneous Endoscopic Approach, Diagnostic

0FD1 Hepatobiliary System and Pancreas, Extraction1 code

0FD14ZX Extraction of Right Lobe Liver, Percutaneous Endoscopic Approach, Diagnostic

0FD2 Hepatobiliary System and Pancreas, Extraction1 code

0FD24ZX Extraction of Left Lobe Liver, Percutaneous Endoscopic Approach, Diagnostic

0FJ0 Hepatobiliary System and Pancreas, Inspection2 codes

0FJ00ZZ Inspection of Liver, Open Approach
0FJ04ZZ Inspection of Liver, Percutaneous Endoscopic Approach

0FJ4 Hepatobiliary System and Pancreas, Inspection2 codes

0FJ40ZZ Inspection of Gallbladder, Open Approach
0FJ44ZZ Inspection of Gallbladder, Percutaneous Endoscopic Approach

0FJD Hepatobiliary System and Pancreas, Inspection2 codes

0FJD0ZZ Inspection of Pancreatic Duct, Open Approach
0FJD4ZZ Inspection of Pancreatic Duct, Percutaneous Endoscopic Approach

0FJG Hepatobiliary System and Pancreas, Inspection2 codes

0FJG0ZZ Inspection of Pancreas, Open Approach
0FJG4ZZ Inspection of Pancreas, Percutaneous Endoscopic Approach

0W9G Anatomical Regions, General, Drainage6 codes

0W9G00Z Drainage of Peritoneal Cavity with Drainage Device, Open Approach
0W9G0ZX Drainage of Peritoneal Cavity, Open Approach, Diagnostic
0W9G0ZZ Drainage of Peritoneal Cavity, Open Approach
0W9G40Z Drainage of Peritoneal Cavity with Drainage Device, Percutaneous Endoscopic Approach
0W9G4ZX Drainage of Peritoneal Cavity, Percutaneous Endoscopic Approach, Diagnostic
0W9G4ZZ Drainage of Peritoneal Cavity, Percutaneous Endoscopic Approach

0W9H Anatomical Regions, General, Drainage3 codes

0W9H0ZX Drainage of Retroperitoneum, Open Approach, Diagnostic
0W9H3ZX Drainage of Retroperitoneum, Percutaneous Approach, Diagnostic
0W9H4ZX Drainage of Retroperitoneum, Percutaneous Endoscopic Approach, Diagnostic

0W9J Anatomical Regions, General, Drainage2 codes

0W9J0ZX Drainage of Pelvic Cavity, Open Approach, Diagnostic
0W9J4ZX Drainage of Pelvic Cavity, Percutaneous Endoscopic Approach, Diagnostic

0WBH Anatomical Regions, General, Excision1 code

0WBH0ZX Excision of Retroperitoneum, Open Approach, Diagnostic

0WCJ Anatomical Regions, General, Extirpation1 code

0WCJ0ZZ Extirpation of Matter from Pelvic Cavity, Open Approach

0WCP Anatomical Regions, General, Extirpation1 code

0WCP0ZZ Extirpation of Matter from Gastrointestinal Tract, Open Approach

0WCR Anatomical Regions, General, Extirpation1 code

0WCR0ZZ Extirpation of Matter from Genitourinary Tract, Open Approach

0WJF Anatomical Regions, General, Inspection1 code

0WJF4ZZ Inspection of Abdominal Wall, Percutaneous Endoscopic Approach

0WJG Anatomical Regions, General, Inspection2 codes

0WJG0ZZ Inspection of Peritoneal Cavity, Open Approach
0WJG4ZZ Inspection of Peritoneal Cavity, Percutaneous Endoscopic Approach

0WJH Anatomical Regions, General, Inspection1 code

0WJH4ZZ Inspection of Retroperitoneum, Percutaneous Endoscopic Approach

0WJJ Anatomical Regions, General, Inspection2 codes

0WJJ0ZZ Inspection of Pelvic Cavity, Open Approach
0WJJ4ZZ Inspection of Pelvic Cavity, Percutaneous Endoscopic Approach

0WJP Anatomical Regions, General, Inspection2 codes

0WJP0ZZ Inspection of Gastrointestinal Tract, Open Approach
0WJP4ZZ Inspection of Gastrointestinal Tract, Percutaneous Endoscopic Approach

0WJR Anatomical Regions, General, Inspection2 codes

0WJR0ZZ Inspection of Genitourinary Tract, Open Approach
0WJR4ZZ Inspection of Genitourinary Tract, Percutaneous Endoscopic Approach

0Y95 Anatomical Regions, Lower Extremities, Drainage3 codes

0Y950ZX Drainage of Right Inguinal Region, Open Approach, Diagnostic
0Y953ZX Drainage of Right Inguinal Region, Percutaneous Approach, Diagnostic
0Y954ZX Drainage of Right Inguinal Region, Percutaneous Endoscopic Approach, Diagnostic

0Y96 Anatomical Regions, Lower Extremities, Drainage3 codes

0Y960ZX Drainage of Left Inguinal Region, Open Approach, Diagnostic
0Y963ZX Drainage of Left Inguinal Region, Percutaneous Approach, Diagnostic
0Y964ZX Drainage of Left Inguinal Region, Percutaneous Endoscopic Approach, Diagnostic

0YB5 Anatomical Regions, Lower Extremities, Excision3 codes

0YB50ZX Excision of Right Inguinal Region, Open Approach, Diagnostic
0YB53ZX Excision of Right Inguinal Region, Percutaneous Approach, Diagnostic
0YB54ZX Excision of Right Inguinal Region, Percutaneous Endoscopic Approach, Diagnostic

0YB6 Anatomical Regions, Lower Extremities, Excision3 codes

0YB60ZX Excision of Left Inguinal Region, Open Approach, Diagnostic
0YB63ZX Excision of Left Inguinal Region, Percutaneous Approach, Diagnostic
0YB64ZX Excision of Left Inguinal Region, Percutaneous Endoscopic Approach, Diagnostic

0YB7 Anatomical Regions, Lower Extremities, Excision3 codes

0YB70ZX Excision of Right Femoral Region, Open Approach, Diagnostic
0YB73ZX Excision of Right Femoral Region, Percutaneous Approach, Diagnostic
0YB74ZX Excision of Right Femoral Region, Percutaneous Endoscopic Approach, Diagnostic

0YB8 Anatomical Regions, Lower Extremities, Excision3 codes

0YB80ZX Excision of Left Femoral Region, Open Approach, Diagnostic
0YB83ZX Excision of Left Femoral Region, Percutaneous Approach, Diagnostic
0YB84ZX Excision of Left Femoral Region, Percutaneous Endoscopic Approach, Diagnostic

0YJ5 Anatomical Regions, Lower Extremities, Inspection1 code

0YJ54ZZ Inspection of Right Inguinal Region, Percutaneous Endoscopic Approach

0YJ6 Anatomical Regions, Lower Extremities, Inspection1 code

0YJ64ZZ Inspection of Left Inguinal Region, Percutaneous Endoscopic Approach

0YJ7 Anatomical Regions, Lower Extremities, Inspection1 code

0YJ74ZZ Inspection of Right Femoral Region, Percutaneous Endoscopic Approach

0YJ8 Anatomical Regions, Lower Extremities, Inspection1 code

0YJ84ZZ Inspection of Left Femoral Region, Percutaneous Endoscopic Approach

0YJA Anatomical Regions, Lower Extremities, Inspection1 code

0YJA4ZZ Inspection of Bilateral Inguinal Region, Percutaneous Endoscopic Approach

0YJE Anatomical Regions, Lower Extremities, Inspection1 code

0YJE4ZZ Inspection of Bilateral Femoral Region, Percutaneous Endoscopic Approach

4A0C Measurement and Monitoring, Physiological Systems, Measurement2 codes

4A0C45Z Measurement of Biliary Flow, Percutaneous Endoscopic Approach
4A0C4BZ Measurement of Biliary Pressure, Percutaneous Endoscopic Approach

ICD-10-CM

Qualifying Diagnosis Codes

Diagnosis codes do not drive assignment for this DRG. Cases group here from the ICD-10-PCS procedure list below.

Frequently Asked Questions

What is MS-DRG 421?

MS-DRG 421 (Hepatobiliary Diagnostic Procedures with CC) is a surgical DRG in MDC 07 (Diseases & Disorders of the Hepatobiliary System & Pancreas). Its FY 2026 relative weight is 1.7375 with a geometric mean length of stay of 3.4 days.

What is the difference between DRG 420, 421, 422?

All 3 share the same base category; the severity of secondary diagnoses separates them: 420 (with MCC), 421 (with CC), 422 (without CC/MCC). A major complication or comorbidity (MCC) places the case in the highest-weighted DRG of the family; a CC in the middle; neither in the lowest.

How many procedure codes group to DRG 421?

112 ICD-10-PCS operating-room procedure codes group to this DRG.

What is the relative weight of DRG 421?

The FY 2026 relative weight of this DRG is 1.7375, meaning reimbursement of roughly 1.74 times the average Medicare inpatient case. Multiply by a hospital's blended base rate for the approximate payment.

← PreviousDRG 420 – Hepatobiliary Diagnostic Procedures with MCC Next →DRG 422 – Hepatobiliary Diagnostic Procedures without CC/MCC

Source: CMS ICD-10 MS-DRG v43.0 Definitions Manual and the FY 2026 IPPS Final Rule (Table 5), effective October 1, 2025 through September 30, 2026. We publish the DRG assignments as CMS defines them and add the navigation, search, and code links.