MS-DRG 438 – Disorders of Pancreas Except Malignancy with MCC
A Medical DRG in MDC 07 (Diseases & Disorders of the Hepatobiliary System & Pancreas). Inpatient cases group to DRG 438 when the ICD-10-CM principal diagnosis is one of the 66 codes listed below and a secondary diagnosis on the major complication or comorbidity (MCC) list is present. Its FY 2026 relative weight is 1.6302 with a geometric mean length of stay of 4.6 days.
Severity family
The grouper first assigns the case to MDC 07 from the principal diagnosis and finds no qualifying operating-room procedure (this is a Medical DRG; ICD-10-PCS codes do not drive assignment here), then applies the severity split from secondary diagnoses: with MCC → 438; with CC → 439; without CC/MCC → 440.
Principal Diagnosis Codes 66 codes · 9 categories
B25 Cytomegaloviral disease1 code
- B25.2 Cytomegaloviral pancreatitis
B26 Mumps1 code
- B26.3 Mumps pancreatitis
D13 Benign neoplasm of other and ill-defined parts of digestive system1 code
- D13.6 Benign neoplasm of pancreas
K85 Acute pancreatitis18 codes
- K85.00 Idiopathic acute pancreatitis without necrosis or infection
- K85.01 Idiopathic acute pancreatitis with uninfected necrosis
- K85.02 Idiopathic acute pancreatitis with infected necrosis
- K85.10 Biliary acute pancreatitis without necrosis or infection
- K85.11 Biliary acute pancreatitis with uninfected necrosis
- K85.12 Biliary acute pancreatitis with infected necrosis
- K85.20 Alcohol induced acute pancreatitis without necrosis or infection
- K85.21 Alcohol induced acute pancreatitis with uninfected necrosis
- K85.22 Alcohol induced acute pancreatitis with infected necrosis
- K85.30 Drug induced acute pancreatitis without necrosis or infection
- K85.31 Drug induced acute pancreatitis with uninfected necrosis
- K85.32 Drug induced acute pancreatitis with infected necrosis
- K85.80 Other acute pancreatitis without necrosis or infection
- K85.81 Other acute pancreatitis with uninfected necrosis
- K85.82 Other acute pancreatitis with infected necrosis
- K85.90 Acute pancreatitis without necrosis or infection, unspecified
- K85.91 Acute pancreatitis with uninfected necrosis, unspecified
- K85.92 Acute pancreatitis with infected necrosis, unspecified
K86 Other diseases of pancreas7 codes
Q45 Other congenital malformations of digestive system4 codes
S36 Injury of intra-abdominal organs28 codes
- S36.200A Unspecified injury of head of pancreas, initial encounter
- S36.201A Unspecified injury of body of pancreas, initial encounter
- S36.202A Unspecified injury of tail of pancreas, initial encounter
- S36.209A Unspecified injury of unspecified part of pancreas, initial encounter
- S36.220A Contusion of head of pancreas, initial encounter
- S36.221A Contusion of body of pancreas, initial encounter
- S36.222A Contusion of tail of pancreas, initial encounter
- S36.229A Contusion of unspecified part of pancreas, initial encounter
- S36.230A Laceration of head of pancreas, unspecified degree, initial encounter
- S36.231A Laceration of body of pancreas, unspecified degree, initial encounter
- S36.232A Laceration of tail of pancreas, unspecified degree, initial encounter
- S36.239A Laceration of unspecified part of pancreas, unspecified degree, initial encounter
- S36.240A Minor laceration of head of pancreas, initial encounter
- S36.241A Minor laceration of body of pancreas, initial encounter
- S36.242A Minor laceration of tail of pancreas, initial encounter
- S36.249A Minor laceration of unspecified part of pancreas, initial encounter
- S36.250A Moderate laceration of head of pancreas, initial encounter
- S36.251A Moderate laceration of body of pancreas, initial encounter
- S36.252A Moderate laceration of tail of pancreas, initial encounter
- S36.259A Moderate laceration of unspecified part of pancreas, initial encounter
- S36.260A Major laceration of head of pancreas, initial encounter
- S36.261A Major laceration of body of pancreas, initial encounter
- S36.262A Major laceration of tail of pancreas, initial encounter
- S36.269A Major laceration of unspecified part of pancreas, initial encounter
- S36.290A Other injury of head of pancreas, initial encounter
- S36.291A Other injury of body of pancreas, initial encounter
- S36.292A Other injury of tail of pancreas, initial encounter
- S36.299A Other injury of unspecified part of pancreas, initial encounter
T86 Complications of transplanted organs and tissue5 codes
Z94 Transplanted organ and tissue status1 code
- Z94.83 Pancreas transplant status
Procedure Codes
Frequently Asked Questions
What is MS-DRG 438?
MS-DRG 438 (Disorders of Pancreas Except Malignancy with MCC) is a medical DRG in MDC 07 (Diseases & Disorders of the Hepatobiliary System & Pancreas). Its FY 2026 relative weight is 1.6302 with a geometric mean length of stay of 4.6 days.
What is the difference between DRG 438, 439, 440?
All 3 share the same base category; the severity of secondary diagnoses separates them: 438 (with MCC), 439 (with CC), 440 (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 diagnosis codes group to DRG 438?
66 ICD-10-CM principal diagnosis codes group to this DRG, spanning 9 three-character categories.
What is the relative weight of DRG 438?
The FY 2026 relative weight of this DRG is 1.6302, meaning reimbursement of roughly 1.63 times the average Medicare inpatient case. Multiply by a hospital's blended base rate for the approximate payment.
