MS-DRG · FY 2026 v43.0

MS-DRG 446 – Disorders of the Biliary Tract without CC/MCC

A Medical DRG in MDC 07 (Diseases & Disorders of the Hepatobiliary System & Pancreas). Inpatient cases group to DRG 446 when the ICD-10-CM principal diagnosis is one of the 72 codes listed below and no secondary diagnosis on the CC or MCC lists is present. Its FY 2026 relative weight is 0.8273 with a geometric mean length of stay of 2.1 days.

Medical DRG – assigned by principal diagnosis✓ Official CMS v43.0 dataset
0.8273
Relative Weight
2.1
Geometric Mean LOS (days)
2.5
Arithmetic Mean LOS (days)
72
Principal Diagnosis Codes

Severity family

DRG 444with MCCWeight 1.6709 · GMLOS 4.3 daysDRG 445with CCWeight 1.0944 · GMLOS 3.0 daysDRG 446without CC/MCCWeight 0.8273 · GMLOS 2.1 days
How a case is assigned to DRG 446

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 → 444; with CC → 445; without CC/MCC → 446.

ICD-10-CM

Principal Diagnosis Codes 72 codes · 9 categories

72 of 72 shown
K80 Cholelithiasis40 codes
  • K80.00 Calculus of gallbladder with acute cholecystitis without obstruction
  • K80.01 Calculus of gallbladder with acute cholecystitis with obstruction
  • K80.10 Calculus of gallbladder with chronic cholecystitis without obstruction
  • K80.11 Calculus of gallbladder with chronic cholecystitis with obstruction
  • K80.12 Calculus of gallbladder with acute and chronic cholecystitis without obstruction
  • K80.13 Calculus of gallbladder with acute and chronic cholecystitis with obstruction
  • K80.18 Calculus of gallbladder with other cholecystitis without obstruction
  • K80.19 Calculus of gallbladder with other cholecystitis with obstruction
  • K80.20 Calculus of gallbladder without cholecystitis without obstruction
  • K80.21 Calculus of gallbladder without cholecystitis with obstruction
  • K80.30 Calculus of bile duct with cholangitis, unspecified, without obstruction
  • K80.31 Calculus of bile duct with cholangitis, unspecified, with obstruction
  • K80.32 Calculus of bile duct with acute cholangitis without obstruction
  • K80.33 Calculus of bile duct with acute cholangitis with obstruction
  • K80.34 Calculus of bile duct with chronic cholangitis without obstruction
  • K80.35 Calculus of bile duct with chronic cholangitis with obstruction
  • K80.36 Calculus of bile duct with acute and chronic cholangitis without obstruction
  • K80.37 Calculus of bile duct with acute and chronic cholangitis with obstruction
  • K80.40 Calculus of bile duct with cholecystitis, unspecified, without obstruction
  • K80.41 Calculus of bile duct with cholecystitis, unspecified, with obstruction
  • K80.42 Calculus of bile duct with acute cholecystitis without obstruction
  • K80.43 Calculus of bile duct with acute cholecystitis with obstruction
  • K80.44 Calculus of bile duct with chronic cholecystitis without obstruction
  • K80.45 Calculus of bile duct with chronic cholecystitis with obstruction
  • K80.46 Calculus of bile duct with acute and chronic cholecystitis without obstruction
  • K80.47 Calculus of bile duct with acute and chronic cholecystitis with obstruction
  • K80.50 Calculus of bile duct without cholangitis or cholecystitis without obstruction
  • K80.51 Calculus of bile duct without cholangitis or cholecystitis with obstruction
  • K80.60 Calculus of gallbladder and bile duct with cholecystitis, unspecified, without obstruction
  • K80.61 Calculus of gallbladder and bile duct with cholecystitis, unspecified, with obstruction
  • K80.62 Calculus of gallbladder and bile duct with acute cholecystitis without obstruction
  • K80.63 Calculus of gallbladder and bile duct with acute cholecystitis with obstruction
  • K80.64 Calculus of gallbladder and bile duct with chronic cholecystitis without obstruction
  • K80.65 Calculus of gallbladder and bile duct with chronic cholecystitis with obstruction
  • K80.66 Calculus of gallbladder and bile duct with acute and chronic cholecystitis without obstruction
  • K80.67 Calculus of gallbladder and bile duct with acute and chronic cholecystitis with obstruction
  • K80.70 Calculus of gallbladder and bile duct without cholecystitis without obstruction
  • K80.71 Calculus of gallbladder and bile duct without cholecystitis with obstruction
  • K80.80 Other cholelithiasis without obstruction
  • K80.81 Other cholelithiasis with obstruction
K81 Cholecystitis4 codes
  • K81.0 Acute cholecystitis
  • K81.1 Chronic cholecystitis
  • K81.2 Acute cholecystitis with chronic cholecystitis
  • K81.9 Cholecystitis, unspecified
K82 Other diseases of gallbladder9 codes
  • K82.0 Obstruction of gallbladder
  • K82.1 Hydrops of gallbladder
  • K82.2 Perforation of gallbladder
  • K82.3 Fistula of gallbladder
  • K82.4 Cholesterolosis of gallbladder
  • K82.8 Other specified diseases of gallbladder
  • K82.9 Disease of gallbladder, unspecified
  • K82.A1 Gangrene of gallbladder in cholecystitis
  • K82.A2 Perforation of gallbladder in cholecystitis
K83 Other diseases of biliary tract9 codes
  • K83.01 Primary sclerosing cholangitis
  • K83.09 Other cholangitis
  • K83.1 Obstruction of bile duct
  • K83.2 Perforation of bile duct
  • K83.3 Fistula of bile duct
  • K83.4 Spasm of sphincter of Oddi
  • K83.5 Biliary cyst
  • K83.8 Other specified diseases of biliary tract
  • K83.9 Disease of biliary tract, unspecified
K87 Disorders of gallbladder, biliary tract and pancreas in diseases classified elsewhere1 code
  • K87 Disorders of gallbladder, biliary tract and pancreas in diseases classified elsewhere
K91 Intraoperative and postprocedural complications and disorders of digestive system, not elsewhere classified1 code
  • K91.5 Postcholecystectomy syndrome
Q44 Congenital malformations of gallbladder, bile ducts and liver2 codes
  • Q44.2 Atresia of bile ducts
  • Q44.3 Congenital stenosis and stricture of bile ducts
R93 Abnormal findings on diagnostic imaging of other body structures1 code
  • R93.2 Abnormal findings on diagnostic imaging of liver and biliary tract
S36 Injury of intra-abdominal organs5 codes
  • S36.122A Contusion of gallbladder, initial encounter
  • S36.123A Laceration of gallbladder, initial encounter
  • S36.128A Other injury of gallbladder, initial encounter
  • S36.129A Unspecified injury of gallbladder, initial encounter
  • S36.13XA Injury of bile duct, initial encounter
ICD-10-PCS

Procedure Codes

Procedure codes do not drive assignment for this DRG. DRG 446 is a Medical DRG, assigned from the principal diagnosis above.

Frequently Asked Questions

What is MS-DRG 446?

MS-DRG 446 (Disorders of the Biliary Tract without CC/MCC) is a medical DRG in MDC 07 (Diseases & Disorders of the Hepatobiliary System & Pancreas). Its FY 2026 relative weight is 0.8273 with a geometric mean length of stay of 2.1 days.

What is the difference between DRG 444, 445, 446?

All 3 share the same base category; the severity of secondary diagnoses separates them: 444 (with MCC), 445 (with CC), 446 (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 446?

72 ICD-10-CM principal diagnosis codes group to this DRG, spanning 9 three-character categories.

What is the relative weight of DRG 446?

The FY 2026 relative weight of this DRG is 0.8273, meaning reimbursement of roughly 0.83 times the average Medicare inpatient case. Multiply by a hospital's blended base rate for the approximate payment.

← PreviousDRG 445 – Disorders of the Biliary Tract with CC
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.