MS-DRG · FY 2026 v43.0

MS-DRG 520 – Back and Neck Procedures Except Spinal Fusion without CC/MCC

A Surgical DRG in MDC 08 (Diseases & Disorders of the Musculoskeletal System & Connective Tissue). Inpatient cases group to DRG 520 when one of the 381 ICD-10-PCS operating-room procedures listed below is reported. Its FY 2026 relative weight is 1.4939 with a geometric mean length of stay of 2.1 days.

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

1.4939

Relative Weight

2.1

Geometric Mean LOS (days)

2.6

Arithmetic Mean LOS (days)

381

Procedure Codes

Severity family

DRG 519with CCWeight 2.0002 · GMLOS 3.2 daysDRG 520without CC/MCCWeight 1.4939 · GMLOS 2.1 days

How a case is assigned to DRG 520

The grouper first assigns the case to MDC 08 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 CC → 519; without CC/MCC → 520.

ICD-10-PCS

Procedure Codes 381 codes · 99 categories

381 of 381 shown

005T Central Nervous System and Cranial Nerves, Destruction3 codes

005T0ZZ Destruction of Spinal Meninges, Open Approach
005T3ZZ Destruction of Spinal Meninges, Percutaneous Approach
005T4ZZ Destruction of Spinal Meninges, Percutaneous Endoscopic Approach

005W Central Nervous System and Cranial Nerves, Destruction6 codes

005W0Z3 Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach
005W0ZZ Destruction of Cervical Spinal Cord, Open Approach
005W3Z3 Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Percutaneous Approach
005W3ZZ Destruction of Cervical Spinal Cord, Percutaneous Approach
005W4Z3 Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Percutaneous Endoscopic Approach
005W4ZZ Destruction of Cervical Spinal Cord, Percutaneous Endoscopic Approach

005X Central Nervous System and Cranial Nerves, Destruction6 codes

005X0Z3 Destruction of Thoracic Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach
005X0ZZ Destruction of Thoracic Spinal Cord, Open Approach
005X3Z3 Destruction of Thoracic Spinal Cord using Laser Interstitial Thermal Therapy, Percutaneous Approach
005X3ZZ Destruction of Thoracic Spinal Cord, Percutaneous Approach
005X4Z3 Destruction of Thoracic Spinal Cord using Laser Interstitial Thermal Therapy, Percutaneous Endoscopic Approach
005X4ZZ Destruction of Thoracic Spinal Cord, Percutaneous Endoscopic Approach

005Y Central Nervous System and Cranial Nerves, Destruction6 codes

005Y0Z3 Destruction of Lumbar Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach
005Y0ZZ Destruction of Lumbar Spinal Cord, Open Approach
005Y3Z3 Destruction of Lumbar Spinal Cord using Laser Interstitial Thermal Therapy, Percutaneous Approach
005Y3ZZ Destruction of Lumbar Spinal Cord, Percutaneous Approach
005Y4Z3 Destruction of Lumbar Spinal Cord using Laser Interstitial Thermal Therapy, Percutaneous Endoscopic Approach
005Y4ZZ Destruction of Lumbar Spinal Cord, Percutaneous Endoscopic Approach

009T Central Nervous System and Cranial Nerves, Drainage6 codes

009T00Z Drainage of Spinal Meninges with Drainage Device, Open Approach
009T0ZX Drainage of Spinal Meninges, Open Approach, Diagnostic
009T0ZZ Drainage of Spinal Meninges, Open Approach
009T40Z Drainage of Spinal Meninges with Drainage Device, Percutaneous Endoscopic Approach
009T4ZX Drainage of Spinal Meninges, Percutaneous Endoscopic Approach, Diagnostic
009T4ZZ Drainage of Spinal Meninges, Percutaneous Endoscopic Approach

009U Central Nervous System and Cranial Nerves, Drainage3 codes

009U00Z Drainage of Spinal Canal with Drainage Device, Open Approach
009U0ZX Drainage of Spinal Canal, Open Approach, Diagnostic
009U0ZZ Drainage of Spinal Canal, Open Approach

009W Central Nervous System and Cranial Nerves, Drainage6 codes

009W00Z Drainage of Cervical Spinal Cord with Drainage Device, Open Approach
009W0ZX Drainage of Cervical Spinal Cord, Open Approach, Diagnostic
009W0ZZ Drainage of Cervical Spinal Cord, Open Approach
009W40Z Drainage of Cervical Spinal Cord with Drainage Device, Percutaneous Endoscopic Approach
009W4ZX Drainage of Cervical Spinal Cord, Percutaneous Endoscopic Approach, Diagnostic
009W4ZZ Drainage of Cervical Spinal Cord, Percutaneous Endoscopic Approach

009X Central Nervous System and Cranial Nerves, Drainage6 codes

009X00Z Drainage of Thoracic Spinal Cord with Drainage Device, Open Approach
009X0ZX Drainage of Thoracic Spinal Cord, Open Approach, Diagnostic
009X0ZZ Drainage of Thoracic Spinal Cord, Open Approach
009X40Z Drainage of Thoracic Spinal Cord with Drainage Device, Percutaneous Endoscopic Approach
009X4ZX Drainage of Thoracic Spinal Cord, Percutaneous Endoscopic Approach, Diagnostic
009X4ZZ Drainage of Thoracic Spinal Cord, Percutaneous Endoscopic Approach

009Y Central Nervous System and Cranial Nerves, Drainage6 codes

009Y00Z Drainage of Lumbar Spinal Cord with Drainage Device, Open Approach
009Y0ZX Drainage of Lumbar Spinal Cord, Open Approach, Diagnostic
009Y0ZZ Drainage of Lumbar Spinal Cord, Open Approach
009Y40Z Drainage of Lumbar Spinal Cord with Drainage Device, Percutaneous Endoscopic Approach
009Y4ZX Drainage of Lumbar Spinal Cord, Percutaneous Endoscopic Approach, Diagnostic
009Y4ZZ Drainage of Lumbar Spinal Cord, Percutaneous Endoscopic Approach

00BT Central Nervous System and Cranial Nerves, Excision6 codes

00BT0ZX Excision of Spinal Meninges, Open Approach, Diagnostic
00BT0ZZ Excision of Spinal Meninges, Open Approach
00BT3ZX Excision of Spinal Meninges, Percutaneous Approach, Diagnostic
00BT3ZZ Excision of Spinal Meninges, Percutaneous Approach
00BT4ZX Excision of Spinal Meninges, Percutaneous Endoscopic Approach, Diagnostic
00BT4ZZ Excision of Spinal Meninges, Percutaneous Endoscopic Approach

00BW Central Nervous System and Cranial Nerves, Excision6 codes

00BW0ZX Excision of Cervical Spinal Cord, Open Approach, Diagnostic
00BW0ZZ Excision of Cervical Spinal Cord, Open Approach
00BW3ZX Excision of Cervical Spinal Cord, Percutaneous Approach, Diagnostic
00BW3ZZ Excision of Cervical Spinal Cord, Percutaneous Approach
00BW4ZX Excision of Cervical Spinal Cord, Percutaneous Endoscopic Approach, Diagnostic
00BW4ZZ Excision of Cervical Spinal Cord, Percutaneous Endoscopic Approach

00BX Central Nervous System and Cranial Nerves, Excision6 codes

00BX0ZX Excision of Thoracic Spinal Cord, Open Approach, Diagnostic
00BX0ZZ Excision of Thoracic Spinal Cord, Open Approach
00BX3ZX Excision of Thoracic Spinal Cord, Percutaneous Approach, Diagnostic
00BX3ZZ Excision of Thoracic Spinal Cord, Percutaneous Approach
00BX4ZX Excision of Thoracic Spinal Cord, Percutaneous Endoscopic Approach, Diagnostic
00BX4ZZ Excision of Thoracic Spinal Cord, Percutaneous Endoscopic Approach

00BY Central Nervous System and Cranial Nerves, Excision6 codes

00BY0ZX Excision of Lumbar Spinal Cord, Open Approach, Diagnostic
00BY0ZZ Excision of Lumbar Spinal Cord, Open Approach
00BY3ZX Excision of Lumbar Spinal Cord, Percutaneous Approach, Diagnostic
00BY3ZZ Excision of Lumbar Spinal Cord, Percutaneous Approach
00BY4ZX Excision of Lumbar Spinal Cord, Percutaneous Endoscopic Approach, Diagnostic
00BY4ZZ Excision of Lumbar Spinal Cord, Percutaneous Endoscopic Approach

00DT Central Nervous System and Cranial Nerves, Extraction3 codes

00DT0ZZ Extraction of Spinal Meninges, Open Approach
00DT3ZZ Extraction of Spinal Meninges, Percutaneous Approach
00DT4ZZ Extraction of Spinal Meninges, Percutaneous Endoscopic Approach

00FU Central Nervous System and Cranial Nerves, Fragmentation4 codes

00FU0ZZ Fragmentation in Spinal Canal, Open Approach
00FU3ZZ Fragmentation in Spinal Canal, Percutaneous Approach
00FU4ZZ Fragmentation in Spinal Canal, Percutaneous Endoscopic Approach
00FUXZZ Fragmentation in Spinal Canal, External Approach

00HU Central Nervous System and Cranial Nerves, Insertion9 codes

00HU01Z Insertion of Radioactive Element into Spinal Canal, Open Approach
00HU02Z Insertion of Monitoring Device into Spinal Canal, Open Approach
00HU0MZ Insertion of Neurostimulator Lead into Spinal Canal, Open Approach
00HU0YZ Insertion of Other Device into Spinal Canal, Open Approach
00HU31Z Insertion of Radioactive Element into Spinal Canal, Percutaneous Approach
00HU3MZ Insertion of Neurostimulator Lead into Spinal Canal, Percutaneous Approach
00HU41Z Insertion of Radioactive Element into Spinal Canal, Percutaneous Endoscopic Approach
00HU42Z Insertion of Monitoring Device into Spinal Canal, Percutaneous Endoscopic Approach
00HU4MZ Insertion of Neurostimulator Lead into Spinal Canal, Percutaneous Endoscopic Approach

00HV Central Nervous System and Cranial Nerves, Insertion11 codes

00HV01Z Insertion of Radioactive Element into Spinal Cord, Open Approach
00HV02Z Insertion of Monitoring Device into Spinal Cord, Open Approach
00HV0MZ Insertion of Neurostimulator Lead into Spinal Cord, Open Approach
00HV0YZ Insertion of Other Device into Spinal Cord, Open Approach
00HV31Z Insertion of Radioactive Element into Spinal Cord, Percutaneous Approach
00HV3MZ Insertion of Neurostimulator Lead into Spinal Cord, Percutaneous Approach
00HV3YZ Insertion of Other Device into Spinal Cord, Percutaneous Approach
00HV41Z Insertion of Radioactive Element into Spinal Cord, Percutaneous Endoscopic Approach
00HV42Z Insertion of Monitoring Device into Spinal Cord, Percutaneous Endoscopic Approach
00HV4MZ Insertion of Neurostimulator Lead into Spinal Cord, Percutaneous Endoscopic Approach
00HV4YZ Insertion of Other Device into Spinal Cord, Percutaneous Endoscopic Approach

00JU Central Nervous System and Cranial Nerves, Inspection2 codes

00JU0ZZ Inspection of Spinal Canal, Open Approach
00JU4ZZ Inspection of Spinal Canal, Percutaneous Endoscopic Approach

00JV Central Nervous System and Cranial Nerves, Inspection2 codes

00JV0ZZ Inspection of Spinal Cord, Open Approach
00JV4ZZ Inspection of Spinal Cord, Percutaneous Endoscopic Approach

00NT Central Nervous System and Cranial Nerves, Release3 codes

00NT0ZZ Release Spinal Meninges, Open Approach
00NT3ZZ Release Spinal Meninges, Percutaneous Approach
00NT4ZZ Release Spinal Meninges, Percutaneous Endoscopic Approach

00NW Central Nervous System and Cranial Nerves, Release3 codes

00NW0ZZ Release Cervical Spinal Cord, Open Approach
00NW3ZZ Release Cervical Spinal Cord, Percutaneous Approach
00NW4ZZ Release Cervical Spinal Cord, Percutaneous Endoscopic Approach

00NX Central Nervous System and Cranial Nerves, Release3 codes

00NX0ZZ Release Thoracic Spinal Cord, Open Approach
00NX3ZZ Release Thoracic Spinal Cord, Percutaneous Approach
00NX4ZZ Release Thoracic Spinal Cord, Percutaneous Endoscopic Approach

00NY Central Nervous System and Cranial Nerves, Release3 codes

00NY0ZZ Release Lumbar Spinal Cord, Open Approach
00NY3ZZ Release Lumbar Spinal Cord, Percutaneous Approach
00NY4ZZ Release Lumbar Spinal Cord, Percutaneous Endoscopic Approach

00PU Central Nervous System and Cranial Nerves, Removal13 codes

00PU00Z Removal of Drainage Device from Spinal Canal, Open Approach
00PU02Z Removal of Monitoring Device from Spinal Canal, Open Approach
00PU03Z Removal of Infusion Device from Spinal Canal, Open Approach
00PU0JZ Removal of Synthetic Substitute from Spinal Canal, Open Approach
00PU0MZ Removal of Neurostimulator Lead from Spinal Canal, Open Approach
00PU0YZ Removal of Other Device from Spinal Canal, Open Approach
00PU3JZ Removal of Synthetic Substitute from Spinal Canal, Percutaneous Approach
00PU3MZ Removal of Neurostimulator Lead from Spinal Canal, Percutaneous Approach
00PU40Z Removal of Drainage Device from Spinal Canal, Percutaneous Endoscopic Approach
00PU42Z Removal of Monitoring Device from Spinal Canal, Percutaneous Endoscopic Approach
00PU43Z Removal of Infusion Device from Spinal Canal, Percutaneous Endoscopic Approach
00PU4JZ Removal of Synthetic Substitute from Spinal Canal, Percutaneous Endoscopic Approach
00PU4MZ Removal of Neurostimulator Lead from Spinal Canal, Percutaneous Endoscopic Approach

00PV Central Nervous System and Cranial Nerves, Removal3 codes

00PV0MZ Removal of Neurostimulator Lead from Spinal Cord, Open Approach
00PV3MZ Removal of Neurostimulator Lead from Spinal Cord, Percutaneous Approach
00PV4MZ Removal of Neurostimulator Lead from Spinal Cord, Percutaneous Endoscopic Approach

00QT Central Nervous System and Cranial Nerves, Repair3 codes

00QT0ZZ Repair Spinal Meninges, Open Approach
00QT3ZZ Repair Spinal Meninges, Percutaneous Approach
00QT4ZZ Repair Spinal Meninges, Percutaneous Endoscopic Approach

00QW Central Nervous System and Cranial Nerves, Repair3 codes

00QW0ZZ Repair Cervical Spinal Cord, Open Approach
00QW3ZZ Repair Cervical Spinal Cord, Percutaneous Approach
00QW4ZZ Repair Cervical Spinal Cord, Percutaneous Endoscopic Approach

00QX Central Nervous System and Cranial Nerves, Repair3 codes

00QX0ZZ Repair Thoracic Spinal Cord, Open Approach
00QX3ZZ Repair Thoracic Spinal Cord, Percutaneous Approach
00QX4ZZ Repair Thoracic Spinal Cord, Percutaneous Endoscopic Approach

00QY Central Nervous System and Cranial Nerves, Repair3 codes

00QY0ZZ Repair Lumbar Spinal Cord, Open Approach
00QY3ZZ Repair Lumbar Spinal Cord, Percutaneous Approach
00QY4ZZ Repair Lumbar Spinal Cord, Percutaneous Endoscopic Approach

00RT Central Nervous System and Cranial Nerves, Replacement6 codes

00RT07Z Replacement of Spinal Meninges with Autologous Tissue Substitute, Open Approach
00RT0JZ Replacement of Spinal Meninges with Synthetic Substitute, Open Approach
00RT0KZ Replacement of Spinal Meninges with Nonautologous Tissue Substitute, Open Approach
00RT47Z Replacement of Spinal Meninges with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
00RT4JZ Replacement of Spinal Meninges with Synthetic Substitute, Percutaneous Endoscopic Approach
00RT4KZ Replacement of Spinal Meninges with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

00SW Central Nervous System and Cranial Nerves, Reposition3 codes

00SW0ZZ Reposition Cervical Spinal Cord, Open Approach
00SW3ZZ Reposition Cervical Spinal Cord, Percutaneous Approach
00SW4ZZ Reposition Cervical Spinal Cord, Percutaneous Endoscopic Approach

00SX Central Nervous System and Cranial Nerves, Reposition3 codes

00SX0ZZ Reposition Thoracic Spinal Cord, Open Approach
00SX3ZZ Reposition Thoracic Spinal Cord, Percutaneous Approach
00SX4ZZ Reposition Thoracic Spinal Cord, Percutaneous Endoscopic Approach

00SY Central Nervous System and Cranial Nerves, Reposition3 codes

00SY0ZZ Reposition Lumbar Spinal Cord, Open Approach
00SY3ZZ Reposition Lumbar Spinal Cord, Percutaneous Approach
00SY4ZZ Reposition Lumbar Spinal Cord, Percutaneous Endoscopic Approach

00UT Central Nervous System and Cranial Nerves, Supplement9 codes

00UT07Z Supplement Spinal Meninges with Autologous Tissue Substitute, Open Approach
00UT0JZ Supplement Spinal Meninges with Synthetic Substitute, Open Approach
00UT0KZ Supplement Spinal Meninges with Nonautologous Tissue Substitute, Open Approach
00UT37Z Supplement Spinal Meninges with Autologous Tissue Substitute, Percutaneous Approach
00UT3JZ Supplement Spinal Meninges with Synthetic Substitute, Percutaneous Approach
00UT3KZ Supplement Spinal Meninges with Nonautologous Tissue Substitute, Percutaneous Approach
00UT47Z Supplement Spinal Meninges with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
00UT4JZ Supplement Spinal Meninges with Synthetic Substitute, Percutaneous Endoscopic Approach
00UT4KZ Supplement Spinal Meninges with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

00WU Central Nervous System and Cranial Nerves, Revision16 codes

00WU00Z Revision of Drainage Device in Spinal Canal, Open Approach
00WU02Z Revision of Monitoring Device in Spinal Canal, Open Approach
00WU03Z Revision of Infusion Device in Spinal Canal, Open Approach
00WU0JZ Revision of Synthetic Substitute in Spinal Canal, Open Approach
00WU0MZ Revision of Neurostimulator Lead in Spinal Canal, Open Approach
00WU0YZ Revision of Other Device in Spinal Canal, Open Approach
00WU30Z Revision of Drainage Device in Spinal Canal, Percutaneous Approach
00WU32Z Revision of Monitoring Device in Spinal Canal, Percutaneous Approach
00WU33Z Revision of Infusion Device in Spinal Canal, Percutaneous Approach
00WU3JZ Revision of Synthetic Substitute in Spinal Canal, Percutaneous Approach
00WU3MZ Revision of Neurostimulator Lead in Spinal Canal, Percutaneous Approach
00WU40Z Revision of Drainage Device in Spinal Canal, Percutaneous Endoscopic Approach
00WU42Z Revision of Monitoring Device in Spinal Canal, Percutaneous Endoscopic Approach
00WU43Z Revision of Infusion Device in Spinal Canal, Percutaneous Endoscopic Approach
00WU4JZ Revision of Synthetic Substitute in Spinal Canal, Percutaneous Endoscopic Approach
00WU4MZ Revision of Neurostimulator Lead in Spinal Canal, Percutaneous Endoscopic Approach

0151 Peripheral Nervous System, Destruction2 codes

01510ZZ Destruction of Cervical Nerve, Open Approach
01514ZZ Destruction of Cervical Nerve, Percutaneous Endoscopic Approach

0158 Peripheral Nervous System, Destruction2 codes

01580ZZ Destruction of Thoracic Nerve, Open Approach
01584ZZ Destruction of Thoracic Nerve, Percutaneous Endoscopic Approach

015B Peripheral Nervous System, Destruction2 codes

015B0ZZ Destruction of Lumbar Nerve, Open Approach
015B4ZZ Destruction of Lumbar Nerve, Percutaneous Endoscopic Approach

015R Peripheral Nervous System, Destruction2 codes

015R0ZZ Destruction of Sacral Nerve, Open Approach
015R4ZZ Destruction of Sacral Nerve, Percutaneous Endoscopic Approach

0181 Peripheral Nervous System, Division3 codes

01810ZZ Division of Cervical Nerve, Open Approach
01813ZZ Division of Cervical Nerve, Percutaneous Approach
01814ZZ Division of Cervical Nerve, Percutaneous Endoscopic Approach

0188 Peripheral Nervous System, Division3 codes

01880ZZ Division of Thoracic Nerve, Open Approach
01883ZZ Division of Thoracic Nerve, Percutaneous Approach
01884ZZ Division of Thoracic Nerve, Percutaneous Endoscopic Approach

018B Peripheral Nervous System, Division3 codes

018B0ZZ Division of Lumbar Nerve, Open Approach
018B3ZZ Division of Lumbar Nerve, Percutaneous Approach
018B4ZZ Division of Lumbar Nerve, Percutaneous Endoscopic Approach

018R Peripheral Nervous System, Division3 codes

018R0ZZ Division of Sacral Nerve, Open Approach
018R3ZZ Division of Sacral Nerve, Percutaneous Approach
018R4ZZ Division of Sacral Nerve, Percutaneous Endoscopic Approach

0PS3 Upper Bones, Reposition5 codes

0PS304Z Reposition Cervical Vertebra with Internal Fixation Device, Open Approach
0PS30ZZ Reposition Cervical Vertebra, Open Approach
0PS334Z Reposition Cervical Vertebra with Internal Fixation Device, Percutaneous Approach
0PS344Z Reposition Cervical Vertebra with Internal Fixation Device, Percutaneous Endoscopic Approach
0PS34ZZ Reposition Cervical Vertebra, Percutaneous Endoscopic Approach

0PS4 Upper Bones, Reposition7 codes

0PS403Z Reposition Thoracic Vertebra with Spinal Stabilization Device, Vertebral Body Tether, Open Approach
0PS404Z Reposition Thoracic Vertebra with Internal Fixation Device, Open Approach
0PS40ZZ Reposition Thoracic Vertebra, Open Approach
0PS434Z Reposition Thoracic Vertebra with Internal Fixation Device, Percutaneous Approach
0PS443Z Reposition Thoracic Vertebra with Spinal Stabilization Device, Vertebral Body Tether, Percutaneous Endoscopic Approach
0PS444Z Reposition Thoracic Vertebra with Internal Fixation Device, Percutaneous Endoscopic Approach
0PS44ZZ Reposition Thoracic Vertebra, Percutaneous Endoscopic Approach

0QS0 Lower Bones, Reposition7 codes

0QS003Z Reposition Lumbar Vertebra with Spinal Stabilization Device, Vertebral Body Tether, Open Approach
0QS004Z Reposition Lumbar Vertebra with Internal Fixation Device, Open Approach
0QS00ZZ Reposition Lumbar Vertebra, Open Approach
0QS034Z Reposition Lumbar Vertebra with Internal Fixation Device, Percutaneous Approach
0QS043Z Reposition Lumbar Vertebra with Spinal Stabilization Device, Vertebral Body Tether, Percutaneous Endoscopic Approach
0QS044Z Reposition Lumbar Vertebra with Internal Fixation Device, Percutaneous Endoscopic Approach
0QS04ZZ Reposition Lumbar Vertebra, Percutaneous Endoscopic Approach

0QS1 Lower Bones, Reposition5 codes

0QS104Z Reposition Sacrum with Internal Fixation Device, Open Approach
0QS10ZZ Reposition Sacrum, Open Approach
0QS134Z Reposition Sacrum with Internal Fixation Device, Percutaneous Approach
0QS144Z Reposition Sacrum with Internal Fixation Device, Percutaneous Endoscopic Approach
0QS14ZZ Reposition Sacrum, Percutaneous Endoscopic Approach

0QSS Lower Bones, Reposition6 codes

0QSS04Z Reposition Coccyx with Internal Fixation Device, Open Approach
0QSS0ZZ Reposition Coccyx, Open Approach
0QSS34Z Reposition Coccyx with Internal Fixation Device, Percutaneous Approach
0QSS3ZZ Reposition Coccyx, Percutaneous Approach
0QSS44Z Reposition Coccyx with Internal Fixation Device, Percutaneous Endoscopic Approach
0QSS4ZZ Reposition Coccyx, Percutaneous Endoscopic Approach

0R53 Upper Joints, Destruction1 code

0R530ZZ Destruction of Cervical Vertebral Disc, Open Approach

0R55 Upper Joints, Destruction1 code

0R550ZZ Destruction of Cervicothoracic Vertebral Disc, Open Approach

0R59 Upper Joints, Destruction1 code

0R590ZZ Destruction of Thoracic Vertebral Disc, Open Approach

0R5B Upper Joints, Destruction1 code

0R5B0ZZ Destruction of Thoracolumbar Vertebral Disc, Open Approach

0RB0 Upper Joints, Excision3 codes

0RB00ZZ Excision of Occipital-cervical Joint, Open Approach
0RB03ZZ Excision of Occipital-cervical Joint, Percutaneous Approach
0RB04ZZ Excision of Occipital-cervical Joint, Percutaneous Endoscopic Approach

0RB1 Upper Joints, Excision3 codes

0RB10ZZ Excision of Cervical Vertebral Joint, Open Approach
0RB13ZZ Excision of Cervical Vertebral Joint, Percutaneous Approach
0RB14ZZ Excision of Cervical Vertebral Joint, Percutaneous Endoscopic Approach

0RB3 Upper Joints, Excision3 codes

0RB30ZZ Excision of Cervical Vertebral Disc, Open Approach
0RB33ZZ Excision of Cervical Vertebral Disc, Percutaneous Approach
0RB34ZZ Excision of Cervical Vertebral Disc, Percutaneous Endoscopic Approach

0RB4 Upper Joints, Excision3 codes

0RB40ZZ Excision of Cervicothoracic Vertebral Joint, Open Approach
0RB43ZZ Excision of Cervicothoracic Vertebral Joint, Percutaneous Approach
0RB44ZZ Excision of Cervicothoracic Vertebral Joint, Percutaneous Endoscopic Approach

0RB5 Upper Joints, Excision3 codes

0RB50ZZ Excision of Cervicothoracic Vertebral Disc, Open Approach
0RB53ZZ Excision of Cervicothoracic Vertebral Disc, Percutaneous Approach
0RB54ZZ Excision of Cervicothoracic Vertebral Disc, Percutaneous Endoscopic Approach

0RB6 Upper Joints, Excision3 codes

0RB60ZZ Excision of Thoracic Vertebral Joint, Open Approach
0RB63ZZ Excision of Thoracic Vertebral Joint, Percutaneous Approach
0RB64ZZ Excision of Thoracic Vertebral Joint, Percutaneous Endoscopic Approach

0RB9 Upper Joints, Excision3 codes

0RB90ZZ Excision of Thoracic Vertebral Disc, Open Approach
0RB93ZZ Excision of Thoracic Vertebral Disc, Percutaneous Approach
0RB94ZZ Excision of Thoracic Vertebral Disc, Percutaneous Endoscopic Approach

0RBA Upper Joints, Excision3 codes

0RBA0ZZ Excision of Thoracolumbar Vertebral Joint, Open Approach
0RBA3ZZ Excision of Thoracolumbar Vertebral Joint, Percutaneous Approach
0RBA4ZZ Excision of Thoracolumbar Vertebral Joint, Percutaneous Endoscopic Approach

0RBB Upper Joints, Excision3 codes

0RBB0ZZ Excision of Thoracolumbar Vertebral Disc, Open Approach
0RBB3ZZ Excision of Thoracolumbar Vertebral Disc, Percutaneous Approach
0RBB4ZZ Excision of Thoracolumbar Vertebral Disc, Percutaneous Endoscopic Approach

0RQ3 Upper Joints, Repair1 code

0RQ30ZZ Repair Cervical Vertebral Disc, Open Approach

0RQ9 Upper Joints, Repair1 code

0RQ90ZZ Repair Thoracic Vertebral Disc, Open Approach

0RQB Upper Joints, Repair1 code

0RQB0ZZ Repair Thoracolumbar Vertebral Disc, Open Approach

0RR9 Upper Joints, Replacement1 code

0RR90JZ Replacement of Thoracic Vertebral Disc with Synthetic Substitute, Open Approach

0RRB Upper Joints, Replacement1 code

0RRB0JZ Replacement of Thoracolumbar Vertebral Disc with Synthetic Substitute, Open Approach

0RT3 Upper Joints, Resection1 code

0RT30ZZ Resection of Cervical Vertebral Disc, Open Approach

0RT4 Upper Joints, Resection1 code

0RT40ZZ Resection of Cervicothoracic Vertebral Joint, Open Approach

0RT5 Upper Joints, Resection1 code

0RT50ZZ Resection of Cervicothoracic Vertebral Disc, Open Approach

0RT9 Upper Joints, Resection1 code

0RT90ZZ Resection of Thoracic Vertebral Disc, Open Approach

0RTB Upper Joints, Resection1 code

0RTB0ZZ Resection of Thoracolumbar Vertebral Disc, Open Approach

0RU3 Upper Joints, Supplement9 codes

0RU307Z Supplement Cervical Vertebral Disc with Autologous Tissue Substitute, Open Approach
0RU30JZ Supplement Cervical Vertebral Disc with Synthetic Substitute, Open Approach
0RU30KZ Supplement Cervical Vertebral Disc with Nonautologous Tissue Substitute, Open Approach
0RU337Z Supplement Cervical Vertebral Disc with Autologous Tissue Substitute, Percutaneous Approach
0RU33JZ Supplement Cervical Vertebral Disc with Synthetic Substitute, Percutaneous Approach
0RU33KZ Supplement Cervical Vertebral Disc with Nonautologous Tissue Substitute, Percutaneous Approach
0RU347Z Supplement Cervical Vertebral Disc with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0RU34JZ Supplement Cervical Vertebral Disc with Synthetic Substitute, Percutaneous Endoscopic Approach
0RU34KZ Supplement Cervical Vertebral Disc with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

0RU9 Upper Joints, Supplement9 codes

0RU907Z Supplement Thoracic Vertebral Disc with Autologous Tissue Substitute, Open Approach
0RU90JZ Supplement Thoracic Vertebral Disc with Synthetic Substitute, Open Approach
0RU90KZ Supplement Thoracic Vertebral Disc with Nonautologous Tissue Substitute, Open Approach
0RU937Z Supplement Thoracic Vertebral Disc with Autologous Tissue Substitute, Percutaneous Approach
0RU93JZ Supplement Thoracic Vertebral Disc with Synthetic Substitute, Percutaneous Approach
0RU93KZ Supplement Thoracic Vertebral Disc with Nonautologous Tissue Substitute, Percutaneous Approach
0RU947Z Supplement Thoracic Vertebral Disc with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0RU94JZ Supplement Thoracic Vertebral Disc with Synthetic Substitute, Percutaneous Endoscopic Approach
0RU94KZ Supplement Thoracic Vertebral Disc with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

0RUB Upper Joints, Supplement9 codes

0RUB07Z Supplement Thoracolumbar Vertebral Disc with Autologous Tissue Substitute, Open Approach
0RUB0JZ Supplement Thoracolumbar Vertebral Disc with Synthetic Substitute, Open Approach
0RUB0KZ Supplement Thoracolumbar Vertebral Disc with Nonautologous Tissue Substitute, Open Approach
0RUB37Z Supplement Thoracolumbar Vertebral Disc with Autologous Tissue Substitute, Percutaneous Approach
0RUB3JZ Supplement Thoracolumbar Vertebral Disc with Synthetic Substitute, Percutaneous Approach
0RUB3KZ Supplement Thoracolumbar Vertebral Disc with Nonautologous Tissue Substitute, Percutaneous Approach
0RUB47Z Supplement Thoracolumbar Vertebral Disc with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0RUB4JZ Supplement Thoracolumbar Vertebral Disc with Synthetic Substitute, Percutaneous Endoscopic Approach
0RUB4KZ Supplement Thoracolumbar Vertebral Disc with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

0RW3 Upper Joints, Revision3 codes

0RW30JZ Revision of Synthetic Substitute in Cervical Vertebral Disc, Open Approach
0RW33JZ Revision of Synthetic Substitute in Cervical Vertebral Disc, Percutaneous Approach
0RW34JZ Revision of Synthetic Substitute in Cervical Vertebral Disc, Percutaneous Endoscopic Approach

0RW5 Upper Joints, Revision3 codes

0RW50JZ Revision of Synthetic Substitute in Cervicothoracic Vertebral Disc, Open Approach
0RW53JZ Revision of Synthetic Substitute in Cervicothoracic Vertebral Disc, Percutaneous Approach
0RW54JZ Revision of Synthetic Substitute in Cervicothoracic Vertebral Disc, Percutaneous Endoscopic Approach

0RW9 Upper Joints, Revision3 codes

0RW90JZ Revision of Synthetic Substitute in Thoracic Vertebral Disc, Open Approach
0RW93JZ Revision of Synthetic Substitute in Thoracic Vertebral Disc, Percutaneous Approach
0RW94JZ Revision of Synthetic Substitute in Thoracic Vertebral Disc, Percutaneous Endoscopic Approach

0RWB Upper Joints, Revision3 codes

0RWB0JZ Revision of Synthetic Substitute in Thoracolumbar Vertebral Disc, Open Approach
0RWB3JZ Revision of Synthetic Substitute in Thoracolumbar Vertebral Disc, Percutaneous Approach
0RWB4JZ Revision of Synthetic Substitute in Thoracolumbar Vertebral Disc, Percutaneous Endoscopic Approach

0S52 Lower Joints, Destruction3 codes

0S520ZZ Destruction of Lumbar Vertebral Disc, Open Approach
0S523ZZ Destruction of Lumbar Vertebral Disc, Percutaneous Approach
0S524ZZ Destruction of Lumbar Vertebral Disc, Percutaneous Endoscopic Approach

0S54 Lower Joints, Destruction3 codes

0S540ZZ Destruction of Lumbosacral Disc, Open Approach
0S543ZZ Destruction of Lumbosacral Disc, Percutaneous Approach
0S544ZZ Destruction of Lumbosacral Disc, Percutaneous Endoscopic Approach

0SB0 Lower Joints, Excision3 codes

0SB00ZZ Excision of Lumbar Vertebral Joint, Open Approach
0SB03ZZ Excision of Lumbar Vertebral Joint, Percutaneous Approach
0SB04ZZ Excision of Lumbar Vertebral Joint, Percutaneous Endoscopic Approach

0SB2 Lower Joints, Excision3 codes

0SB20ZZ Excision of Lumbar Vertebral Disc, Open Approach
0SB23ZZ Excision of Lumbar Vertebral Disc, Percutaneous Approach
0SB24ZZ Excision of Lumbar Vertebral Disc, Percutaneous Endoscopic Approach

0SB3 Lower Joints, Excision3 codes

0SB30ZZ Excision of Lumbosacral Joint, Open Approach
0SB33ZZ Excision of Lumbosacral Joint, Percutaneous Approach
0SB34ZZ Excision of Lumbosacral Joint, Percutaneous Endoscopic Approach

0SB4 Lower Joints, Excision3 codes

0SB40ZZ Excision of Lumbosacral Disc, Open Approach
0SB43ZZ Excision of Lumbosacral Disc, Percutaneous Approach
0SB44ZZ Excision of Lumbosacral Disc, Percutaneous Endoscopic Approach

0SB5 Lower Joints, Excision3 codes

0SB50ZZ Excision of Sacrococcygeal Joint, Open Approach
0SB53ZZ Excision of Sacrococcygeal Joint, Percutaneous Approach
0SB54ZZ Excision of Sacrococcygeal Joint, Percutaneous Endoscopic Approach

0SB6 Lower Joints, Excision3 codes

0SB60ZZ Excision of Coccygeal Joint, Open Approach
0SB63ZZ Excision of Coccygeal Joint, Percutaneous Approach
0SB64ZZ Excision of Coccygeal Joint, Percutaneous Endoscopic Approach

0SB7 Lower Joints, Excision3 codes

0SB70ZZ Excision of Right Sacroiliac Joint, Open Approach
0SB73ZZ Excision of Right Sacroiliac Joint, Percutaneous Approach
0SB74ZZ Excision of Right Sacroiliac Joint, Percutaneous Endoscopic Approach

0SB8 Lower Joints, Excision3 codes

0SB80ZZ Excision of Left Sacroiliac Joint, Open Approach
0SB83ZZ Excision of Left Sacroiliac Joint, Percutaneous Approach
0SB84ZZ Excision of Left Sacroiliac Joint, Percutaneous Endoscopic Approach

0SQ2 Lower Joints, Repair1 code

0SQ20ZZ Repair Lumbar Vertebral Disc, Open Approach

0SQ4 Lower Joints, Repair1 code

0SQ40ZZ Repair Lumbosacral Disc, Open Approach

0ST2 Lower Joints, Resection1 code

0ST20ZZ Resection of Lumbar Vertebral Disc, Open Approach

0ST4 Lower Joints, Resection1 code

0ST40ZZ Resection of Lumbosacral Disc, Open Approach

0SU2 Lower Joints, Supplement9 codes

0SU207Z Supplement Lumbar Vertebral Disc with Autologous Tissue Substitute, Open Approach
0SU20JZ Supplement Lumbar Vertebral Disc with Synthetic Substitute, Open Approach
0SU20KZ Supplement Lumbar Vertebral Disc with Nonautologous Tissue Substitute, Open Approach
0SU237Z Supplement Lumbar Vertebral Disc with Autologous Tissue Substitute, Percutaneous Approach
0SU23JZ Supplement Lumbar Vertebral Disc with Synthetic Substitute, Percutaneous Approach
0SU23KZ Supplement Lumbar Vertebral Disc with Nonautologous Tissue Substitute, Percutaneous Approach
0SU247Z Supplement Lumbar Vertebral Disc with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0SU24JZ Supplement Lumbar Vertebral Disc with Synthetic Substitute, Percutaneous Endoscopic Approach
0SU24KZ Supplement Lumbar Vertebral Disc with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

0SU4 Lower Joints, Supplement9 codes

0SU407Z Supplement Lumbosacral Disc with Autologous Tissue Substitute, Open Approach
0SU40JZ Supplement Lumbosacral Disc with Synthetic Substitute, Open Approach
0SU40KZ Supplement Lumbosacral Disc with Nonautologous Tissue Substitute, Open Approach
0SU437Z Supplement Lumbosacral Disc with Autologous Tissue Substitute, Percutaneous Approach
0SU43JZ Supplement Lumbosacral Disc with Synthetic Substitute, Percutaneous Approach
0SU43KZ Supplement Lumbosacral Disc with Nonautologous Tissue Substitute, Percutaneous Approach
0SU447Z Supplement Lumbosacral Disc with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0SU44JZ Supplement Lumbosacral Disc with Synthetic Substitute, Percutaneous Endoscopic Approach
0SU44KZ Supplement Lumbosacral Disc with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

0SW2 Lower Joints, Revision3 codes

0SW20JZ Revision of Synthetic Substitute in Lumbar Vertebral Disc, Open Approach
0SW23JZ Revision of Synthetic Substitute in Lumbar Vertebral Disc, Percutaneous Approach
0SW24JZ Revision of Synthetic Substitute in Lumbar Vertebral Disc, Percutaneous Endoscopic Approach

0SW4 Lower Joints, Revision3 codes

0SW40JZ Revision of Synthetic Substitute in Lumbosacral Disc, Open Approach
0SW43JZ Revision of Synthetic Substitute in Lumbosacral Disc, Percutaneous Approach
0SW44JZ Revision of Synthetic Substitute in Lumbosacral Disc, Percutaneous Endoscopic Approach

XNS0 New Technology, Bones, Reposition4 codes

XNS0032 Reposition of Lumbar Vertebra using Magnetically Controlled Growth Rod(s), Open Approach, New Technology Group 2
XNS00C7 Reposition of Lumbar Vertebra using Posterior (Dynamic) Distraction Device, Open Approach, New Technology Group 7
XNS0332 Reposition of Lumbar Vertebra using Magnetically Controlled Growth Rod(s), Percutaneous Approach, New Technology Group 2
XNS03C7 Reposition of Lumbar Vertebra using Posterior (Dynamic) Distraction Device, Percutaneous Approach, New Technology Group 7

XNS3 New Technology, Bones, Reposition2 codes

XNS3032 Reposition of Cervical Vertebra using Magnetically Controlled Growth Rod(s), Open Approach, New Technology Group 2
XNS3332 Reposition of Cervical Vertebra using Magnetically Controlled Growth Rod(s), Percutaneous Approach, New Technology Group 2

XNS4 New Technology, Bones, Reposition4 codes

XNS4032 Reposition of Thoracic Vertebra using Magnetically Controlled Growth Rod(s), Open Approach, New Technology Group 2
XNS40C7 Reposition of Thoracic Vertebra using Posterior (Dynamic) Distraction Device, Open Approach, New Technology Group 7
XNS4332 Reposition of Thoracic Vertebra using Magnetically Controlled Growth Rod(s), Percutaneous Approach, New Technology Group 2
XNS43C7 Reposition of Thoracic Vertebra using Posterior (Dynamic) Distraction Device, Percutaneous Approach, New Technology Group 7

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 520?

MS-DRG 520 (Back and Neck Procedures Except Spinal Fusion without CC/MCC) is a surgical DRG in MDC 08 (Diseases & Disorders of the Musculoskeletal System & Connective Tissue). Its FY 2026 relative weight is 1.4939 with a geometric mean length of stay of 2.1 days.

What is the difference between DRG 519, 520?

All 2 share the same base category; the severity of secondary diagnoses separates them: 519 (with CC), 520 (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 520?

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

What is the relative weight of DRG 520?

The FY 2026 relative weight of this DRG is 1.4939, meaning reimbursement of roughly 1.49 times the average Medicare inpatient case. Multiply by a hospital's blended base rate for the approximate payment.

← PreviousDRG 519 – Back and Neck Procedures Except Spinal Fusion with CC Next →DRG 521 – Hip Replacement with Principal Diagnosis of Hip Fracture

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.