MS-DRG · FY 2026 v43.0

MS-DRG 969 – HIV with Extensive O.R. Procedures with MCC

A Surgical DRG in MDC 25 (Human Immunodeficiency Virus Infections). Its FY 2026 relative weight is 6.1213 with a geometric mean length of stay of 11.7 days.

Surgical DRG – assigned by operating-room procedure✓ Official CMS v43.0 dataset
6.1213
Relative Weight
11.7
Geometric Mean LOS (days)
15.9
Arithmetic Mean LOS (days)
1
Diagnosis Codes

Severity family

DRG 969with MCCWeight 6.1213 · GMLOS 11.7 daysDRG 970without MCCWeight 2.6374 · GMLOS 7.5 days
How a case is assigned to DRG 969

The grouper first assigns the case to MDC 25 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 → 969; without MCC → 970.

ICD-10-PCS

Procedure Codes

Procedure codes do not drive assignment for this DRG.
ICD-10-CM

Qualifying Diagnosis Codes 1 code · 1 category

B20 Human immunodeficiency virus [HIV] disease1 code
  • B20 Human immunodeficiency virus [HIV] disease

Frequently Asked Questions

What is MS-DRG 969?

MS-DRG 969 (HIV with Extensive O.R. Procedures with MCC) is a surgical DRG in MDC 25 (Human Immunodeficiency Virus Infections). Its FY 2026 relative weight is 6.1213 with a geometric mean length of stay of 11.7 days.

What is the difference between DRG 969, 970?

All 2 share the same base category; the severity of secondary diagnoses separates them: 969 (with MCC), 970 (without 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.

What is the relative weight of DRG 969?

The FY 2026 relative weight of this DRG is 6.1213, meaning reimbursement of roughly 6.12 times the average Medicare inpatient case. Multiply by a hospital's blended base rate for the approximate payment.

← PreviousDRG 965 – Other Multiple Significant Trauma 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.