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  3. Procedure Codes in MS-DRG 469 - Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With MCC Or Total Ankle Replacement

Procedure Codes in MS-DRG 469 - Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With MCC Or Total Ankle Replacement

The Medicare Severity Diagnosis-Related Group (MS-DRG) is a patient classification system used to categorize hospital cases based on clinical similarity and expected resource use. MS-DRGs organize all possible principal diagnoses into mutually exclusive groups known as Major Diagnostic Categories (MDCs), which help determine reimbursement under the Medicare Inpatient Prospective Payment System.

This section lists the procedure codes included in MS-DRG V42.0: Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity with MCC or Total Ankle Replacement from October 1, 2024, through September 30, 2025.

MS-DRG: 469

MS-DRG Title: Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity with MCC or Total Ankle Replacement

MCD: 08

Relative Weight: Relative Weight
The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Geometric LOS: Geometric Length of Stay
The geometric mean length of stay (GMLOS) is used by Medicare to calculate the reimbursement for patients whose medical treatment takes a much longer or shorter time than average.

Arithmetic LOS: Arithmetic Length of Stay
The average length of stay (ALOS) reflects the average number of days a patient spends in a hospital for each admission.

  • 0SR - Lower Joints, Replacement

    • 0SR907Z - Replacement of Right Hip Joint with Autologous Tissue Substitute, Open Approach

    • 0SR90KZ - Replacement of Right Hip Joint with Nonautologous Tissue Substitute, Open Approach

    • 0SRA07Z - Replacement of Right Hip Joint, Acetabular Surface with Autologous Tissue Substitute, Open Approach

    • 0SRA0KZ - Replacement of Right Hip Joint, Acetabular Surface with Nonautologous Tissue Substitute, Open Approach

    • 0SRB07Z - Replacement of Left Hip Joint with Autologous Tissue Substitute, Open Approach

    • 0SRB0KZ - Replacement of Left Hip Joint with Nonautologous Tissue Substitute, Open Approach

    • 0SRC07Z - Replacement of Right Knee Joint with Autologous Tissue Substitute, Open Approach

    • 0SRC0KZ - Replacement of Right Knee Joint with Nonautologous Tissue Substitute, Open Approach

    • 0SRD07Z - Replacement of Left Knee Joint with Autologous Tissue Substitute, Open Approach

    • 0SRD0KZ - Replacement of Left Knee Joint with Nonautologous Tissue Substitute, Open Approach

    • 0SRE07Z - Replacement of Left Hip Joint, Acetabular Surface with Autologous Tissue Substitute, Open Approach

    • 0SRE0KZ - Replacement of Left Hip Joint, Acetabular Surface with Nonautologous Tissue Substitute, Open Approach

    • 0SRF07Z - Replacement of Right Ankle Joint with Autologous Tissue Substitute, Open Approach

    • 0SRF0J9 - Replacement of Right Ankle Joint with Synthetic Substitute, Cemented, Open Approach

    • 0SRF0JA - Replacement of Right Ankle Joint with Synthetic Substitute, Uncemented, Open Approach

    • 0SRF0JZ - Replacement of Right Ankle Joint with Synthetic Substitute, Open Approach

    • 0SRF0KZ - Replacement of Right Ankle Joint with Nonautologous Tissue Substitute, Open Approach

    • 0SRG07Z - Replacement of Left Ankle Joint with Autologous Tissue Substitute, Open Approach

    • 0SRG0J9 - Replacement of Left Ankle Joint with Synthetic Substitute, Cemented, Open Approach

    • 0SRG0JA - Replacement of Left Ankle Joint with Synthetic Substitute, Uncemented, Open Approach

    • 0SRG0JZ - Replacement of Left Ankle Joint with Synthetic Substitute, Open Approach

    • 0SRG0KZ - Replacement of Left Ankle Joint with Nonautologous Tissue Substitute, Open Approach

    • 0SRR07Z - Replacement of Right Hip Joint, Femoral Surface with Autologous Tissue Substitute, Open Approach

    • 0SRR0KZ - Replacement of Right Hip Joint, Femoral Surface with Nonautologous Tissue Substitute, Open Approach

    • 0SRS07Z - Replacement of Left Hip Joint, Femoral Surface with Autologous Tissue Substitute, Open Approach

    • 0SRS0KZ - Replacement of Left Hip Joint, Femoral Surface with Nonautologous Tissue Substitute, Open Approach

    • 0SRT07Z - Replacement of Right Knee Joint, Femoral Surface with Autologous Tissue Substitute, Open Approach

    • 0SRT0KZ - Replacement of Right Knee Joint, Femoral Surface with Nonautologous Tissue Substitute, Open Approach

    • 0SRU07Z - Replacement of Left Knee Joint, Femoral Surface with Autologous Tissue Substitute, Open Approach

    • 0SRU0KZ - Replacement of Left Knee Joint, Femoral Surface with Nonautologous Tissue Substitute, Open Approach

    • 0SRV07Z - Replacement of Right Knee Joint, Tibial Surface with Autologous Tissue Substitute, Open Approach

    • 0SRV0KZ - Replacement of Right Knee Joint, Tibial Surface with Nonautologous Tissue Substitute, Open Approach

    • 0SRW07Z - Replacement of Left Knee Joint, Tibial Surface with Autologous Tissue Substitute, Open Approach

    • 0SRW0KZ - Replacement of Left Knee Joint, Tibial Surface with Nonautologous Tissue Substitute, Open Approach

  • 0SU - Lower Joints, Supplement

    • 0SU90BZ - Supplement Right Hip Joint with Resurfacing Device, Open Approach

    • 0SUA0BZ - Supplement Right Hip Joint, Acetabular Surface with Resurfacing Device, Open Approach

    • 0SUB0BZ - Supplement Left Hip Joint with Resurfacing Device, Open Approach

    • 0SUE0BZ - Supplement Left Hip Joint, Acetabular Surface with Resurfacing Device, Open Approach

    • 0SUR0BZ - Supplement Right Hip Joint, Femoral Surface with Resurfacing Device, Open Approach

    • 0SUS0BZ - Supplement Left Hip Joint, Femoral Surface with Resurfacing Device, Open Approach

  • 0YM - Anatomical Regions, Lower Extremities, Reattachment

    • 0YM70ZZ - Reattachment of Right Femoral Region, Open Approach

    • 0YM80ZZ - Reattachment of Left Femoral Region, Open Approach

    • 0YMC0ZZ - Reattachment of Right Upper Leg, Open Approach

    • 0YMD0ZZ - Reattachment of Left Upper Leg, Open Approach

    • 0YMF0ZZ - Reattachment of Right Knee Region, Open Approach

    • 0YMG0ZZ - Reattachment of Left Knee Region, Open Approach

    • 0YMH0ZZ - Reattachment of Right Lower Leg, Open Approach

    • 0YMJ0ZZ - Reattachment of Left Lower Leg, Open Approach

    • 0YMK0ZZ - Reattachment of Right Ankle Region, Open Approach

    • 0YML0ZZ - Reattachment of Left Ankle Region, Open Approach

    • 0YMM0ZZ - Reattachment of Right Foot, Open Approach

    • 0YMN0ZZ - Reattachment of Left Foot, Open Approach