2025 ICD-10-CM MS-DRG V42.0 - Major Diagnostic Categories and Classification Overview
Diagnosis-Related Groups (DRGs) are a patient classification system used to categorize hospital cases based on a patient’s principal diagnosis and treatment. DRGs are organized into Major Diagnostic Categories (MDCs), which are mutually exclusive groups that align with specific organ systems or medical specialties. This ensures that clinically similar cases are grouped together for consistent reimbursement under Medicare. The current version, V42.0, is effective for discharges from October 1, 2024, through September 30, 2025.
Each MDC typically corresponds to a single organ system or etiology and is closely tied to a particular medical specialty. To preserve clinical consistency, patients from different MDCs are not assigned to the same DRG. While most MDCs are structured around organ systems, some exceptions exist. Conditions that do not fit neatly into a specific organ system are assigned to residual MDCs, such as Systemic Infectious Diseases, Myeloproliferative Diseases, and Poorly Differentiated Neoplasms.
- 01 - Diseases & Disorders of the Nervous System
- 02 - Diseases & Disorders of the Eye
- 03 - Diseases & Disorders of the Ear, Nose, Mouth & Throat
- 04 - Diseases & Disorders of the Respiratory System
- 05 - Diseases & Disorders of the Circulatory System
- 06 - Diseases & Disorders of the Digestive System
- 07 - Diseases & Disorders of the Hepatobiliary System & Panc
- 08 - Diseases & Disorders of the Musculoskeletal System & Co
- 09 - Diseases & Disorders of the Skin, Subcutaneous Tissue &
- 10 - Endocrine, Nutritional & Metabolic Diseases & Disorders
- 11 - Diseases & Disorders of the Kidney & Urinary Tract
- 12 - Diseases & Disorders of the Male Reproductive System
- 13 - Diseases & Disorders of the Female Reproductive System
- 14 - Pregnancy, Childbirth & the Puerperium
- 15 - Newborns & Other Neonates with Conditions Originating i
- 16 - Diseases & Disorders of Blood, Blood Forming Organs, Im
- 17 - Myeloproliferative Diseases & Disorders, Poorly Differe
- 18 - Infectious & Parasitic Diseases, Systemic or Unspecifie
- 20 - Alcohol/Drug Use & Alcohol/Drug Induced Organic Mental
- 21 - Injuries, Poisonings & Toxic Effects of Drugs
- 22 - Burns
- 23 - Factors Influencing Health Status & Other Contacts with
- 24 - Multiple Significant Trauma
- 25 - Human Immunodeficiency Virus Infections
03 - Diseases & Disorders of the Ear, Nose, Mouth & Throat
146 - Ear, Nose, Mouth and Throat Malignancy with MCC
147 - Ear, Nose, Mouth and Throat Malignancy with CC
148 - Ear, Nose, Mouth and Throat Malignancy without CC/MCC
150 - Epistaxis with MCC
151 - Epistaxis without MCC
152 - Otitis Media and URI with MCC
153 - Otitis Media and URI without MCC
154 - Other Ear, Nose, Mouth and Throat Diagnoses with MCC
155 - Other Ear, Nose, Mouth and Throat Diagnoses with CC
156 - Other Ear, Nose, Mouth and Throat Diagnoses without CC/MCC
157 - Dental and Oral Diseases with MCC
158 - Dental and Oral Diseases with CC
159 - Dental and Oral Diseases without CC/MCC
04 - Diseases & Disorders of the Respiratory System
175 - Pulmonary Embolism with MCC or Acute Cor Pulmonale
176 - Pulmonary Embolism without MCC
177 - Respiratory Infections and Inflammations with MCC
178 - Respiratory Infections and Inflammations with CC
179 - Respiratory Infections and Inflammations without CC/MCC
180 - Respiratory Neoplasms with MCC
181 - Respiratory Neoplasms with CC
182 - Respiratory Neoplasms without CC/MCC
183 - Major Chest Trauma with MCC
184 - Major Chest Trauma with CC
185 - Major Chest Trauma without CC/MCC
186 - Pleural Effusion with MCC
187 - Pleural Effusion with CC
188 - Pleural Effusion without CC/MCC
190 - Chronic Obstructive Pulmonary Disease with MCC
191 - Chronic Obstructive Pulmonary Disease with CC
192 - Chronic Obstructive Pulmonary Disease without CC/MCC
193 - Simple Pneumonia and Pleurisy with MCC
194 - Simple Pneumonia and Pleurisy with CC
195 - Simple Pneumonia and Pleurisy without CC/MCC
196 - Interstitial Lung Disease with MCC
197 - Interstitial Lung Disease with CC
198 - Interstitial Lung Disease without CC/MCC
199 - Pneumothorax with MCC
200 - Pneumothorax with CC
201 - Pneumothorax without CC/MCC
202 - Bronchitis and Asthma with CC/MCC
203 - Bronchitis and Asthma without CC/MCC
205 - Other Respiratory System Diagnoses with MCC
206 - Other Respiratory System Diagnoses without MCC
05 - Diseases & Disorders of the Circulatory System
280 - Acute Myocardial Infarction, Discharged Alive with MCC
281 - Acute Myocardial Infarction, Discharged Alive with CC
282 - Acute Myocardial Infarction, Discharged Alive without CC/MCC
283 - Acute Myocardial Infarction, Expired with MCC
284 - Acute Myocardial Infarction, Expired with CC
285 - Acute Myocardial Infarction, Expired without CC/MCC
288 - Acute and Subacute Endocarditis with MCC
289 - Acute and Subacute Endocarditis with CC
290 - Acute and Subacute Endocarditis without CC/MCC
291 - Heart Failure and Shock with MCC
292 - Heart Failure and Shock with CC
293 - Heart Failure and Shock without CC/MCC
294 - Deep Vein Thrombophlebitis with CC/MCC
295 - Deep Vein Thrombophlebitis without CC/MCC
296 - Cardiac Arrest, Unexplained with MCC
297 - Cardiac Arrest, Unexplained with CC
298 - Cardiac Arrest, Unexplained without CC/MCC
299 - Peripheral Vascular Disorders with MCC
300 - Peripheral Vascular Disorders with CC
301 - Peripheral Vascular Disorders without CC/MCC
302 - Atherosclerosis with MCC
303 - Atherosclerosis without MCC
304 - Hypertension with MCC
305 - Hypertension without MCC
306 - Cardiac Congenital and Valvular Disorders with MCC
307 - Cardiac Congenital and Valvular Disorders without MCC
308 - Cardiac Arrhythmia and Conduction Disorders with MCC
309 - Cardiac Arrhythmia and Conduction Disorders with CC
310 - Cardiac Arrhythmia and Conduction Disorders without CC/MCC
314 - Other Circulatory System Diagnoses with MCC
315 - Other Circulatory System Diagnoses with CC
316 - Other Circulatory System Diagnoses without CC/MCC
06 - Diseases & Disorders of the Digestive System
368 - Major Esophageal Disorders with MCC
369 - Major Esophageal Disorders with CC
370 - Major Esophageal Disorders without CC/MCC
371 - Major Gastrointestinal Disorders and Peritoneal Infections with MCC
372 - Major Gastrointestinal Disorders and Peritoneal Infections with CC
373 - Major Gastrointestinal Disorders and Peritoneal Infections without CC/MCC
374 - Digestive Malignancy with MCC
375 - Digestive Malignancy with CC
376 - Digestive Malignancy without CC/MCC
377 - Gastrointestinal Hemorrhage with MCC
378 - Gastrointestinal Hemorrhage with CC
379 - Gastrointestinal Hemorrhage without CC/MCC
380 - Complicated Peptic Ulcer with MCC
381 - Complicated Peptic Ulcer with CC
382 - Complicated Peptic Ulcer without CC/MCC
383 - Uncomplicated Peptic Ulcer with MCC
384 - Uncomplicated Peptic Ulcer without MCC
385 - Inflammatory Bowel Disease with MCC
386 - Inflammatory Bowel Disease with CC
387 - Inflammatory Bowel Disease without CC/MCC
388 - Gastrointestinal Obstruction with MCC
389 - Gastrointestinal Obstruction with CC
390 - Gastrointestinal Obstruction without CC/MCC
391 - Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders with MCC
392 - Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders without MCC
393 - Other Digestive System Diagnoses with MCC
394 - Other Digestive System Diagnoses with CC
395 - Other Digestive System Diagnoses without CC/MCC
07 - Diseases & Disorders of the Hepatobiliary System & Pancreas
432 - Cirrhosis and Alcoholic Hepatitis with MCC
433 - Cirrhosis and Alcoholic Hepatitis with CC
434 - Cirrhosis and Alcoholic Hepatitis without CC/MCC
435 - Malignancy of Hepatobiliary System or Pancreas with MCC
436 - Malignancy of Hepatobiliary System or Pancreas with CC
437 - Malignancy of Hepatobiliary System or Pancreas without CC/MCC
438 - Disorders of Pancreas Except Malignancy with MCC
439 - Disorders of Pancreas Except Malignancy with CC
440 - Disorders of Pancreas Except Malignancy without CC/MCC
441 - Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis with MCC
442 - Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis with CC
443 - Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis without CC/MCC
444 - Disorders of the Biliary Tract with MCC
445 - Disorders of the Biliary Tract with CC
446 - Disorders of the Biliary Tract without CC/MCC
08 - Diseases & Disorders of the Musculoskeletal System & Connective Tissue
456 - Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, Infection or Extensive Fusions with MCC
457 - Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, Infection or Extensive Fusions with CC
458 - Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, Infection or Extensive Fusions without CC/MCC
485 - Knee Procedures with Principal Diagnosis of Infection with MCC
486 - Knee Procedures with Principal Diagnosis of Infection with CC
487 - Knee Procedures with Principal Diagnosis of Infection without CC/MCC
521 - Hip Replacement with Principal Diagnosis of Hip Fracture with MCC
522 - Hip Replacement with Principal Diagnosis of Hip Fracture without MCC
533 - Fractures of Femur with MCC
534 - Fractures of Femur without MCC
535 - Fractures of Hip and Pelvis with MCC
536 - Fractures of Hip and Pelvis without MCC
537 - Sprains, Strains, and Dislocations of Hip, Pelvis and Thigh with CC/MCC
538 - Sprains, Strains, and Dislocations of Hip, Pelvis and Thigh without CC/MCC
539 - Osteomyelitis with MCC
540 - Osteomyelitis with CC
541 - Osteomyelitis without CC/MCC
542 - Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with MCC
543 - Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with CC
544 - Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy without CC/MCC
545 - Connective Tissue Disorders with MCC
546 - Connective Tissue Disorders with CC
547 - Connective Tissue Disorders without CC/MCC
548 - Septic Arthritis with MCC
549 - Septic Arthritis with CC
550 - Septic Arthritis without CC/MCC
551 - Medical Back Problems with MCC
552 - Medical Back Problems without MCC
553 - Bone Diseases and Arthropathies with MCC
554 - Bone Diseases and Arthropathies without MCC
555 - Signs and Symptoms of Musculoskeletal System and Connective Tissue with MCC
556 - Signs and Symptoms of Musculoskeletal System and Connective Tissue without MCC
557 - Tendonitis, Myositis and Bursitis with MCC
558 - Tendonitis, Myositis and Bursitis without MCC
559 - Aftercare, Musculoskeletal System and Connective Tissue with MCC
560 - Aftercare, Musculoskeletal System and Connective Tissue with CC
561 - Aftercare, Musculoskeletal System and Connective Tissue without CC/MCC
562 - Fracture, Sprain, Strain and Dislocation Except Femur, Hip, Pelvis and Thigh with MCC
563 - Fracture, Sprain, Strain and Dislocation Except Femur, Hip, Pelvis and Thigh without MCC
564 - Other Musculoskeletal System and Connective Tissue Diagnoses with MCC
565 - Other Musculoskeletal System and Connective Tissue Diagnoses with CC
566 - Other Musculoskeletal System and Connective Tissue Diagnoses without CC/MCC
09 - Diseases & Disorders of the Skin, Subcutaneous Tissue & Breast
573 - Skin Graft for Skin Ulcer or Cellulitis with MCC
574 - Skin Graft for Skin Ulcer or Cellulitis with CC
575 - Skin Graft for Skin Ulcer or Cellulitis without CC/MCC
582 - Mastectomy for Malignancy with CC/MCC
583 - Mastectomy for Malignancy without CC/MCC
592 - Skin Ulcers with MCC
593 - Skin Ulcers with CC
594 - Skin Ulcers without CC/MCC
595 - Major Skin Disorders with MCC
596 - Major Skin Disorders without MCC
597 - Malignant Breast Disorders with MCC
598 - Malignant Breast Disorders with CC
599 - Malignant Breast Disorders without CC/MCC
600 - Non-Malignant Breast Disorders with CC/MCC
601 - Non-Malignant Breast Disorders without CC/MCC
602 - Cellulitis with MCC
603 - Cellulitis without MCC
604 - Trauma to the Skin, Subcutaneous Tissue and Breast with MCC
605 - Trauma to the Skin, Subcutaneous Tissue and Breast without MCC
606 - Minor Skin Disorders with MCC
607 - Minor Skin Disorders without MCC
10 - Endocrine, Nutritional & Metabolic Diseases & Disorders
637 - Diabetes with MCC
638 - Diabetes with CC
639 - Diabetes without CC/MCC
640 - Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes with MCC
641 - Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes without MCC
643 - Endocrine Disorders with MCC
644 - Endocrine Disorders with CC
645 - Endocrine Disorders without CC/MCC
11 - Diseases & Disorders of the Kidney & Urinary Tract
656 - Kidney and Ureter Procedures for Neoplasm with MCC
657 - Kidney and Ureter Procedures for Neoplasm with CC
658 - Kidney and Ureter Procedures for Neoplasm without CC/MCC
673 - Other Kidney and Urinary Tract Procedures with MCC
674 - Other Kidney and Urinary Tract Procedures with CC
675 - Other Kidney and Urinary Tract Procedures without CC/MCC
682 - Renal Failure with MCC
683 - Renal Failure with CC
684 - Renal Failure without CC/MCC
686 - Kidney and Urinary Tract Neoplasms with MCC
687 - Kidney and Urinary Tract Neoplasms with CC
688 - Kidney and Urinary Tract Neoplasms without CC/MCC
689 - Kidney and Urinary Tract Infections with MCC
690 - Kidney and Urinary Tract Infections without MCC
693 - Urinary Stones with MCC
694 - Urinary Stones without MCC
695 - Kidney and Urinary Tract Signs and Symptoms with MCC
696 - Kidney and Urinary Tract Signs and Symptoms without MCC
698 - Other Kidney and Urinary Tract Diagnoses with MCC
699 - Other Kidney and Urinary Tract Diagnoses with CC
700 - Other Kidney and Urinary Tract Diagnoses without CC/MCC
12 - Diseases & Disorders of the Male Reproductive System
715 - Other Male Reproductive System O.R. Procedures for Malignancy with CC/MCC
716 - Other Male Reproductive System O.R. Procedures for Malignancy without CC/MCC
722 - Malignancy, Male Reproductive System with MCC
723 - Malignancy, Male Reproductive System with CC
724 - Malignancy, Male Reproductive System without CC/MCC
725 - Benign Prostatic Hypertrophy with MCC
726 - Benign Prostatic Hypertrophy without MCC
727 - Inflammation of the Male Reproductive System with MCC
728 - Inflammation of the Male Reproductive System without MCC
729 - Other Male Reproductive System Diagnoses with CC/MCC
730 - Other Male Reproductive System Diagnoses without CC/MCC
13 - Diseases & Disorders of the Female Reproductive System
736 - Uterine and Adnexa Procedures for Ovarian or Adnexal Malignancy with MCC
737 - Uterine and Adnexa Procedures for Ovarian or Adnexal Malignancy with CC
738 - Uterine and Adnexa Procedures for Ovarian or Adnexal Malignancy without CC/MCC
739 - Uterine and Adnexa Procedures for Non-Ovarian and Non-Adnexal Malignancy with MCC
740 - Uterine and Adnexa Procedures for Non-Ovarian and Non-Adnexal Malignancy with CC
741 - Uterine and Adnexa Procedures for Non-Ovarian and Non-Adnexal Malignancy without CC/MCC
742 - Uterine and Adnexa Procedures for Non-Malignancy with CC/MCC
743 - Uterine and Adnexa Procedures for Non-Malignancy without CC/MCC
754 - Malignancy, Female Reproductive System with MCC
755 - Malignancy, Female Reproductive System with CC
756 - Malignancy, Female Reproductive System without CC/MCC
757 - Infections, Female Reproductive System with MCC
758 - Infections, Female Reproductive System with CC
759 - Infections, Female Reproductive System without CC/MCC
760 - Menstrual and Other Female Reproductive System Disorders with CC/MCC
761 - Menstrual and Other Female Reproductive System Disorders without CC/MCC
14 - Pregnancy, Childbirth & the Puerperium
796 - Vaginal Delivery with Sterilization and/or D&C with MCC
797 - Vaginal Delivery with Sterilization and/or D&C with CC
798 - Vaginal Delivery with Sterilization and/or D&C without CC/MCC
805 - Vaginal Delivery without Sterilization or D&C with MCC
806 - Vaginal Delivery without Sterilization or D&C with CC
807 - Vaginal Delivery without Sterilization or D&C without CC/MCC
817 - Other Antepartum Diagnoses with O.R. Procedures with MCC
818 - Other Antepartum Diagnoses with O.R. Procedures with CC
819 - Other Antepartum Diagnoses with O.R. Procedures without CC/MCC
831 - Other Antepartum Diagnoses without O.R. Procedures with MCC
832 - Other Antepartum Diagnoses without O.R. Procedures with CC
833 - Other Antepartum Diagnoses without O.R. Procedures without CC/MCC
16 - Diseases & Disorders of Blood, Blood Forming Organs, Immunologic Disorders
808 - Major Hematological and Immunological Diagnoses Except Sickle Cell Crisis and Coagulation Disorders with MCC
809 - Major Hematological and Immunological Diagnoses Except Sickle Cell Crisis and Coagulation Disorders with CC
810 - Major Hematological and Immunological Diagnoses Except Sickle Cell Crisis and Coagulation Disorders without CC/MCC
811 - Red Blood Cell Disorders with MCC
812 - Red Blood Cell Disorders without MCC
814 - Reticuloendothelial and Immunity Disorders with MCC
815 - Reticuloendothelial and Immunity Disorders with CC
816 - Reticuloendothelial and Immunity Disorders without CC/MCC
17 - Myeloproliferative Diseases & Disorders, Poorly Differentiated Neoplasms
820 - Lymphoma and Leukemia with Major O.R. Procedures with MCC
821 - Lymphoma and Leukemia with Major O.R. Procedures with CC
822 - Lymphoma and Leukemia with Major O.R. Procedures without CC/MCC
823 - Lymphoma and Non-Acute Leukemia with Other Procedures with MCC
824 - Lymphoma and Non-Acute Leukemia with Other Procedures with CC
825 - Lymphoma and Non-Acute Leukemia with Other Procedures without CC/MCC
826 - Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures with MCC
827 - Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures with CC
828 - Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures without CC/MCC
829 - Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Other Procedures with CC/MCC
830 - Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Other Procedures without CC/MCC
834 - Acute Leukemia with MCC
835 - Acute Leukemia with CC
836 - Acute Leukemia without CC/MCC
837 - Chemotherapy with Acute Leukemia as Secondary Diagnosis or with High Dose Chemotherapy Agent with MCC
838 - Chemotherapy with Acute Leukemia as Secondary Diagnosis with CC or High Dose Chemotherapy Agent
839 - Chemotherapy with Acute Leukemia as Secondary Diagnosis without CC/MCC
840 - Lymphoma and Non-Acute Leukemia with MCC
841 - Lymphoma and Non-Acute Leukemia with CC
842 - Lymphoma and Non-Acute Leukemia without CC/MCC
843 - Other Myeloproliferative Disorders or Poorly Differentiated Neoplastic Diagnoses with MCC
844 - Other Myeloproliferative Disorders or Poorly Differentiated Neoplastic Diagnoses with CC
845 - Other Myeloproliferative Disorders or Poorly Differentiated Neoplastic Diagnoses without CC/MCC
846 - Chemotherapy without Acute Leukemia as Secondary Diagnosis with MCC
847 - Chemotherapy without Acute Leukemia as Secondary Diagnosis with CC
848 - Chemotherapy without Acute Leukemia as Secondary Diagnosis without CC/MCC
18 - Infectious & Parasitic Diseases, Systemic or Unspecified Sites
856 - Postoperative or Post-Traumatic Infections with O.R. Procedures with MCC
857 - Postoperative or Post-Traumatic Infections with O.R. Procedures with CC
858 - Postoperative or Post-Traumatic Infections with O.R. Procedures without CC/MCC
862 - Postoperative and Post-Traumatic Infections with MCC
863 - Postoperative and Post-Traumatic Infections without MCC
865 - Viral Illness with MCC
866 - Viral Illness without MCC
867 - Other Infectious and Parasitic Diseases Diagnoses with MCC
868 - Other Infectious and Parasitic Diseases Diagnoses with CC
869 - Other Infectious and Parasitic Diseases Diagnoses without CC/MCC
870 - Septicemia or Severe Sepsis with MV >96 Hours
871 - Septicemia or Severe Sepsis without MV >96 Hours with MCC
872 - Septicemia or Severe Sepsis without MV >96 Hours without MCC
20 - Alcohol/Drug Use & Alcohol/Drug Induced Organic Mental Disorders
21 - Injuries, Poisonings & Toxic Effects of Drugs
913 - Traumatic Injury with MCC
914 - Traumatic Injury without MCC
915 - Allergic Reactions with MCC
916 - Allergic Reactions without MCC
917 - Poisoning and Toxic Effects of Drugs with MCC
918 - Poisoning and Toxic Effects of Drugs without MCC
919 - Complications of Treatment with MCC
920 - Complications of Treatment with CC
921 - Complications of Treatment without CC/MCC
922 - Other Injury, Poisoning and Toxic Effect Diagnoses with MCC
923 - Other Injury, Poisoning and Toxic Effect Diagnoses without MCC