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  3. Diagnosis Codes in MS-DRG 437 - Malignancy Of Hepatobiliary System Or Pancreas Without CC/MCC

Diagnosis Codes in MS-DRG 437 - Malignancy Of Hepatobiliary System Or Pancreas Without CC/MCC

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 diagnosis codes included in MS-DRG V42.0: Malignancy of Hepatobiliary System or Pancreas without CC/MCC from October 1, 2024, through September 30, 2025.

MS-DRG: 437

MS-DRG Title: Malignancy of Hepatobiliary System or Pancreas without CC/MCC

MCD: 07

Relative Weight: 0.7851 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: 0.79 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: 2.30 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.

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    • C23 - Malignant neoplasm of gallbladder

  • C22 - Malignant neoplasm of liver and intrahepatic bile ducts

    • C22.0 - Liver cell carcinoma

    • C22.1 - Intrahepatic bile duct carcinoma

    • C22.2 - Hepatoblastoma

    • C22.3 - Angiosarcoma of liver

    • C22.4 - Other sarcomas of liver

    • C22.7 - Other specified carcinomas of liver

    • C22.8 - Malignant neoplasm of liver, primary, unspecified as to type

    • C22.9 - Malignant neoplasm of liver, not specified as primary or secondary

  • C24 - Malignant neoplasm of other and unspecified parts of biliary tract

    • C24.0 - Malignant neoplasm of extrahepatic bile duct

    • C24.1 - Malignant neoplasm of ampulla of Vater

    • C24.8 - Malignant neoplasm of overlapping sites of biliary tract

    • C24.9 - Malignant neoplasm of biliary tract, unspecified

  • C25 - Malignant neoplasm of pancreas

    • C25.0 - Malignant neoplasm of head of pancreas

    • C25.1 - Malignant neoplasm of body of pancreas

    • C25.2 - Malignant neoplasm of tail of pancreas

    • C25.3 - Malignant neoplasm of pancreatic duct

    • C25.4 - Malignant neoplasm of endocrine pancreas

    • C25.7 - Malignant neoplasm of other parts of pancreas

    • C25.8 - Malignant neoplasm of overlapping sites of pancreas

    • C25.9 - Malignant neoplasm of pancreas, unspecified

  • C78 - Secondary malignant neoplasm of respiratory and digestive organs

    • C78.7 - Secondary malignant neoplasm of liver and intrahepatic bile duct

  • C7B.0 - Secondary carcinoid tumors

    • C7B.02 - Secondary carcinoid tumors of liver

  • D01 - Carcinoma in situ of other and unspecified digestive organs

    • D01.5 - Carcinoma in situ of liver, gallbladder and bile ducts

  • D37 - Neoplasm of uncertain behavior of oral cavity and digestive organs

    • D37.6 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts