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  3. Diagnosis Codes in MS-DRG 597 - Malignant Breast Disorders With MCC

Diagnosis Codes in MS-DRG 597 - Malignant Breast Disorders With 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: Malignant Breast Disorders with MCC from October 1, 2024, through September 30, 2025.

MS-DRG: 597

MS-DRG Title: Malignant Breast Disorders with MCC

MCD: 09

Relative Weight: 1.7565 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: 1.76 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: 4.80 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.

  • C50.01 - Malignant neoplasm of nipple and areola, female

    • C50.011 - Malignant neoplasm of nipple and areola, right female breast

    • C50.012 - Malignant neoplasm of nipple and areola, left female breast

    • C50.019 - Malignant neoplasm of nipple and areola, unspecified female breast

  • C50.02 - Malignant neoplasm of nipple and areola, male

    • C50.021 - Malignant neoplasm of nipple and areola, right male breast

    • C50.022 - Malignant neoplasm of nipple and areola, left male breast

    • C50.029 - Malignant neoplasm of nipple and areola, unspecified male breast

  • C50.11 - Malignant neoplasm of central portion of breast, female

    • C50.111 - Malignant neoplasm of central portion of right female breast

    • C50.112 - Malignant neoplasm of central portion of left female breast

    • C50.119 - Malignant neoplasm of central portion of unspecified female breast

  • C50.12 - Malignant neoplasm of central portion of breast, male

    • C50.121 - Malignant neoplasm of central portion of right male breast

    • C50.122 - Malignant neoplasm of central portion of left male breast

    • C50.129 - Malignant neoplasm of central portion of unspecified male breast

  • C50.21 - Malignant neoplasm of upper-inner quadrant of breast, female

    • C50.211 - Malignant neoplasm of upper-inner quadrant of right female breast

    • C50.212 - Malignant neoplasm of upper-inner quadrant of left female breast

    • C50.219 - Malignant neoplasm of upper-inner quadrant of unspecified female breast

  • C50.22 - Malignant neoplasm of upper-inner quadrant of breast, male

    • C50.221 - Malignant neoplasm of upper-inner quadrant of right male breast

    • C50.222 - Malignant neoplasm of upper-inner quadrant of left male breast

    • C50.229 - Malignant neoplasm of upper-inner quadrant of unspecified male breast

  • C50.31 - Malignant neoplasm of lower-inner quadrant of breast, female

    • C50.311 - Malignant neoplasm of lower-inner quadrant of right female breast

    • C50.312 - Malignant neoplasm of lower-inner quadrant of left female breast

    • C50.319 - Malignant neoplasm of lower-inner quadrant of unspecified female breast

  • C50.32 - Malignant neoplasm of lower-inner quadrant of breast, male

    • C50.321 - Malignant neoplasm of lower-inner quadrant of right male breast

    • C50.322 - Malignant neoplasm of lower-inner quadrant of left male breast

    • C50.329 - Malignant neoplasm of lower-inner quadrant of unspecified male breast

  • C50.41 - Malignant neoplasm of upper-outer quadrant of breast, female

    • C50.411 - Malignant neoplasm of upper-outer quadrant of right female breast

    • C50.412 - Malignant neoplasm of upper-outer quadrant of left female breast

    • C50.419 - Malignant neoplasm of upper-outer quadrant of unspecified female breast

  • C50.42 - Malignant neoplasm of upper-outer quadrant of breast, male

    • C50.421 - Malignant neoplasm of upper-outer quadrant of right male breast

    • C50.422 - Malignant neoplasm of upper-outer quadrant of left male breast

    • C50.429 - Malignant neoplasm of upper-outer quadrant of unspecified male breast

  • C50.51 - Malignant neoplasm of lower-outer quadrant of breast, female

    • C50.511 - Malignant neoplasm of lower-outer quadrant of right female breast

    • C50.512 - Malignant neoplasm of lower-outer quadrant of left female breast

    • C50.519 - Malignant neoplasm of lower-outer quadrant of unspecified female breast

  • C50.52 - Malignant neoplasm of lower-outer quadrant of breast, male

    • C50.521 - Malignant neoplasm of lower-outer quadrant of right male breast

    • C50.522 - Malignant neoplasm of lower-outer quadrant of left male breast

    • C50.529 - Malignant neoplasm of lower-outer quadrant of unspecified male breast

  • C50.61 - Malignant neoplasm of axillary tail of breast, female

    • C50.611 - Malignant neoplasm of axillary tail of right female breast

    • C50.612 - Malignant neoplasm of axillary tail of left female breast

    • C50.619 - Malignant neoplasm of axillary tail of unspecified female breast

  • C50.62 - Malignant neoplasm of axillary tail of breast, male

    • C50.621 - Malignant neoplasm of axillary tail of right male breast

    • C50.622 - Malignant neoplasm of axillary tail of left male breast

    • C50.629 - Malignant neoplasm of axillary tail of unspecified male breast

  • C50.81 - Malignant neoplasm of overlapping sites of breast, female

    • C50.811 - Malignant neoplasm of overlapping sites of right female breast

    • C50.812 - Malignant neoplasm of overlapping sites of left female breast

    • C50.819 - Malignant neoplasm of overlapping sites of unspecified female breast

  • C50.82 - Malignant neoplasm of overlapping sites of breast, male

    • C50.821 - Malignant neoplasm of overlapping sites of right male breast

    • C50.822 - Malignant neoplasm of overlapping sites of left male breast

    • C50.829 - Malignant neoplasm of overlapping sites of unspecified male breast

  • C50.91 - Malignant neoplasm of breast of unspecified site, female

    • C50.911 - Malignant neoplasm of unspecified site of right female breast

    • C50.912 - Malignant neoplasm of unspecified site of left female breast

    • C50.919 - Malignant neoplasm of unspecified site of unspecified female breast

  • C50.92 - Malignant neoplasm of breast of unspecified site, male

    • C50.921 - Malignant neoplasm of unspecified site of right male breast

    • C50.922 - Malignant neoplasm of unspecified site of left male breast

    • C50.929 - Malignant neoplasm of unspecified site of unspecified male breast

  • C79 - Secondary malignant neoplasm of other and unspecified sites

    • C79.2 - Secondary malignant neoplasm of skin

  • C79.8 - Secondary malignant neoplasm of other specified sites

    • C79.81 - Secondary malignant neoplasm of breast

  • D05.0 - Lobular carcinoma in situ of breast

    • D05.00 - Lobular carcinoma in situ of unspecified breast

    • D05.01 - Lobular carcinoma in situ of right breast

    • D05.02 - Lobular carcinoma in situ of left breast

  • D05.1 - Intraductal carcinoma in situ of breast

    • D05.10 - Intraductal carcinoma in situ of unspecified breast

    • D05.11 - Intraductal carcinoma in situ of right breast

    • D05.12 - Intraductal carcinoma in situ of left breast

  • D05.8 - Other specified type of carcinoma in situ of breast

    • D05.80 - Other specified type of carcinoma in situ of unspecified breast

    • D05.81 - Other specified type of carcinoma in situ of right breast

    • D05.82 - Other specified type of carcinoma in situ of left breast

  • D05.9 - Unspecified type of carcinoma in situ of breast

    • D05.90 - Unspecified type of carcinoma in situ of unspecified breast

    • D05.91 - Unspecified type of carcinoma in situ of right breast

    • D05.92 - Unspecified type of carcinoma in situ of left breast

  • D48.6 - Neoplasm of uncertain behavior of breast

    • D48.60 - Neoplasm of uncertain behavior of unspecified breast

    • D48.61 - Neoplasm of uncertain behavior of right breast

    • D48.62 - Neoplasm of uncertain behavior of left breast