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  3. Diagnosis Codes in MS-DRG 601 - NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC

Diagnosis Codes in MS-DRG 601 - NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC

The Medicare Severity Diagnosis-Related Group or MS-DRG is a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). This is the group for Diagnosis Codes in MS-DRG 601 - NON-MALIGNANT BREAST DISORDERS WITHOUT Complication Comorbidity/Major Complication or Comorbidity diseases in version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG MS-DRG Title MCD Relative Weight Geometric LOS Arithmetic LOS
601 NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC 09 0.6226 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.		 0.63 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.		 2.50 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.

List of ICD-10-CM Codes in Diagnostic Related Group


  • D49
    • D49.3 Neoplasm of unspecified behavior of breast
  • I97
    • I97.2 Postmastectomy lymphedema syndrome
  • N60.0
    • N60.01 Solitary cyst of right breast
    • N60.02 Solitary cyst of left breast
    • N60.09 Solitary cyst of unspecified breast
  • N60.1
    • N60.11 Diffuse cystic mastopathy of right breast
    • N60.12 Diffuse cystic mastopathy of left breast
    • N60.19 Diffuse cystic mastopathy of unspecified breast
  • N60.2
    • N60.21 Fibroadenosis of right breast
    • N60.22 Fibroadenosis of left breast
    • N60.29 Fibroadenosis of unspecified breast
  • N60.3
    • N60.31 Fibrosclerosis of right breast
    • N60.32 Fibrosclerosis of left breast
    • N60.39 Fibrosclerosis of unspecified breast
  • N60.4
    • N60.41 Mammary duct ectasia of right breast
    • N60.42 Mammary duct ectasia of left breast
    • N60.49 Mammary duct ectasia of unspecified breast
  • N60.8
    • N60.81 Other benign mammary dysplasias of right breast
    • N60.82 Other benign mammary dysplasias of left breast
    • N60.89 Other benign mammary dysplasias of unspecified breast
  • N60.9
    • N60.91 Unspecified benign mammary dysplasia of right breast
    • N60.92 Unspecified benign mammary dysplasia of left breast
    • N60.99 Unspecified benign mammary dysplasia of unspecified breast
  • N61
    • N61.0 Mastitis without abscess
    • N61.1 Abscess of the breast and nipple
  • N61.2
    • N61.20 Granulomatous mastitis, unspecified breast
    • N61.21 Granulomatous mastitis, right breast
    • N61.22 Granulomatous mastitis, left breast
    • N61.23 Granulomatous mastitis, bilateral breast
    • N62 Hypertrophy of breast
  • N63
    • N63.0 Unspecified lump in unspecified breast
  • N63.1
    • N63.10 Unspecified lump in the right breast, unspecified quadrant
    • N63.11 Unspecified lump in the right breast, upper outer quadrant
    • N63.12 Unspecified lump in the right breast, upper inner quadrant
    • N63.13 Unspecified lump in the right breast, lower outer quadrant
    • N63.14 Unspecified lump in the right breast, lower inner quadrant
    • N63.15 Unspecified lump in the right breast, overlapping quadrants
  • N63.2
    • N63.20 Unspecified lump in the left breast, unspecified quadrant
    • N63.21 Unspecified lump in the left breast, upper outer quadrant
    • N63.22 Unspecified lump in the left breast, upper inner quadrant
    • N63.23 Unspecified lump in the left breast, lower outer quadrant
    • N63.24 Unspecified lump in the left breast, lower inner quadrant
    • N63.25 Unspecified lump in the left breast, overlapping quadrants
  • N63.3
    • N63.31 Unspecified lump in axillary tail of the right breast
    • N63.32 Unspecified lump in axillary tail of the left breast
  • N63.4
    • N63.41 Unspecified lump in right breast, subareolar
    • N63.42 Unspecified lump in left breast, subareolar
  • N64
    • N64.0 Fissure and fistula of nipple
    • N64.1 Fat necrosis of breast
    • N64.2 Atrophy of breast
    • N64.3 Galactorrhea not associated with childbirth
    • N64.4 Mastodynia
    • N64.9 Disorder of breast, unspecified
  • N64.5
    • N64.51 Induration of breast
    • N64.52 Nipple discharge
    • N64.53 Retraction of nipple
    • N64.59 Other signs and symptoms in breast
  • N64.8
    • N64.81 Ptosis of breast
    • N64.82 Hypoplasia of breast
    • N64.89 Other specified disorders of breast
  • N65
    • N65.0 Deformity of reconstructed breast
    • N65.1 Disproportion of reconstructed breast
  • Q83
    • Q83.0 Congenital absence of breast with absent nipple
    • Q83.1 Accessory breast
    • Q83.2 Absent nipple
    • Q83.3 Accessory nipple
    • Q83.8 Other congenital malformations of breast
    • Q83.9 Congenital malformation of breast, unspecified
  • R92
    • R92.0 Mammographic microcalcification found on diagnostic imaging of breast
    • R92.1 Mammographic calcification found on diagnostic imaging of breast
    • R92.2 Inconclusive mammogram
    • R92.8 Other abnormal and inconclusive findings on diagnostic imaging of breast
  • R92.3
    • R92.30 Dense breasts, unspecified
  • R92.31
    • R92.311 Mammographic fatty tissue density, right breast
    • R92.312 Mammographic fatty tissue density, left breast
    • R92.313 Mammographic fatty tissue density, bilateral breasts
  • R92.32
    • R92.321 Mammographic fibroglandular density, right breast
    • R92.322 Mammographic fibroglandular density, left breast
    • R92.323 Mammographic fibroglandular density, bilateral breasts
  • R92.33
    • R92.331 Mammographic heterogeneous density, right breast
    • R92.332 Mammographic heterogeneous density, left breast
    • R92.333 Mammographic heterogeneous density, bilateral breasts
  • R92.34
    • R92.341 Mammographic extreme density, right breast
    • R92.342 Mammographic extreme density, left breast
    • R92.343 Mammographic extreme density, bilateral breasts
  • T85.41
    • T85.41XA Breakdown (mechanical) of breast prosthesis and implant, initial encounter
  • T85.42
    • T85.42XA Displacement of breast prosthesis and implant, initial encounter
  • T85.43
    • T85.43XA Leakage of breast prosthesis and implant, initial encounter
  • T85.44
    • T85.44XA Capsular contracture of breast implant, initial encounter
  • T85.49
    • T85.49XA Other mechanical complication of breast prosthesis and implant, initial encounter
  • Z40.0
    • Z40.01 Encounter for prophylactic removal of breast