195 MS-DRG: SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC
MS-DRG 195 groups Medicare inpatient hospital stays for: SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC. This is a medical MS-DRG. It falls under MDC 04 (Diseases and Disorders of the Respiratory System).
Payment & Classification Data
Official CMS values from the FY2027 IPPS Final Rule Table 5.
| Major Diagnostic Category | MDC 04 — Diseases and Disorders of the Respiratory System |
| DRG Type | Medical |
| Severity Level | None |
| Relative Weight | 0.6063 |
| Relative Weight (10% Cap Applied) | 0.6063 |
| Geometric Mean Length of Stay | 2.2 days |
| Arithmetic Mean Length of Stay | 2.6 days |
| Post-Acute Transfer DRG | Yes |
| Special Pay Transfer DRG | No |
Defining Codes (FY2027)
34 diagnosis codes can drive assignment here: B33.0, J09.X1, J09.X2, J10.00, J10.01, J10.08, J10.1, J11.00, J11.08, J12.0, J12.1, J12.2 and 22 more.
From the CMS MS-DRG Definitions Manual (Appendices B and E). Assignment also depends on severity, discharge status and the rest of the claim.
Contextual Map
Every relationship of 195 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Major Diagnostic Category
- MDC 04 — Diseases and Disorders of the Respiratory System[MDC]— CMS MS-DRG Definitions Manual · FY2027
Defining diagnoses (34)
- B33.0 — Epidemic myalgia[Grouper diagnosis]— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- J09.X1 — Influenza due to identified novel influenza A virus with pneumonia[Grouper diagnosis]— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- J09.X2 — Influenza due to identified novel influenza A virus with other respiratory manifestations[Grouper diagnosis]— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- J10.00 — Influenza due to other identified influenza virus with unspecified type of pneumonia[Grouper diagnosis]— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- J10.01 — Influenza due to other identified influenza virus with the same other identified influenza virus pneumonia[Grouper diagnosis]— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- J10.08 — Influenza due to other identified influenza virus with other specified pneumonia[Grouper diagnosis]— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- J10.1 — Influenza due to other identified influenza virus with other respiratory manifestations[Grouper diagnosis]— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- J11.00 — Influenza due to unidentified influenza virus with unspecified type of pneumonia[Grouper diagnosis]— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- and 26 more
DRG family
- DRG 193 — SIMPLE PNEUMONIA AND PLEURISY WITH MCC[DRG family]: “SIMPLE PNEUMONIA AND PLEURISY WITH MCC — same CMS DRG family (193-195), split by severity.”— CMS MS-DRG Definitions Manual (DRG family 193-195) · FY2027
- DRG 194 — SIMPLE PNEUMONIA AND PLEURISY WITH CC[DRG family]: “SIMPLE PNEUMONIA AND PLEURISY WITH CC — same CMS DRG family (193-195), split by severity.”— CMS MS-DRG Definitions Manual (DRG family 193-195) · FY2027
Read from: CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44. All data sources · How to read the labels