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MS-DRGSurgical

486

KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC

MS-DRG 486 groups Medicare inpatient hospital stays for: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC. This is a surgical MS-DRG. It falls under MDC 08 (Diseases and Disorders of the Musculoskeletal System and Connective Tissue).

Payment & Classification Data

Official CMS values from the current fiscal year's IPPS Final Rule.

Major Diagnostic CategoryMDC 08 — Diseases and Disorders of the Musculoskeletal System and Connective Tissue
DRG TypeSurgical
Severity LevelCC
Relative Weight2.0911
Relative Weight (10% Cap Applied)2.0911
Geometric Mean Length of Stay5.1 days
Arithmetic Mean Length of Stay6 days
Post-Acute Transfer DRGNo
Special Pay Transfer DRGNo

Defining Codes (FY2026)

56 diagnosis codes can drive assignment here: A18.02, A54.42, M00.061, M00.062, M00.069, M00.161, M00.162, M00.169, M00.261, M00.262, M00.269, M00.861 and 44 more.

274 procedure codes appear in its surgical logic (: 274): 0M9N40Z, 0M9P40Z, 0MQN0ZZ, 0MQN3ZZ, 0MQN4ZZ, 0MQP0ZZ, 0MQP3ZZ, 0MQP4ZZ, 0MRN07Z, 0MRN0JZ, 0MRN0KZ, 0MRN47Z and 262 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 486 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 08 — Diseases and Disorders of the Musculoskeletal System and Connective Tissue [MDC]

Defining diagnoses (56)

  • A18.02 — Tuberculous arthritis of other joints [Grouper diagnosis]
  • A54.42 — Gonococcal arthritis [Grouper diagnosis]
  • M00.061 — Staphylococcal arthritis, right knee [Grouper diagnosis]
  • M00.062 — Staphylococcal arthritis, left knee [Grouper diagnosis]
  • M00.069 — Staphylococcal arthritis, unspecified knee [Grouper diagnosis]
  • M00.161 — Pneumococcal arthritis, right knee [Grouper diagnosis]
  • M00.162 — Pneumococcal arthritis, left knee [Grouper diagnosis]
  • M00.169 — Pneumococcal arthritis, unspecified knee [Grouper diagnosis]
  • and 48 more

Defining procedures (274)

  • 0M9N40Z — Drainage of Right Knee Bursa and Ligament with Drainage Device, Percutaneous Endoscopic Approach [Grouper procedure]
  • 0M9P40Z — Drainage of Left Knee Bursa and Ligament with Drainage Device, Percutaneous Endoscopic Approach [Grouper procedure]
  • 0MQN0ZZ — Repair Right Knee Bursa and Ligament, Open Approach [Grouper procedure]
  • 0MQN3ZZ — Repair Right Knee Bursa and Ligament, Percutaneous Approach [Grouper procedure]
  • 0MQN4ZZ — Repair Right Knee Bursa and Ligament, Percutaneous Endoscopic Approach [Grouper procedure]
  • 0MQP0ZZ — Repair Left Knee Bursa and Ligament, Open Approach [Grouper procedure]
  • 0MQP3ZZ — Repair Left Knee Bursa and Ligament, Percutaneous Approach [Grouper procedure]
  • 0MQP4ZZ — Repair Left Knee Bursa and Ligament, Percutaneous Endoscopic Approach [Grouper procedure]
  • and 266 more

DRG family

  • DRG 485 — KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC [DRG family]: “KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC — same CMS DRG family (485-487), split by severity.”
  • DRG 487 — KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC [DRG family]: “KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC — same CMS DRG family (485-487), split by severity.”