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MS-DRG/MDC 08/492
MS-DRGSurgical

492

LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC

MS-DRG 492 groups Medicare inpatient hospital stays for: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC. 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 LevelMCC
Relative Weight3.6716
Relative Weight (10% Cap Applied)3.6716
Geometric Mean Length of Stay6.6 days
Arithmetic Mean Length of Stay8.4 days
Post-Acute Transfer DRGYes
Special Pay Transfer DRGYes

Defining Codes (FY2026)

766 procedure codes appear in its surgical logic (Lower Extremity and Humerus Procedures Except Hip, Foot and Femur: 766): 0M5Q0ZZ, 0M5Q3ZZ, 0M5Q4ZZ, 0M5R0ZZ, 0M5R3ZZ, 0M5R4ZZ, 0M9Q40Z, 0M9R40Z, 0P8C0ZZ, 0P8C3ZZ, 0P8C4ZZ, 0P8D0ZZ and 754 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 492 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 procedures (766)

  • 0M5Q0ZZ — Destruction of Right Ankle Bursa and Ligament, Open Approach [Grouper procedure]
  • 0M5Q3ZZ — Destruction of Right Ankle Bursa and Ligament, Percutaneous Approach [Grouper procedure]
  • 0M5Q4ZZ — Destruction of Right Ankle Bursa and Ligament, Percutaneous Endoscopic Approach [Grouper procedure]
  • 0M5R0ZZ — Destruction of Left Ankle Bursa and Ligament, Open Approach [Grouper procedure]
  • 0M5R3ZZ — Destruction of Left Ankle Bursa and Ligament, Percutaneous Approach [Grouper procedure]
  • 0M5R4ZZ — Destruction of Left Ankle Bursa and Ligament, Percutaneous Endoscopic Approach [Grouper procedure]
  • 0M9Q40Z — Drainage of Right Ankle Bursa and Ligament with Drainage Device, Percutaneous Endoscopic Approach [Grouper procedure]
  • 0M9R40Z — Drainage of Left Ankle Bursa and Ligament with Drainage Device, Percutaneous Endoscopic Approach [Grouper procedure]
  • and 758 more

DRG family

  • DRG 493 — LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC [DRG family]: “LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC — same CMS DRG family (492-494), split by severity.”
  • DRG 494 — LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC [DRG family]: “LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC — same CMS DRG family (492-494), split by severity.”