816 MS-DRG: RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC
MS-DRG 816 groups Medicare inpatient hospital stays for: RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC. This is a medical MS-DRG. It falls under MDC 16 (Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders).
Payment & Classification Data
Official CMS values from the FY2027 IPPS Final Rule Table 5.
| Major Diagnostic Category | MDC 16 — Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders |
| DRG Type | Medical |
| Severity Level | None |
| Relative Weight | 0.7381 |
| Relative Weight (10% Cap Applied) | 0.7381 |
| Geometric Mean Length of Stay | 2.1 days |
| Arithmetic Mean Length of Stay | 2.6 days |
| Post-Acute Transfer DRG | No |
| Special Pay Transfer DRG | No |
Defining Codes (FY2027)
137 diagnosis codes can drive assignment here: A18.2, A18.85, A28.1, D15.0, D18.1, D36.0, D3A.091, D47.2, D47.3, D47.4, D68.312, D68.51 and 125 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 816 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 16 — Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders[MDC]— CMS MS-DRG Definitions Manual · FY2027
Defining diagnoses (137)
- A18.2 — Tuberculous peripheral lymphadenopathy[Grouper diagnosis]— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- A18.85 — Tuberculosis of spleen[Grouper diagnosis]— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- A28.1 — Cat-scratch disease[Grouper diagnosis]— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- D15.0 — Benign neoplasm of thymus[Grouper diagnosis]— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- D18.1 — Lymphangioma, any site[Grouper diagnosis]— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- D36.0 — Benign neoplasm of lymph nodes[Grouper diagnosis]— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- D3A.091 — Benign carcinoid tumor of the thymus[Grouper diagnosis]— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- D47.2 — Monoclonal gammopathy[Grouper diagnosis]— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- and 129 more
DRG family
- DRG 814 — RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC[DRG family]: “RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC — same CMS DRG family (814-816), split by severity.”— CMS MS-DRG Definitions Manual (DRG family 814-816) · FY2027
- DRG 815 — RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC[DRG family]: “RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC — same CMS DRG family (814-816), split by severity.”— CMS MS-DRG Definitions Manual (DRG family 814-816) · 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