PROPOSED COMPOSITION OF LOW-VOLUME QUINTILES FOR MS-LTC-DRGS FY 2026	
MS-LTC-DRG	MS-LTC-DRG Description
Quintile 1	
053	Spinal Disorders and Injuries without CC/MCC
304	Hypertension with MCC
069	Transient Ischemia without Thrombolytic
513	"Hand or Wrist Procedures, Except Major Thumb or Joint Procedures with CC/MCC"
923	"Other Injury, Poisoning and Toxic Effect Diagnoses without MCC"
282	"Acute Myocardial Infarction, Discharged Alive without CC/MCC"
642	Inborn and Other Disorders of Metabolism
330	Major Small and Large Bowel Procedures with CC
379	Gastrointestinal Hemorrhage without CC/MCC
913	Traumatic Injury with MCC
668	Transurethral Procedures with MCC
197	Interstitial Lung Disease with CC
084	Traumatic Stupor and Coma >1 Hour without CC/MCC
562	"Fracture, Sprain, Strain and Dislocation Except Femur, Hip, Pelvis and Thigh with MCC"
378	Gastrointestinal Hemorrhage with CC
983	Extensive O.R. Procedures Unrelated to Principal Diagnosis without CC/MCC
755	"Malignancy, Female Reproductive System with CC"
556	Signs and Symptoms of Musculoskeletal System and Connective Tissue without MCC
310	Cardiac Arrhythmia and Conduction Disorders without CC/MCC
096	Bacterial and Tuberculous Infections of Nervous System without CC/MCC
922	"Other Injury, Poisoning and Toxic Effect Diagnoses with MCC"
181	Respiratory Neoplasms with CC
915	Allergic Reactions with MCC
535	Fractures of Hip and Pelvis with MCC
183	Major Chest Trauma with MCC
287	"Circulatory Disorders Except AMI, with Cardiac Catheterization without MCC"
977	HIV with or without Other Related Condition
542	Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with MCC
644	Endocrine Disorders with CC
447	Multiple Level Spinal Fusion Except Cervical with MCC or Custom-Made Anatomically Designed Interbody Fusion Device
550	Septic Arthritis without CC/MCC
417	Laparoscopic Cholecystectomy without C.D.E. with MCC
303	Atherosclerosis without MCC
933	Extensive Burns or Full Thickness Burns with MV >96 Hours without Skin Graft
975	HIV with Major Related Condition with CC
058	Multiple Sclerosis and Cerebellar Ataxia with MCC
917	Poisoning and Toxic Effects of Drugs with MCC
581	"Other Skin, Subcutaneous Tissue and Breast Procedures without CC/MCC"
948	Signs and Symptoms without MCC
081	Nontraumatic Stupor and Coma without MCC
435	Malignancy of Hepatobiliary System or Pancreas with MCC
963	Other Multiple Significant Trauma with MCC
605	"Trauma to the Skin, Subcutaneous Tissue and Breast without MCC"
395	Other Digestive System Diagnoses without CC/MCC
146	"Ear, Nose, Mouth and Throat Malignancy with MCC"
383	Uncomplicated Peptic Ulcer with MCC
835	Acute Leukemia with CC
866	Viral Illness without MCC
Quintile 2	
200	Pneumothorax with CC
553	Bone Diseases and Arthropathies with MCC
068	Precerebral Occlusion without Infarction without MCC
572	Skin Debridement without CC/MCC
373	Major Gastrointestinal Disorders and Peritoneal Infections without CC/MCC
844	Other Myeloproliferative Disorders or Poorly Differentiated Neoplastic Diagnoses with CC
080	Nontraumatic Stupor and Coma with MCC
934	Full Thickness Burn without Skin Graft or Inhalation Injury
195	Simple Pneumonia and Pleurisy without CC/MCC
596	Major Skin Disorders without MCC
192	Chronic Obstructive Pulmonary Disease without CC/MCC
475	Amputation for Musculoskeletal System and Connective Tissue Disorders with CC
381	Complicated Peptic Ulcer with CC
903	Wound Debridements for Injuries without CC/MCC
510	"Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures with MCC"
465	Wound Debridement and Skin Graft Except Hand for Musculoskeletal and Connective Tissue Disorders without CC/MCC
950	Aftercare without CC/MCC
694	Urinary Stones without MCC
607	Minor Skin Disorders without MCC
746	"Vagina, Cervix and Vulva Procedures with CC/MCC"
125	Other Disorders of the Eye without MCC
281	"Acute Myocardial Infarction, Discharged Alive with CC"
307	Cardiac Congenital and Valvular Disorders without MCC
446	Disorders of the Biliary Tract without CC/MCC
260	Cardiac Pacemaker Revision Except Device Replacement with MCC
176	Pulmonary Embolism without MCC
729	Other Male Reproductive System Diagnoses with CC/MCC
597	Malignant Breast Disorders with MCC
750	Other Female Reproductive System O.R. Procedures without CC/MCC
841	Lymphoma and Non-Acute Leukemia with CC
175	Pulmonary Embolism with MCC or Acute Cor Pulmonale
101	Seizures without MCC
099	Non-Bacterial Infection of Nervous System Except Viral Meningitis without CC/MCC
868	Other Infectious and Parasitic Diseases Diagnoses with CC
947	Signs and Symptoms with MCC
643	Endocrine Disorders with MCC
345	Minor Small and Large Bowel Procedures with CC
187	Pleural Effusion with CC
815	Reticuloendothelial and Immunity Disorders with CC
147	"Ear, Nose, Mouth and Throat Malignancy with CC"
179	Respiratory Infections and Inflammations without CC/MCC
072	Other Cerebrovascular Disorders without CC/MCC
445	Disorders of the Biliary Tract with CC
075	Viral Meningitis with CC/MCC
759	"Infections, Female Reproductive System without CC/MCC"
041	"Peripheral, Cranial Nerve and Other Nervous System Procedures with CC or Peripheral Neurostimulator"
442	"Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis with CC"
543	Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with CC
Quintile 3	
921	Complications of Treatment without CC/MCC
728	Inflammation of the Male Reproductive System without MCC
253	Other Vascular Procedures with CC
316	Other Circulatory System Diagnoses without CC/MCC
433	Cirrhosis and Alcoholic Hepatitis with CC
555	Signs and Symptoms of Musculoskeletal System and Connective Tissue with MCC
723	"Malignancy, Male Reproductive System with CC"
311	Angina Pectoris
204	Respiratory Signs and Symptoms
369	Major Esophageal Disorders with CC
377	Gastrointestinal Hemorrhage with MCC
436	Malignancy of Hepatobiliary System or Pancreas with CC
443	"Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis without CC/MCC"
037	Extracranial Procedures with MCC
375	Digestive Malignancy with CC
066	Intracranial Hemorrhage or Cerebral Infarction without CC/MCC
566	Other Musculoskeletal System and Connective Tissue Diagnoses without CC/MCC
309	Cardiac Arrhythmia and Conduction Disorders with CC
148	"Ear, Nose, Mouth and Throat Malignancy without CC/MCC"
505	Foot Procedures without CC/MCC
155	"Other Ear, Nose, Mouth and Throat Diagnoses with CC"
368	Major Esophageal Disorders with MCC
546	Connective Tissue Disorders with CC
552	Medical Back Problems without MCC
206	Other Respiratory System Diagnoses without MCC
715	Other Male Reproductive System O.R. Procedures for Malignancy with CC/MCC
086	Traumatic Stupor and Coma <1 Hour with CC
054	Nervous System Neoplasms with MCC
306	Cardiac Congenital and Valvular Disorders with MCC
439	Disorders of Pancreas Except Malignancy with CC
390	Gastrointestinal Obstruction without CC/MCC
534	Fractures of Femur without MCC
312	Syncope and Collapse
180	Respiratory Neoplasms with MCC
905	Skin Grafts for Injuries without CC/MCC
073	Cranial and Peripheral Nerve Disorders with MCC
935	Non-Extensive Burns
812	Red Blood Cell Disorders without MCC
074	Cranial and Peripheral Nerve Disorders without MCC
814	Reticuloendothelial and Immunity Disorders with MCC
711	Testes Procedures with CC/MCC
834	Acute Leukemia with MCC
809	Major Hematological and Immunological Diagnoses Except Sickle Cell Crisis and Coagulation Disorders with CC
595	Major Skin Disorders with MCC
617	"Amputation of Lower Limb for Endocrine, Nutritional and Metabolic Disorders with CC"
191	Chronic Obstructive Pulmonary Disease with CC
533	Fractures of Femur with MCC
065	Intracranial Hemorrhage or Cerebral Infarction with CC or tPA in 24 Hours
Quintile 4	
842	Lymphoma and Non-Acute Leukemia without CC/MCC
098	Non-Bacterial Infection of Nervous System Except Viral Meningitis with CC
594	Skin Ulcers without CC/MCC
152	Otitis Media and URI with MCC
545	Connective Tissue Disorders with MCC
758	"Infections, Female Reproductive System with CC"
695	Kidney and Urinary Tract Signs and Symptoms with MCC
598	Malignant Breast Disorders with CC
032	Ventricular Shunt Procedures with CC
684	Renal Failure without CC/MCC
302	Atherosclerosis with MCC
902	Wound Debridements for Injuries with CC
554	Bone Diseases and Arthropathies without MCC
964	Other Multiple Significant Trauma with CC
380	Complicated Peptic Ulcer with MCC
374	Digestive Malignancy with MCC
492	"Lower Extremity and Humerus Procedures Except Hip, Foot and Femur with MCC"
840	Lymphoma and Non-Acute Leukemia with MCC
370	Major Esophageal Disorders without CC/MCC
754	"Malignancy, Female Reproductive System with MCC"
055	Nervous System Neoplasms without MCC
501	Soft Tissue Procedures with CC
808	Major Hematological and Immunological Diagnoses Except Sickle Cell Crisis and Coagulation Disorders with MCC
576	Skin Graft Except for Skin Ulcer or Cellulitis with MCC
286	"Circulatory Disorders Except AMI, with Cardiac Catheterization with MCC"
278	Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures with MCC
616	"Amputation of Lower Limb for Endocrine, Nutritional and Metabolic Disorders with MCC"
918	Poisoning and Toxic Effects of Drugs without MCC
565	Other Musculoskeletal System and Connective Tissue Diagnoses with CC
717	Other Male Reproductive System O.R. Procedures Except Malignancy with CC/MCC
813	Coagulation Disorders
093	Other Disorders of Nervous System without CC/MCC
357	Other Digestive System O.R. Procedures with CC
085	Traumatic Stupor and Coma <1 Hour with MCC
103	Headaches without MCC
604	"Trauma to the Skin, Subcutaneous Tissue and Breast with MCC"
843	Other Myeloproliferative Disorders or Poorly Differentiated Neoplastic Diagnoses with MCC
347	Anal and Stomal Procedures with MCC
405	"Pancreas, Liver and Shunt Procedures with MCC"
270	Other Major Cardiovascular Procedures with MCC
495	Local Excision and Removal of Internal Fixation Devices Except Hip and Femur with MCC
283	"Acute Myocardial Infarction, Expired with MCC"
504	Foot Procedures with CC
423	Other Hepatobiliary or Pancreas O.R. Procedures with MCC
541	Osteomyelitis without CC/MCC
202	Bronchitis and Asthma with CC/MCC
854	Infectious and Parasitic Diseases with O.R. Procedures with CC
154	"Other Ear, Nose, Mouth and Throat Diagnoses with MCC"
Quintile 5	
158	Dental and Oral Diseases with CC
865	Viral Illness with MCC
031	Ventricular Shunt Procedures with MCC
143	"Other Ear, Nose, Mouth and Throat O.R. Procedures with MCC"
408	Biliary Tract Procedures Except Only Cholecystectomy with or without C.D.E. with MCC
440	Disorders of Pancreas Except Malignancy without CC/MCC
503	Foot Procedures with MCC
908	Other O.R. Procedures for Injuries with CC
904	Skin Grafts for Injuries with CC/MCC
823	Lymphoma and Non-Acute Leukemia with Other Procedures with MCC
574	Skin Graft for Skin Ulcer or Cellulitis with CC
498	Local Excision and Removal of Internal Fixation Devices of Hip and Femur with CC/MCC
686	Kidney and Urinary Tract Neoplasms with MCC
674	Other Kidney and Urinary Tract Procedures with CC
519	Back and Neck Procedures Except Spinal Fusion with CC
749	Other Female Reproductive System O.R. Procedures with CC/MCC
653	Major Bladder Procedures with MCC
385	Inflammatory Bowel Disease with MCC
857	Postoperative or Post-Traumatic Infections with O.R. Procedures with CC
239	Amputation for Circulatory System Disorders Except Upper Limb and Toe with MCC
326	"Stomach, Esophageal and Duodenal Procedures with MCC"
324	Coronary Intravascular Lithotripsy with Intraluminal Device without MCC
344	Minor Small and Large Bowel Procedures with MCC
629	"Other Endocrine, Nutritional and Metabolic O.R. Procedures with CC"
709	Penis Procedures with CC/MCC
659	Kidney and Ureter Procedures for Non-Neoplasm with MCC
456	"Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, Infection or Extensive Fusions with MCC"
404	Hip or Knee Procedures with Principal Diagnosis of Periprosthetic Joint Infection without MCC
329	Major Small and Large Bowel Procedures with MCC
474	Amputation for Musculoskeletal System and Connective Tissue Disorders with MCC
164	Major Chest Procedures with CC
850	Acute Leukemia with Other Procedures
255	Upper Limb and Toe Amputation for Circulatory System Disorders with MCC
157	Dental and Oral Diseases with MCC
353	Hernia Procedures Except Inguinal and Femoral with MCC
386	Inflammatory Bowel Disease with CC
477	Biopsies of Musculoskeletal System and Connective Tissue with MCC
628	"Other Endocrine, Nutritional and Metabolic O.R. Procedures with MCC"
802	Other O.R. Procedures of the Blood and Blood Forming Organs with MCC
722	"Malignancy, Male Reproductive System with MCC"
988	Non-Extensive O.R. Procedures Unrelated to Principal Diagnosis with CC
252	Other Vascular Procedures with MCC
293	Heart Failure and Shock without CC/MCC
969	HIV with Extensive O.R. Procedures with MCC
067	Precerebral Occlusion without Infarction with MCC
466	Revision of Hip or Knee Replacement with MCC
693	Urinary Stones with MCC
