ICD-10 MS-DRGs Version 43.1 Effective April 1, 2026

ICD-10 MS-DRGs Version 43.1

The Centers for Medicare & Medicaid Services (CMS) will introduce 80 new procedure codes to the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS), effective April 1, 2026.

The ICD-10 MS-DRG Grouper continues to assign each inpatient case to an appropriate MS-DRG based on reported diagnosis and procedure codes, along with demographic details such as age, sex, and discharge status.

To support these updates, the ICD-10 Medicare Code Editor (MCE) Version 43.1 will apply enhanced edits to identify and report coding errors, ensuring the accuracy and validity of ICD-10 codes submitted on claims for discharges occurring on or after April 1, 2026.

Additionally, the ICD-10 MS-DRG Grouper software package has been updated to Version 43.1 to accommodate the 80 new procedure codes and will be effective for all applicable discharges on or after April 1, 2026.

ICD-10 MS-DRG V43.1 Software and Code Tables Availability

CMS has announced the availability of the ICD-10 MS-DRG V43.1 Grouper Software, along with the Definitions Manual, Table of Contents, and the Medicare Code Edits Definitions Manual (V43.1). These resources are essential for healthcare providers, medical coders, and billing professionals to ensure accurate inpatient claim processing, compliance, and reimbursement under the Medicare Inpatient Prospective Payment System (IPPS).

In addition, CMS will release the Code Tables, Alphabetic Index, and related addenda files covering 80 newly introduced ICD-10-PCS procedure codes. These updates support precise clinical documentation, correct MS-DRG assignment, and alignment with the latest Medicare coding and billing requirements.

Staying current with these CMS updates is critical for minimizing claim denials, improving coding accuracy, and maintaining regulatory compliance in an evolving reimbursement landscape.

Assignment of the 80 new ICD-10-PCS procedure codes is as follows:

Procedure

Code

 Description O.R. MDC MS-DRG
02HM3JZ** Insertion of pacemaker lead into ventricular septum, N 01 040-042
percutaneous approach 05 260-262
21 907-909
24 957-959
02HM3KZ Insertion of defibrillator lead into ventricular septum, Y 05 265
percutaneous approach 14 768-769
817-819
17 823-825
829-830
850
18 853-855
856-858
19 876
23 939-941
25 969-970
02HM3MZ** Insertion of cardiac lead into ventricular septum,

percutaneous approach

 N 05 260-262
02HM3NZ Insertion of intracardiac pacemaker into ventricular Y 05 228-229
septum, percutaneous approach 14 768-769
817-819
17 823-825
829-830
850
18 853-855
856-858
19 876
23 939-941
25 969-970

 

02HM3YZ Insertion of other device into ventricular septum, Y 05 260-262
percutaneous approach 14 768-769
817-819
17 823-825
829-830
850
18 853-855
856-858
19 876
23 939-941
25 969-970
0DDU0ZZ Extraction of omentum, open approach Y 06 356-358
07 423-425
10 628-630
13 749-750
14 768-769
817-819
17 820-822
826-828
18 853-855
18 856-858
19 876
23 939-941
0DDU4ZZ Extraction of omentum, percutaneous endoscopic Y 06 356-358
approach 07 423-425
10 628-630
13 749-750
14 768-769
817-819
17 820-822
826-828
18 853-855
18 856-858
19 876
23 939-941
0DDV0ZZ Extraction of mesentery, open approach Y 06 356-358
07 423-425
10 628-630
13 749-750
14 768-769
817-819
17 820-822
826-828
18 853-855
18 856-858
19 876
23 939-941

 

0DDV4ZZ Extraction of mesentery, percutaneous endoscopic Y 06 356-358
approach 07 423-425
10 628-630
13 749-750
14 768-769
817-819
17 820-822
826-828
18 853-855
18 856-858
19 876
23 939-941
0F9480D* Drainage of gallbladder with drainage device, via natural

or artificial opening endoscopic, transmural

 N
0F9480E* Drainage of gallbladder with drainage device, via natural

or artificial opening endoscopic, transpapillary

 N
0F9580D* Drainage of right hepatic duct with drainage device, via

natural or artificial opening endoscopic, transmural

 N
0F9580E* Drainage of right hepatic duct with drainage device, via

natural or artificial opening endoscopic, transpapillary

 N
0F9680D* Drainage of left hepatic duct with drainage device, via

natural or artificial opening endoscopic, transmural

 N
0F9680E* Drainage of left hepatic duct with drainage device, via

natural or artificial opening endoscopic, transpapillary

 N
0F9780D* Drainage of common hepatic duct with drainage device,

via natural or artificial opening endoscopic, transmural

 N
0F9780E* Drainage of common hepatic duct with drainage device,

via natural or artificial opening endoscopic, transpapillary

 N
0F9880D* Drainage of cystic duct with drainage device, via natural

or artificial opening endoscopic, transmural

 N
0F9880E* Drainage of cystic duct with drainage device, via natural

or artificial opening endoscopic, transpapillary

 N
0F9980D* Drainage of common bile duct with drainage device, via

natural or artificial opening endoscopic, transmural

 N
0F9980E* Drainage of common bile duct with drainage device, via

natural or artificial opening endoscopic, transpapillary

 N
0F9C80D* Drainage of ampulla of vater with drainage device, via

natural or artificial opening endoscopic, transmural

 N
0F9C80E* Drainage of ampulla of vater with drainage device, via

natural or artificial opening endoscopic, transpapillary

 N
0F9D80D* Drainage of pancreatic duct with drainage device, via

natural or artificial opening endoscopic, transmural

 N
0F9D80E* Drainage of pancreatic duct with drainage device, via

natural or artificial opening endoscopic, transpapillary

 N
0F9F80D* Drainage of accessory pancreatic duct with drainage device, via natural or artificial opening endoscopic,

transmural

 N

 

0F9F80E* Drainage of accessory pancreatic duct with drainage device, via natural or artificial opening endoscopic,

transpapillary

 N
0F9G80D* Drainage of pancreas with drainage device, via natural or

artificial opening endoscopic, transmural

 N
0F9G80E* Drainage of pancreas with drainage device, via natural or

artificial opening endoscopic, transpapillary

 N
0TXB0Z6 Transfer bladder to right ureter, open approach Y 11 656-658
659-661
14 768-769
817-819
17 823-825
829-830
850
18 853-855
856-858
19 876
21 907-909
23 939-941
24 957-959
25 969-970
0TXB0Z7 Transfer bladder to left ureter, open approach Y 11 656-658
659-661
14 768-769
817-819
17 823-825
829-830
850
18 853-855
856-858
19 876
21 907-909
23 939-941
24 957-959
25 969-970
0TXB4Z6 Transfer bladder to right ureter, percutaneous Y 11 656-658
endoscopic approach 659-661
14 768-769
817-819
17 823-825
829-830
850
18 853-855
856-858
19 876
21 907-909
23 939-941

 

24

25

 957-959

969-970
0TXB4Z7 Transfer bladder to left ureter, percutaneous endoscopic Y 11 656-658
approach 659-661
14 768-769
817-819
17 823-825
829-830
850
18 853-855
856-858
19 876
21 907-909
23 939-941
24 957-959
25 969-970
0VT00ZE Resection of prostate, open approach, capsule intact Y 11 665-667
12 707-708
17 823-825
829-830
850
18 853-855
856-858
19 876
23 939-941
25 969-970
0VT04ZE Resection of prostate, percutaneous endoscopic Y 11 665-667
approach, capsule intact 12 707-708
17 823-825
829-830
850
18 853-855
856-858
19 876
23 939-941
0VT07ZE Resection of prostate, via natural or artificial opening, Y 11 665-667
capsule intact 12 713-714
17 823-825
829-830
850
18 853-855
856-858
19 876
23 939-941
0VT08ZE Resection of prostate, via natural or artificial opening Y 11 665-667
endoscopic, capsule intact 12 713-714
17 823-825

 

829-830
850
18 853-855
856-858
19 876
23 939-941
3E033AZ* Introduction of embryonic stem cells into peripheral vein,

percutaneous approach

 N
3E043AZ* Introduction of embryonic stem cells into central vein,

percutaneous approach

 N
4A0FXEJ* Measurement of musculoskeletal body composition using air displacement plethysmography, external

approach

 N
5A0221E Assistance with cardiac output using blood flow Y 05 270-272
modulator, continuous 14 768-769
817-819
17 823-825
829-830
850
18 853-855
856-858
19 876
23 939-941
25 969-970
F07DYD0** Electrotherapeutic treatment of integumentary system –

head and neck using microcurrent stimulation

 N 23 945-946
F07EYD0** Electrotherapeutic treatment of integumentary system –

thorax / abdomen using microcurrent stimulation

 N 23 945-946
F07FYD0** Electrotherapeutic treatment of integumentary system – upper back / upper extremity using microcurrent

stimulation

 N 23 945-946
F07GYD0** Electrotherapeutic treatment of integumentary system –

lower back / lower extremity using microcurrent stimulation

 N 23 945-946
F07HYD0** Electrotherapeutic treatment of integumentary system –

whole body using microcurrent stimulation

 N 23 945-946
F08E5AZ** Wound management treatment of integumentary system

– thorax / abdomen using negative pressure therapy

 N 23 945-946
F08E5BZ** Wound management treatment of integumentary system

– thorax / abdomen using physical agents

 N 23 945-946
F08E5CZ** Wound management treatment of integumentary system

– thorax / abdomen using mechanical equipment

 N 23 945-946
F08E5DZ** Wound management treatment of integumentary system

– thorax / abdomen using electrotherapeutic equipment

 N 23 945-946
F08E5EZ** Wound management treatment of integumentary system

– thorax / abdomen using orthosis

 N 23 945-946

 

F08E5FZ** Wound management treatment of integumentary system

– thorax / abdomen using assistive, adaptive, supportive or protective equipment

 N 23 945-946
F08E5UZ** Wound management treatment of integumentary system

– thorax / abdomen using prosthesis

 N 23 945-946
F08E5YZ** Wound management treatment of integumentary system

– thorax / abdomen using other equipment

 N 23 945-946
F08E5ZZ** Wound management treatment of integumentary system

– thorax / abdomen

 N 23 945-946
F08P5AZ** Wound management treatment of musculoskeletal system – thorax / abdomen using negative pressure

therapy

 N 23 945-946
F08P5BZ** Wound management treatment of musculoskeletal

system – thorax / abdomen using physical agents

 N 23 945-946
F08P5CZ** Wound management treatment of musculoskeletal

system – thorax / abdomen using mechanical equipment

 N 23 945-946
F08P5DZ** Wound management treatment of musculoskeletal system – thorax / abdomen using electrotherapeutic

equipment

 N 23 945-946
F08P5EZ** Wound management treatment of musculoskeletal

system – thorax / abdomen using orthosis

 N 23 945-946
F08P5FZ** Wound management treatment of musculoskeletal system – thorax / abdomen using assistive, adaptive,

supportive or protective equipment

 N 23 945-946
F08P5UZ** Wound management treatment of musculoskeletal

system – thorax / abdomen using prosthesis

 N 23 945-946
F08P5YZ** Wound management treatment of musculoskeletal

system – thorax / abdomen using other equipment

 N 23 945-946
F08P5ZZ** Wound management treatment of musculoskeletal

system – thorax / abdomen

 N 23 945-946
X2723CB Dilation of inferior vena cava and iliocaval confluence Y 01 037-039
with open-structure polymer lattice intraluminal device, 04 166-168
percutaneous approach, new technology group 11 05 252-254
06 356-358
07 423-425
08 515-517
09 579-581
10 628-630
11 673-675
14 768-769
817-819
17 823-825
829-830
850
18 853-855
856-858
19 876

 

21 907-909
23 939-941
24 957-959
25 969-970
X2HM3GB Insertion of lumenless small-diameter defibrillator lead Y 05 265
into ventricular septum, percutaneous approach, new 14 768-769
technology group 11 817-819
17 823-825
829-830
850
18 853-855
856-858
19 876
23 939-941
25 969-970
X2HV3GB Insertion of lumenless small-diameter defibrillator lead Y 05 265
into right ventricle, percutaneous approach, new 14 768-769
technology group 11 817-819
17 823-825
829-830
850
18 853-855
856-858
19 876
23 939-941
25 969-970
X2K00FB Bypass inferior vena cava using autologous cell seeded Y 05 228-229
tissue engineered resorbable scaffold to pulmonary 14 768-769
artery, open approach, new technology group 11 817-819
17 823-825
829-830
850
18 853-855
856-858
19 876
23 939-941
25 969-970
X2KG0FB Bypass hepatic vein using autologous cell seeded tissue Y 05 228-229
engineered resorbable scaffold to pulmonary artery, 14 768-769
open approach, new technology group 11 817-819
17 823-825
829-830
850
18 853-855
856-858
19 876
23 939-941
25 969-970

 

X9HD01B Insertion of temporary infusion device into right inner Y 03 143-145
ear, open approach, new technology group 11 14 768-769
817-819
17 823-825
829-830
850
18 853-855
856-858
19 876
23 939-941
25 969-970
X9HE01B Insertion of temporary infusion device into left inner ear, Y 03 143-145
open approach, new technology group 11 14 768-769
817-819
17 823-825
829-830
850
18 853-855
856-858
19 876
23 939-941
25 969-970
X9HF01B Insertion of temporary infusion device into bilateral inner Y 03 143-145
ear, open approach, new technology group 11 14 768-769
817-819
17 823-825
829-830
850
18 853-855
856-858
19 876
23 939-941
25 969-970
XU7G71B* Dilation of vagina with temporary electromechanical

intraluminal device, via natural or artificial opening, new technology group 11

 N
XW0330B* Introduction of alpha1-proteinase inhibitor into peripheral vein, percutaneous approach, new technology

group 11

 N
XW0331B** Introduction of anitocabtagene autoleucel immunotherapy into peripheral vein, percutaneous

approach, new technology group 11

 N Pre- MDC 018
XW0430B* Introduction of alpha1-proteinase inhibitor into central

vein, percutaneous approach, new technology group 11

 N
XW0431B** Introduction of anitocabtagene autoleucel immunotherapy into central vein, percutaneous

approach, new technology group 11

 N Pre- MDC 018
XW0534B* Introduction of somatic stem cells into peripheral artery,

percutaneous approach, new technology group 11

 N
XW0632B* Introduction of CPI-601 enzyme replacement therapy into cerebral ventricle, percutaneous approach, new

technology group 11

 N
XW0E33B* Introduction of DB-OTO via intracochlear infusion into

ear(s), percutaneous approach, new technology group 11

 N

 

The ICD-10 MS-DRG V43.1 Grouper Software, the Definitions Manual (including the Table of Contents), and the Medicare Code Edits Definitions Manual (V43.1) will be available at:
https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software.html

The Code Tables, Index, and related addenda files for the 80 new procedure codes will be available at:
https://www.cms.gov/medicare/coding-billing/icd-10-codes

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