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