CMS corrects FY 2027 IPPS final rule (CMS-1849-CN3); Table 5 weights and rates for Oct 1

On September 29, 2026, the Centers for Medicare & Medicaid Services published a Federal Register final-rule correction for the FY 2027 IPPS and LTCH PPS final rule. The correcting document is CMS-1849-CN3 / CMS-0062-CN (FR Doc. 2026-19946, 91 FR 61328-61343). It fixes technical and typographical errors in FR Doc. 2026-15833 of August 4, 2026, and is effective October 1, 2026.

For inpatient coding and billing desks loading October rates, the payment-file delta is the part to flag today: CMS recalculated Table 5 MS-DRG relative weights and the national standardized amounts after correcting hospital data used in ratesetting.

What CMS says went wrong in ratesetting

In the correction notice, CMS states that under the methodologies finalized in the FY 2027 IPPS/LTCH PPS final rule, Rural Emergency Hospitals (REHs) are excluded from certain IPPS ratesetting calculations, including MS-DRG relative weights and the wage index.

CMS then says it inadvertently treated a current IPPS hospital (CCN 250078) as a hospital that had converted to REH status, excluding that hospital's data from the MS-DRG relative-weight calculation and the wage index. CMS restored the applicable data for that hospital.

Separately, CMS says it inadvertently treated urban hospital CCN 360068 as rural under 42 CFR 412.103 after the hospital timely canceled its rural reclassification request, which wrongly included that hospital's data in the Ohio rural wage index and rural floor. Effective for FY 2027, CMS says CCN 360068 is no longer reclassified as rural under § 412.103.

After those fixes, CMS recalculated MS-DRG relative weights, all wage indexes and geographic adjustment factors, budget neutrality factors, the fixed-loss cost threshold, national operating standardized amounts, and the capital Federal rate. CMS also updated Factor 3 uncompensated-care amounts for DSH-eligible hospitals and made conforming LTCH PPS wage-index and standard Federal payment rate corrections.

Corrected tables desks should pull before October 1

CMS says the tables available on the internet on the CMS website have been updated to reflect the revisions in the correcting document. The FY 2027 IPPS Final Rule Home Page labels the updated files as Final Rule and Correction Notice, including:

Printed rate examples in the correcting document include:

• FY 2027 outlier fixed-loss cost threshold corrected to $49,331 (from $49,346 in the preamble discussion being corrected)
• Capital Federal rate corrected to $539.95
• LTCH PPS standard Federal payment rate (full update) corrected to $52,126.94

Do not invent MS-DRG-by-MS-DRG weight deltas from this article. Pull the corrected Table 5 zip from CMS.

Coding typographical fixes in the same notice

The correcting document also fixes code references in the final-rule preamble:

• Adult-onset Still's disease: ICD-10-CM M06.1 (the proposed-rule / final-rule table text that listed M06.10 is corrected)
• Infuse Bone Graft New Technology: CMS corrects the preamble to list unique ICD-10-PCS codes XW0U0CC, XW0U3CC, and XW0U4CC (open, percutaneous, and percutaneous endoscopic approaches) for recombinant human bone morphogenetic protein-2 with collagen scaffold into joints, new technology group 12
• ICD-10-PCS inventory counts referenced for FY 2027: new procedure codes corrected to 103 and total procedure codes to 79,258

Those are typographical / inventory corrections in the Federal Register text. They are not a new coverage policy and they are not a substitute for the Grouper / ICD files your MAC and encoder already load for October 1.

Dates that matter for the desk

Desk impact for October IPPS staging

• Replace any local copies of FY 2027 Table 5 and Tables 1A-1E that predate the correction-notice files on the CMS final-rule home page.
• Re-check MS-DRG relative-weight and standardized-amount loads for discharges on or after October 1, 2026, against the Final Rule and Correction Notice zips, not only the August final-rule display set.
• Keep wage-index / DSH Factor 3 / LTCH rate updates on the revenue-cycle side in sync with the same correction-notice files.
• Keep Adult-onset Still's disease as M06.1 on any local tip sheet that still shows M06.10 from the uncorrected final-rule table text.
• Keep this page as the CN3 correction / recalculated Table 5 and rates delta. Broader FY 2027 IPPS table, housing Z-code, post-acute transfer, replaced-device, and MS-DRG V44 errata coverage already live elsewhere.

What this is not

• Not a rewrite of the live FY 2027 IPPS final rule tables before October 1 (Table 6A-6K) overview.
• Not a rewrite of the live FY 2027 IPPS post-acute transfer MS-DRG adds (CR 14592 / R13930CP).
• Not a rewrite of the live FY 2027 IPPS housing Z-codes CC-to-nonCC story.
• Not a rewrite of the live FY 2027 IPPS replaced-device MS-DRGs story.
• Not a rewrite of the live FY 2027 MS-DRG V44 errata PCS codes story.
• Not a claim that CMS changed IPPS payment methodologies or MS-DRG classification policy in this notice. CMS states the document corrects technical and typographical errors and does not make substantive policy changes.
• Not an NCCI PTP or MUE file. NCCI quarterly items remain on a separate desk track (HOLD).

Look up related diagnosis and procedure descriptors in the encoder after you confirm the corrected Table 5 and ICD files. Browse companion CMS Watch items on /news.