FY2027 IPPS adds 3 MS-DRGs to the replaced-device credit list on October 1

CMS updated the list of MS-DRGs that take an IPPS payment cut when a hospital replaces an implanted device at no cost or with a credit equal to 50 percent or more of the replacement-device cost. The instruction is Transmittal 13812 / CR 14519. CMS dated the transmittal June 4, 2026, then re-communicated it on August 7, 2026, once it was no longer sensitive. MM14519 followed on August 10, 2026.

The change is effective October 1, 2026. MACs implement on October 5, 2026. The recurring update applies to the Medicare Claims Processing Manual, Chapter 3, section 100.8.

This is not the FY 2027 IPPS Table 6A–6K file list, and it is not the housing Z-code CC→NonCC change. Those are different FY 2027 IPPS files. CR 14519 is only the replaced-device credit list.

What CMS adds

For FY 2027, CMS adds three MS-DRGs to the list:

CMS says it adds new MS-DRGs to this list when they are formed from procedures that were already assigned to MS-DRGs on the list.

What CMS deletes

MM14519 says CMS is deleting eight MS-DRGs from the list: 258, 259, 260, 261, 262, 466, 467, and 468. The transmittal and the MLN article give those numbers only. They do not publish titles for the deletions.

Do not invent titles for those eight codes. If you need the FY 2027 title, use Table 5 on the FY 2027 IPPS final-rule home page.

The full FY 2027 list

Attachment A of Transmittal 13812 is the full FY 2027 list of MS-DRGs subject to the policy. CMS also posted MAC Implementation File 7 on the FY 2027 IPPS final-rule home page as “FY 2027 MS-DRGs Subject to the Replaced Devices Policy.”

CR 14519 tells the shared system maintainer to update current edits and system processes for replaced devices offered without cost or with a credit, for discharges on or after October 1, 2026.

What this is not

It is not a CMS-HCC or V28 mapping change. The list decides when an IPPS case takes a device-credit payment reduction. It does not change risk-adjustment mapping. Confirm the model year you are actually coding in ICD-10 to HCC.

It is not a new ICD-10-CM or ICD-10-PCS code set. The official FY 2027 ICD-10-CM Coding Guidelines PDF is still marked “not yet available” on the CMS ICD-10 page.

It is also not permission to drop the device from the record. The policy applies when the replacement device is free or the credit is 50 percent or more of its cost, and only for MS-DRGs on this list.

What to do before October 1

1. If your grouper, encoder, or abstracting notes still treat 258–262 or 466–468 as the device-credit MS-DRGs, mark the FY 2027 deletions.

2. Add 210, 211, and 449 to the device-credit edit. Those are the three CMS named.

3. Pull Attachment A or MAC Implementation File 7 and compare it to your current list. Do not rebuild the list from memory.

4. Keep the 50 percent credit threshold. CMS did not change that test in this CR.

Look up a specific ICD-10-CM or ICD-10-PCS code in the encoder when the question is the tabular, not the device-credit flag.