FY2026 · MS-DRG v43.1 · live engine

Definitive grouping.
Payment to the cent.

The grouping and pricing engine behind this site runs every FY2026 formula — operating, capital, IME, DSH, uncompensated care, outliers — with each hospital's real factors, and proves itself against the official Medicare pricer live.

Open the calculator Developer API docs
Verified vs the official pricer — to the cent FHIR R4 · vendor · Epic Tapestry claim shapes 10 grouper manuals · FY2022–FY2026
System workflows
ENGINE ONLINE · FY2026
drg_engine · msdrg_v43.1 · fy2026
LIVE VALUES
Active diagnosis arrayCASE-7731
A41.9PDX
Sepsis, unspecified organism
J98.11CC
Atelectasis
J96.01NOT CODED
Acute respiratory failure with hypoxia — documented, not coded
Grouped & priced — real FY2026 output
MS-DRG 872
Septicemia or Severe Sepsis without MV >96 Hours without MCC
FY2026 relative weight
1.0233
Geometric mean LOS
3.4 days
Total Medicare payment
Houston Methodist Hospital · CCN 450358
$9,602.32
Documentation scan — H&P
Patient is a 68-year-old male presenting to the ED with fever, chills, and productive cough. Vitals show T 102.4, HR 115, BP 90/60. Labs indicate elevated WBC and lactate. Patient is currently experiencing acute hypoxemic respiratory failuredocumented — not on the claim requiring supplemental oxygen and escalation of respiratory support. Initiating broad-spectrum IV antibiotics for presumed sepsis. Chest imaging shows basilar atelectasis.
!

Undercoding risk — documentation gap

Clinical evidence supports J96.01 (MCC) — in the note, absent from the claim. $7,478.98 at risk in revenue leakage.

Documentation impact
As coded
MS-DRG 872
$9,602.32
Fully documented
MS-DRG 872
$9,602.32
Revenue leakage
not yet coded

Surfaces conditions already documented by the physician. Documentation completeness — never severity inflation.

POST/api/v1/drg/group
200 OK
// FHIR R4 Claim in — format auto-detected (native / vendor / Tapestry too)
{
  "resourceType": "Claim",
  "provider": { "identifier": { "value": "450358" } },
  "diagnosis": [
    { "sequence": 1, "code": "A41.9" },
    { "sequence": 2, "code": "J98.11" },
    { "sequence": 3, "code": "J96.01" }
  ]
}

// grouped + priced in one pass (trimmed)
{
  "grouper": {
    "drg": "871", "severity": "MCC", "severityDriver": "J9601",
    "grouperVersion": "v43.1", "path": "medical"
  },
  "drgTitle": "Septicemia or Severe Sepsis w/o MV >96 Hours with MCC",
  "payment": { "grandTotal": 17081.30 }
}