Summary & Overview
Coronary Bypass without Cardiac Catheterization without MCC: Inpatient Reimbursement Overview
DRG 236 applies to inpatient admissions for coronary artery bypass grafting without cardiac catheterization and without a Major Complication or Comorbidity; it captures isolated bypass surgical episodes. This Diagnosis-Related Group is important for inpatient reimbursement because it determines the bundled Medicare payment associated with the procedure and documented comorbidity level.
DRG 236 Overview
DRG 236 covers inpatient admissions for coronary artery bypass grafting without concurrent cardiac catheterization and without a Major Complication or Comorbidity. This Diagnosis-Related Group applies to patients undergoing isolated coronary bypass procedures where no major additional diagnoses elevate payment. It matters for Medicare payment because it defines the bundled payment amount for the surgical hospitalization based on procedure and comorbidity profile. Accurate assignment influences hospital reimbursement and resource categorization for cardiac surgical care.
National Payment Rates
Across payers the observed rate range spans roughly from $1.1K to $140K, with mean rates clustering between about $36K and $68K depending on payer. The widest spread is seen between the lowest and highest observed values (about $1.1K to $140K). See the table and chart below for payer-specific distributions for Anthem, Aetna, Cigna, and BCBS.
The CMS 2023 data represent national Medicare fee-for-service inpatient payments published under the CMS Provider Utilization and Payment Data program. The table below shows average total payment, average submitted covered charges, average Medicare payment amount, and total discharges for DRG 236.