Summary & Overview

Other Vascular Procedures with MCC: Inpatient Reimbursement Overview

DRG 252 includes other vascular procedures complicated by a Major Complication or Comorbidity and represents admissions with higher clinical severity requiring more resources. Understanding this Diagnosis-Related Group is important for inpatient reimbursement because the Major Complication or Comorbidity designation increases payment to account for greater expected costs of care.

Other Vascular Procedures with MCCDRG Other Vascular Procedures with MCCDRG 252Diagnosis-Related GroupInpatient ReimbursementMedicareVascular SurgeryEndovascular ProceduresPeripheral Arterial Disease

DRG 252 Overview

DRG 252 covers admissions involving other vascular procedures when a Major Complication or Comorbidity is present, typically including complex endovascular or open repairs of peripheral, visceral, or non-aortic arterial disease with significant clinical severity. This Diagnosis-Related Group captures higher resource use due to intensive perioperative management, longer lengths of stay, and advanced imaging or device utilization. It matters for Medicare payment because the presence of a Major Complication or Comorbidity shifts reimbursement to reflect increased expected costs for inpatient care. Accurate clinical documentation and coding determine assignment to this Diagnosis-Related Group and the associated payment weight.

National Payment Rates

Across payers, negotiated rates for DRG 252 range broadly from about $370 up to $120K, with payer medians spanning roughly $32K to $58K as shown in the table and chart below. The widest spread is between the minimum and maximum observed across payers (about $370 to $120K). Refer to the table and chart below for payer-specific quartiles and medians.

Mean Rates by Payer — National — DRG 252

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

Across payers in Alaska for DRG 252, observed mean rates range from $54K up to $84K, with BCBS (Blue Cross Blue Shield) clustered at $54K and Anthem standing out at $84K. This produces a notable deviation from national averages where means are more distributed across payers; the higher Anthem mean is the most prominent divergence. Reference the table and chart below for payer-level detail.

Key Insights for Alaska

Anthem is the highest-paying payer in Alaska at a mean of $84K, while BCBS (Blue Cross Blue Shield) and Anthem (Anthem) show distinct clustering with BCBS at $54K as the lowest mean.
Alaska’s payer range is narrow for BCBS and ANTHEM-equivalent entries at $54K but Anthem’s $84K mean represents a meaningful premium above the $54K cluster, diverging from national means where payer means are more varied and generally lower for some payers.

Clinical Trials

Trials evaluating acute endovascular versus open surgical approaches for complex peripheral or visceral arterial lesions: randomized or prospective cohort studies compare immediate procedural success, limb or organ salvage, perioperative morbidity, and in-hospital resource utilization among patients presenting with critical limb ischemia, ruptured or symptomatic visceral aneurysms, or acute arterial thrombosis. These studies focus on the inpatient procedural episode and short-term complications in a high-acuity population typical of DRG 252, informing clinicians about optimal intervention strategies and providing payers data on differences in length of stay, intensive care needs, and complication-driven costs.
Comparative effectiveness studies of perioperative optimization and complication prevention protocols in high-risk vascular surgery inpatients: pragmatic studies assess bundles such as standardized anticoagulation/antiplatelet management, infection prevention, and enhanced hemodynamic monitoring among older patients with multiple comorbidities undergoing other vascular procedures. By targeting reductions in major complications categorized as MCCs (for example major bleeding, sepsis, or renal failure), this research addresses key drivers of higher reimbursement and resource consumption for providers and helps payers evaluate value-based care pathways that reduce costly readmissions and extended stays.
Post-discharge outcomes and long-term functional recovery cohorts examining readmission, limb/organ function, and quality of life after other vascular procedures with major complications: observational studies follow patients discharged after complex inpatient vascular procedures to measure late prosthesis patency, wound healing, rates of secondary interventions, and patient-reported outcomes over months to years. This area is relevant because it links inpatient management decisions and complication profiles to downstream utilization (rehospitalizations, reoperation) and long-term costs, offering evidence for post-acute care planning, durable device selection, and bundled-payment models.

Average Total Payment	Average Submitted Charges	Average Medicare Payment	Total Discharges
$32K	$160K	$28K	20K

Trials evaluating acute endovascular versus open surgical approaches for complex peripheral or visceral arterial lesions: randomized or prospective cohort studies compare immediate procedural success, limb or organ salvage, perioperative morbidity, and in-hospital resource utilization among patients presenting with critical limb ischemia, ruptured or symptomatic visceral aneurysms, or acute arterial thrombosis. These studies focus on the inpatient procedural episode and short-term complications in a high-acuity population typical of DRG 252, informing clinicians about optimal intervention strategies and providing payers data on differences in length of stay, intensive care needs, and complication-driven costs.
Comparative effectiveness studies of perioperative optimization and complication prevention protocols in high-risk vascular surgery inpatients: pragmatic studies assess bundles such as standardized anticoagulation/antiplatelet management, infection prevention, and enhanced hemodynamic monitoring among older patients with multiple comorbidities undergoing other vascular procedures. By targeting reductions in major complications categorized as MCCs (for example major bleeding, sepsis, or renal failure), this research addresses key drivers of higher reimbursement and resource consumption for providers and helps payers evaluate value-based care pathways that reduce costly readmissions and extended stays.
Post-discharge outcomes and long-term functional recovery cohorts examining readmission, limb/organ function, and quality of life after other vascular procedures with major complications: observational studies follow patients discharged after complex inpatient vascular procedures to measure late prosthesis patency, wound healing, rates of secondary interventions, and patient-reported outcomes over months to years. This area is relevant because it links inpatient management decisions and complication profiles to downstream utilization (rehospitalizations, reoperation) and long-term costs, offering evidence for post-acute care planning, durable device selection, and bundled-payment models.

OpenPayer

Summary & Overview

Other Vascular Procedures with MCC: Inpatient Reimbursement Overview

DRG 252 Overview

National Payment Rates

State Payment Rates

Alaska Benchmarks

Key Insights for Alaska

Clinical Trials

Related Codes

Patient Population

State Payment Rates

Alaska Benchmarks

Key Insights for Alaska

Clinical Trials

Related Codes