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.

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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.

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Other Vascular Procedures with MCC: Inpatient Reimbursement Overview

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Get alerted when payer policies referencing 252 are released or updated.

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DRG 252 Overview

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.

The CMS 2023 data shown are national Medicare fee-for-service inpatient payments reported under the CMS Provider Utilization and Payment Data program. The table below presents average total payment, average submitted covered charges, average Medicare payment amount, and total discharges for DRG 252. Values reflect the national Medicare experience for the period reported.

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

Patient Population

The patient population for DRG 252 tends to skew toward Medicare-age patients, with a substantial portion of discharges captured in Medicare fee-for-service data, while private/commercial payers cover a mix of working-age adults. Overall, the cohort is more heavily represented in the Medicare population than exclusively working-age commercial enrollees. This produces a mixed but Medicare-tilted payer mix in most datasets.

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.

Related Codes

209-COMPLEX-AORTIC-ARCH-PROCEDURES

Complex Aortic Arch Procedures: Inpatient Reimbursement Overview

212-CONCOMITANT-AORTIC-AND-MITRAL-VALVE-PROCEDURES

Concomitant Aortic and Mitral Valve Procedures: Inpatient Reimbursement Overview

213-ENDOVASCULAR-ABDOMINAL-AORTA-WITH-ILIAC-BRANCH-PROCEDURES

Endovascular Abdominal Aorta with Iliac Branch Procedures: Inpatient Reimbursement Overview

215-OTHER-HEART-ASSIST-SYSTEM-IMPLANT

Other Heart Assist System Implant: Inpatient Reimbursement Overview

216-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITH-CARDIAC-CATHETERIZATION-WITH-MCC

Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with MCC: Inpatient Reimbursement Overview

217-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITH-CARDIAC-CATHETERIZATION-WITH-CC

Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with CC: Inpatient Reimbursement Overview

218-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITH-CARDIAC-CATHETERIZATION-WITHOUT-CC-MCC

Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization without CC/MCC: Inpatient Reimbursement Overview

219-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITHOUT-CARDIAC-CATHETERIZATION-WITH-MCC

Cardiac Valve and Other Major Cardiothoracic Procedures with MCC: Inpatient Reimbursement Overview

220-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITHOUT-CARDIAC-CATHETERIZATION-WITH-CC

Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization with CC: Inpatient Reimbursement Overview

221-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITHOUT-CARDIAC-CATHETERIZATION-WITHOUT-CC-MCC

Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization without CC/MCC: Inpatient Reimbursement Overview

Showing 1–10 of 100

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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National Payment Rates

Mean Rates by Payer — National — DRG 252

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

Patient Population

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

Mean Rates by Payer — Alaska — DRG 252

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.

Related Codes

209-COMPLEX-AORTIC-ARCH-PROCEDURES

Complex Aortic Arch Procedures: Inpatient Reimbursement Overview

212-CONCOMITANT-AORTIC-AND-MITRAL-VALVE-PROCEDURES

Concomitant Aortic and Mitral Valve Procedures: Inpatient Reimbursement Overview

213-ENDOVASCULAR-ABDOMINAL-AORTA-WITH-ILIAC-BRANCH-PROCEDURES

Endovascular Abdominal Aorta with Iliac Branch Procedures: Inpatient Reimbursement Overview

215-OTHER-HEART-ASSIST-SYSTEM-IMPLANT

Other Heart Assist System Implant: Inpatient Reimbursement Overview

216-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITH-CARDIAC-CATHETERIZATION-WITH-MCC

Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with MCC: Inpatient Reimbursement Overview

217-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITH-CARDIAC-CATHETERIZATION-WITH-CC

Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with CC: Inpatient Reimbursement Overview

218-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITH-CARDIAC-CATHETERIZATION-WITHOUT-CC-MCC

Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization without CC/MCC: Inpatient Reimbursement Overview

219-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITHOUT-CARDIAC-CATHETERIZATION-WITH-MCC

Cardiac Valve and Other Major Cardiothoracic Procedures with MCC: Inpatient Reimbursement Overview

220-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITHOUT-CARDIAC-CATHETERIZATION-WITH-CC

Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization with CC: Inpatient Reimbursement Overview

221-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITHOUT-CARDIAC-CATHETERIZATION-WITHOUT-CC-MCC

Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization without CC/MCC: Inpatient Reimbursement Overview

Showing 1–10 of 100

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.