Other Major Cardiovascular Procedures with MCC: Inpatient Reimbursement Overview

DRG 270 encompasses major non-coronary cardiovascular procedures with a Major Complication or Comorbidity, covering complex valve, thoracic aortic, and other high-acuity intrathoracic cardiac operations. It matters for inpatient reimbursement because assignment to this Diagnosis-Related Group recognizes substantially higher resource needs and results in higher Medicare payments compared with lower-severity groupings.

Customize your policy alerts

Sign up for drg 270 policy alerts

Get alerted when payer policies referencing 270 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

DRG 270 Overview

DRG 270 covers hospital admissions for major cardiovascular procedures other than coronary artery bypass that are accompanied by a Major Complication or Comorbidity, such as complex valve operations, thoracic aorta repairs, or other high-risk intrathoracic cardiac procedures. This Diagnosis-Related Group signals high resource use, extended operative and postoperative care, and greater expected intensity of services. For Medicare payment, classification to DRG 270 typically yields higher inpatient reimbursement to reflect the increased clinical complexity and costs. Accurate coding of procedures and comorbidities directly affects placement in this Diagnosis-Related Group and subsequent payment.

Explore openpayer tools

View all tools

Other Major Cardiovascular Procedures with MCC: Inpatient Reimbursement Overview

Customize your policy alerts

Sign up for drg 270 policy alerts

Get alerted when payer policies referencing 270 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

DRG 270 Overview

National Payment Rates

Across commercial payers the observed rate range for DRG 270 spans roughly from $1.1K (BCBS p25) up to $180K (Anthem max), with the widest payer spread seen between Anthem (max $180K) and BCBS (min $370/$1.1K region), reflecting substantial variability across payers. See the table and chart below for payer-level percentiles and distribution details. Individual payer medians (Anthem $81K, Cigna $80K, Aetna $77K, BCBS $46K) highlight differences in central tendency across commercial plans.

The CMS 2023 data reflect national Medicare fee-for-service inpatient payments reported 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 270. Values summarize payments and volumes at the national level for calendar year 2023.

Average Total Payment	Average Submitted Charges	Average Medicare Payment	Total Discharges
$48K	$240K	$42K	17K

Patient Population

The patient population for DRG 270 skews toward older adults and is largely represented in Medicare-aged cohorts rather than exclusively working-age. While commercial payers cover a subset of cases, the distribution is predominantly Medicare, with a notable but smaller share covered by private or employer-sponsored plans. This reflects a mixed payer mix leaning toward Medicare-age beneficiaries rather than a primarily working-age population.

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

Payer rates in Alaska for DRG 270 range from $82K to $130K across observed payers, with Blue Cross Blue Shield at the low end and Anthem at the high end. The most notable deviation from national averages is Anthem’s mean of $130K, which sits well above typical national means for this DRG. See the table and chart below for payer-specific distributions.

Key Insights for Alaska

Anthem is the highest-paying payer in Alaska at $130K (mean), while BCBS and Blue Cross Blue Shield are the lowest at $82K (mean).
Alaska’s payer range spans from $82K to $130K, with Anthem notably above national means for several payers, indicating higher regional ceilings compared with typical national rates.

Clinical Trials

Acute procedural optimization trials investigating novel intraoperative techniques or adjunctive technologies for complex cardiovascular surgeries (for example, studies assessing strategies to reduce cardiopulmonary bypass time, myocardial protection approaches, or adjunct imaging guidance during reoperative or anatomically challenging procedures). These studies enroll high-acuity inpatients undergoing major non-standard cardiovascular operations included in this DRG, often with significant comorbidity or prior cardiac surgery, and measure perioperative morbidity, organ dysfunction, and short-term mortality. Results are directly relevant to surgeons, intensivists, and hospital finance teams because improved procedural safety and reduced complications can shorten ICU and total length of stay and decrease costly major complication rates that drive higher reimbursement under this DRG.
Comparative effectiveness studies evaluating surgical versus hybrid or less invasive alternatives for complex cardiovascular indications (for example, head-to-head evaluations of open surgical approaches compared with hybrid endovascular-plus-surgical strategies or staged procedures in patients with multilevel disease or redo operations). These trials target heterogeneous inpatient cohorts captured by this DRG who have anatomy or comorbidity profiles that make the optimal approach uncertain; endpoints include complication rates, need for reintervention, functional recovery, and resource utilization. Payers and hospital administrators use this evidence to inform pathway selection, bundle pricing, and case-mix planning because differences in complication patterns and downstream resource use materially affect reimbursement and total cost of care for DRG 270 cases.
Post-discharge outcomes and readmission reduction studies focused on multimorbidity management and transition-of-care interventions after complex cardiovascular procedures (for example, randomized or pragmatic trials of coordinated discharge bundles, intensive early outpatient surveillance, or medication reconciliation and rehabilitation programs in patients with heart failure, renal dysfunction, or frailty who underwent major cardiovascular operations). These studies enroll survivors of inpatient stays classified under this DRG and measure 30- to 90-day readmissions, outpatient resource use, patient-reported outcomes, and downstream costs. Findings are important to clinicians and payers because preventing readmissions and functional decline after high-risk procedures can reduce penalties, lower total episode costs, and improve value for a population that drives substantial inpatient spending under this DRG.

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.

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.

Explore openpayer tools

View all tools

National Payment Rates

Mean Rates by Payer — National — DRG 270

Average Total Payment	Average Submitted Charges	Average Medicare Payment	Total Discharges
$48K	$240K	$42K	17K

Patient Population

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

Mean Rates by Payer — Alaska — DRG 270

Key Insights for Alaska

Anthem is the highest-paying payer in Alaska at $130K (mean), while BCBS and Blue Cross Blue Shield are the lowest at $82K (mean).
Alaska’s payer range spans from $82K to $130K, with Anthem notably above national means for several payers, indicating higher regional ceilings compared with typical national rates.

Clinical Trials

Acute procedural optimization trials investigating novel intraoperative techniques or adjunctive technologies for complex cardiovascular surgeries (for example, studies assessing strategies to reduce cardiopulmonary bypass time, myocardial protection approaches, or adjunct imaging guidance during reoperative or anatomically challenging procedures). These studies enroll high-acuity inpatients undergoing major non-standard cardiovascular operations included in this DRG, often with significant comorbidity or prior cardiac surgery, and measure perioperative morbidity, organ dysfunction, and short-term mortality. Results are directly relevant to surgeons, intensivists, and hospital finance teams because improved procedural safety and reduced complications can shorten ICU and total length of stay and decrease costly major complication rates that drive higher reimbursement under this DRG.
Comparative effectiveness studies evaluating surgical versus hybrid or less invasive alternatives for complex cardiovascular indications (for example, head-to-head evaluations of open surgical approaches compared with hybrid endovascular-plus-surgical strategies or staged procedures in patients with multilevel disease or redo operations). These trials target heterogeneous inpatient cohorts captured by this DRG who have anatomy or comorbidity profiles that make the optimal approach uncertain; endpoints include complication rates, need for reintervention, functional recovery, and resource utilization. Payers and hospital administrators use this evidence to inform pathway selection, bundle pricing, and case-mix planning because differences in complication patterns and downstream resource use materially affect reimbursement and total cost of care for DRG 270 cases.
Post-discharge outcomes and readmission reduction studies focused on multimorbidity management and transition-of-care interventions after complex cardiovascular procedures (for example, randomized or pragmatic trials of coordinated discharge bundles, intensive early outpatient surveillance, or medication reconciliation and rehabilitation programs in patients with heart failure, renal dysfunction, or frailty who underwent major cardiovascular operations). These studies enroll survivors of inpatient stays classified under this DRG and measure 30- to 90-day readmissions, outpatient resource use, patient-reported outcomes, and downstream costs. Findings are important to clinicians and payers because preventing readmissions and functional decline after high-risk procedures can reduce penalties, lower total episode costs, and improve value for a population that drives substantial inpatient spending under this DRG.

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.