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    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Circulatory SystemDRG 288-acute-and-subacute-endocarditis-with-mcc
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    Acute and Subacute Endocarditis with MCC: Inpatient Reimbursement Overview

    DRG 288 addresses acute and subacute infective endocarditis admissions that include a Major Complication or Comorbidity, encompassing severe infection and possible valve surgery or intensive care needs. Proper assignment affects inpatient reimbursement because this Diagnosis-Related Group reflects elevated resource use and complexity under Medicare payment policies.

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    DRG 288 Overview

    DRG 288 covers hospital admissions for acute and subacute infective endocarditis when a Major Complication or Comorbidity is present, typically involving severe systemic infection, heart valve involvement, or embolic phenomena. This Diagnosis-Related Group captures high-acuity medical and procedural resource use, including prolonged intravenous antimicrobial therapy and possible cardiac surgery or intensive care. It matters for Medicare payment because cases assigned to this Diagnosis-Related Group generally generate higher inpatient reimbursement to reflect greater expected resource intensity and complexity. Accurate clinical documentation and coding are essential to ensure correct assignment to this Diagnosis-Related Group.

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    Clinical Trials

    • Studies of early antimicrobial stewardship strategies and rapid diagnostic-guided therapy in hospitalized patients with acute and subacute infective endocarditis focus on whether rapid organism identification and targeted antibiotic regimens can shorten time to effective therapy, reduce use of broad-spectrum agents, and decrease length of stay. These trials enroll adults with suspected or confirmed bacterial endocarditis, often including critically ill patients or those with prosthetic valves, and compare diagnostic workflows and antibiotic adjustment protocols. Results are directly relevant to providers and payers because faster, targeted treatment can lower complications, resource use, and antimicrobial costs while maintaining clinical outcomes.
    • Comparative effectiveness trials evaluating timing and indications for early cardiac surgery versus prolonged medical management examine which patients with endocarditis and complications (for example, heart failure, uncontrolled infection, large vegetations, or embolic risk) benefit most from urgent operative intervention. These studies typically enroll heterogeneous inpatient populations stratified by comorbidity, causative organism, and prosthetic versus native valve involvement, and assess outcomes such as mortality, reoperation, recurrent infection, and hospital resource utilization. Findings inform clinical pathways, triage decisions, and reimbursement strategies by clarifying when high-cost surgical care yields better outcomes versus conservative treatment.
    • Post-discharge cohort studies and randomized interventions testing transitional care models, structured outpatient parenteral antibiotic therapy (OPAT) programs, and readmission-reduction strategies target survivors of acute endocarditis to evaluate long-term functional outcomes, recurrent bacteremia, and healthcare utilization. These studies include patients discharged after inpatient treatment for endocarditis, often emphasizing those with comorbidities (eg, renal disease, diabetes) or social needs that impact adherence to prolonged therapy and follow-up. For providers and payers, evidence from these trials helps optimize discharge planning, reduces preventable readmissions and downstream costs, and identifies which post-acute services improve durable recovery.

    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

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    References

    1. 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. 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. 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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