Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Circulatory SystemDRG 290-acute-and-subacute-endocarditis-without-cc-mcc
    Ask Trek AI about this page

    Acute and Subacute Endocarditis without CC/MCC: Inpatient Reimbursement Overview

    DRG 290 pertains to acute and subacute infective endocarditis cases without a Complication or Comorbidity or Major Complication or Comorbidity, covering inpatient medical and surgical management of heart valve or endocardial infections. Accurate assignment of this Diagnosis-Related Group is important for Medicare inpatient reimbursement because it determines the bundled payment level for stays without higher-severity complications.

    Customize your policy alerts

    Sign up for drg 290 policy alerts

    Get alerted when payer policies referencing 290 are released or updated.

    Monitor payer policy activity

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

    DRG 290 Overview

    DRG 290 covers acute and subacute infective endocarditis cases without a Complication or Comorbidity or Major Complication or Comorbidity, typically involving inpatient medical or surgical management for infection of the heart valves or endocardial surface. This Diagnosis-Related Group matters for Medicare payment because it groups patients with similar clinical resource needs, driving the base payment rate for the inpatient stay. Hospitals receive a bundled reimbursement based on the assigned Diagnosis-Related Group, so accurate clinical coding and documentation determine payment eligibility and grouping. The classification excludes patients with additional coded complications that would move the case to higher-severity Diagnosis-Related Groups.

    Table of contents

    Progress1 / 3

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical Trials

    • Early antimicrobial strategy trials: studies that compare different initial intravenous antibiotic regimens, dosing strategies, or durations in adults hospitalized with acute or subacute bacterial endocarditis who do not have major comorbid complications (no CC/MCC). These trials enroll patients at presentation to evaluate time to bacteremia clearance, need for escalation of care (e.g., transfer to ICU or surgery), and adverse events related to therapy. Results inform inpatient treatment pathways, antibiotic stewardship, length of stay, and expected acute resource use that are critical for clinical teams and hospital payers managing DRG 290 cases.
    • Comparative effectiveness of surgical versus conservative management in non-complicated endocarditis: observational cohort studies or pragmatic trials that examine outcomes for patients without major complications who are managed medically versus those referred for valve repair/replacement during the same admission. These studies focus on 30‑ and 90‑day mortality, readmissions, functional status, and in‑hospital resource utilization, stratified by pathogen, valve involved, and embolic risk. Findings guide decisions about surgical referral thresholds and allocation of inpatient surgical resources, impacting reimbursement, length of stay, and expected post-acute care needs under this DRG.
    • Post-discharge outcomes and care transition studies: prospective studies following patients discharged after treatment for acute/subacute endocarditis without CC/MCC to evaluate readmission rates, adherence to outpatient parenteral antimicrobial therapy (OPAT), complication detection, and coordination with primary care and cardiology. These investigations identify predictors of readmission, monitor adverse events from prolonged outpatient antibiotics, and test models of post-discharge follow-up (e.g., nurse‑led clinics or telehealth). For providers and payers, this research addresses preventable readmissions, continuity of care, and cost drivers after the index hospitalization captured by DRG 290.

    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

    • More pages

    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.
    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.