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    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Circulatory SystemDRG 299-peripheral-vascular-disorders-with-mcc
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    Peripheral Vascular Disorders with MCC: Inpatient Reimbursement Overview

    DRG 299 encompasses peripheral vascular disorders with a Major Complication or Comorbidity and represents more complex vascular admissions. This Diagnosis-Related Group matters for inpatient reimbursement because the Major Complication or Comorbidity designation increases payments to account for higher resource utilization and clinical intensity.

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    DRG 299 Overview

    DRG 299 covers inpatient admissions for peripheral vascular disorders with a Major Complication or Comorbidity present. Typical cases include severe peripheral arterial disease, critical limb ischemia, or complex vascular infections requiring intensive medical management and often interventional or surgical procedures. This Diagnosis-Related Group is associated with higher resource use due to complexity, longer lengths of stay, and increased need for specialized nursing and vascular surgery services. It matters for Medicare payment because the presence of a Major Complication or Comorbidity adjusts reimbursement upward to reflect the greater intensity of care.

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    Clinical Trials

    • Acute revascularization and limb salvage trials: randomized or pragmatic studies evaluating endovascular versus open surgical revascularization strategies in patients hospitalized with critical limb ischemia or acute limb-threatening ischemia and major comorbidities (eg, advanced diabetes, chronic kidney disease, heart failure). These trials focus on in-hospital technical success, need for repeat procedures, perioperative complications, and short-term limb salvage to inform best acute management for high-risk patients. Results are directly relevant to hospital clinicians and payers because choice of initial intervention drives length of stay, resource use (operating room vs cath lab), complication rates that affect post-acute care needs, and readmission risk for this DRG.
    • Comparative effectiveness studies of medical optimization and wound care pathways: observational cohorts or randomized pragmatic trials comparing comprehensive inpatient bundles (eg, intensive glycemic control, infection management, targeted antibiotic stewardship, standardized wound debridement and offloading protocols) versus usual care for patients admitted with peripheral vascular disorders complicated by ischemic ulcers or infected wounds. These studies enroll medically complex inpatients who frequently have multiple MCCs and assess outcomes such as wound healing, amputation rates, hospital length of stay, and 30–90 day readmissions. Findings help clinicians and payers identify which combinations of inpatient medical management and multidisciplinary coordination most efficiently reduce costly complications and downstream utilization in this DRG.
    • Post-discharge outcomes and care-transition research: prospective cohort studies and interventions testing transitional care models, home health intensity, or remote monitoring after hospital discharge for patients with peripheral vascular disease and major comorbidities, assessing rates of rehospitalization, limb loss, functional status, and patient-reported outcomes over 90 days to one year. These studies target the high-risk post-acute period when recurrent ischemia, infection, or wound deterioration commonly drive readmissions and additional procedures. Evidence from this research guides payers and health systems on effective discharge planning, allocation of post-acute resources, and performance metrics tied to reimbursement for this DRG.

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    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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