Cardiac Arrhythmia and Conduction Disorders with CC: Inpatient Reimbursement Overview

DRG 309 addresses inpatient admissions for cardiac arrhythmia and conduction disorders when a Complication or Comorbidity is present, encompassing symptomatic rhythm disturbances and conduction system disease requiring inpatient care. This Diagnosis-Related Group matters for inpatient reimbursement because the Complication or Comorbidity designation increases relative payment to account for higher resource utilization and clinical complexity during the hospital stay.

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DRG 309 Overview

DRG 309 covers hospital stays for patients treated for cardiac arrhythmia and conduction disorders when a Complication or Comorbidity is present. Typical cases include symptomatic atrial or ventricular arrhythmias, conduction blocks, and related procedures or monitoring required during the admission. This Diagnosis-Related Group matters for Medicare payment because the presence of a Complication or Comorbidity elevates reimbursement relative to non-Complication or Comorbidity cohorts, reflecting increased resource use and clinical complexity. Accurate clinical documentation and coding of the arrhythmia and any associated Complication or Comorbidity directly influence payment assignment and hospital case mix.

National Payment Rates

Across payers, negotiated rates for this DRG range from about $7K (10th percentile for Aetna) up to $28K (maximum reported for Anthem), with mean payer benchmarks clustered between $7.5K and $12K. The widest spread between reported payer maxima and minima appears with Anthem (min $390 to max $28K). See the table and chart below for full percentile and payer details.

The CMS 2023 data represent national Medicare fee-for-service inpatient payments reported under the CMS Provider Utilization and Payment Data program. The table below shows average total payment ($7.0k), average submitted covered charges ($34.1k), average Medicare payment amount ($5.1k), and total discharges (65.2k).

Average Total Payment	Average Submitted Charges	Average Medicare Payment	Total Discharges
$7K	$34K	$5.1K	65K

Patient Population

This DRG’s patient mix tends to skew toward Medicare-age beneficiaries, reflecting a higher share of older adults relative to working-age commercial populations. Commercial payers (Aetna, Anthem, BCBS, Cigna) still cover a portion of cases, so the overall population is mixed but leans Medicare-age. Age distribution is therefore concentrated in the Medicare demographic rather than predominantly working-age.

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

Alaska’s DRG 309 mean rates span from 11K to 18K across payers, reflecting a relatively narrow state range. Cigna sits at the high end (mean 18K) while Anthem and Blue Cross Blue Shield are clustered at the low end (mean 11K). This concentration contrasts with broader national dispersion where medians and means vary more widely. See the table and chart below for payer-level detail.

Key Insights for Alaska

Cigna is the highest paying payer in Alaska with a mean of 18K, while both Anthem and Blue Cross Blue Shield are the lowest at 11K.
The Alaska payer range (11K–18K) is compressed relative to national variability, with Cigna notably above the local cluster and exceeding typical national medians for some payers.

Clinical Trials

Trials of acute rhythm-control and stabilization strategies in hospitalized patients presenting with symptomatic arrhythmias or conduction block: these studies evaluate short-term interventions such as intravenous antiarrhythmic protocols, emergency external or temporary pacing algorithms, and protocolized electrolyte/catecholamine management in adults admitted for atrial fibrillation with rapid ventricular response, ventricular tachycardia, or high-grade AV block. The patient population is the inpatient cohort with hemodynamic compromise or significant symptoms requiring urgent management; outcomes include time to rhythm control, need for escalation to device therapy, in-hospital complications, and length of stay. This research is relevant to providers and payers because it targets interventions that can reduce immediate morbidity, prevent ICU transfer, and shorten hospitalization—key drivers of inpatient costs and DRG resource use.
Comparative effectiveness studies of invasive versus conservative management pathways for conduction disorders and recurrent arrhythmias in patients with comorbid cardiac disease: these investigations compare strategies such as expedited permanent pacemaker/ICD implantation versus extended medical optimization and outpatient follow-up for patients who have arrhythmia-related admissions with concurrent heart failure or ischemic heart disease. The population typically includes older adults with multiple comorbidities where the decision between procedural intervention during the index admission versus staged or noninvasive approaches is uncertain; endpoints measure readmission rates, procedure-related complications, functional status, and total 30–90 day costs. Payers and hospital decision-makers value this evidence because it informs resource-intensive choices that affect procedure utilization, readmissions, and bundled payment performance for DRG 309 patients.
Post-discharge outcomes and transitional care trials focused on secondary prevention, anticoagulation management, and remote monitoring: these studies evaluate structured discharge pathways, anticoagulation initiation and monitoring protocols for atrial arrhythmias, and use of ambulatory rhythm monitoring or telehealth follow-up to detect recurrence and prevent readmission in patients discharged after an arrhythmia or conduction disorder admission. The target population is patients recently discharged from the hospital with new or recurrent atrial fibrillation, flutter, or conduction device implantation, assessing outcomes such as 30- and 90-day readmission, stroke prevention metrics, adherence, and patient-reported quality of life. This area is important to providers and payers because effective transitional care can reduce preventable readmissions, improve guideline-concordant secondary prevention, and lower downstream costs associated with thromboembolic events and recurrent hospital care.

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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National Payment Rates

Mean Rates by Payer — National — DRG 309

Average Total Payment	Average Submitted Charges	Average Medicare Payment	Total Discharges
$7K	$34K	$5.1K	65K

Patient Population

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

Mean Rates by Payer — Alaska — DRG 309

Key Insights for Alaska

Cigna is the highest paying payer in Alaska with a mean of 18K, while both Anthem and Blue Cross Blue Shield are the lowest at 11K.
The Alaska payer range (11K–18K) is compressed relative to national variability, with Cigna notably above the local cluster and exceeding typical national medians for some payers.

Clinical Trials

Trials of acute rhythm-control and stabilization strategies in hospitalized patients presenting with symptomatic arrhythmias or conduction block: these studies evaluate short-term interventions such as intravenous antiarrhythmic protocols, emergency external or temporary pacing algorithms, and protocolized electrolyte/catecholamine management in adults admitted for atrial fibrillation with rapid ventricular response, ventricular tachycardia, or high-grade AV block. The patient population is the inpatient cohort with hemodynamic compromise or significant symptoms requiring urgent management; outcomes include time to rhythm control, need for escalation to device therapy, in-hospital complications, and length of stay. This research is relevant to providers and payers because it targets interventions that can reduce immediate morbidity, prevent ICU transfer, and shorten hospitalization—key drivers of inpatient costs and DRG resource use.
Comparative effectiveness studies of invasive versus conservative management pathways for conduction disorders and recurrent arrhythmias in patients with comorbid cardiac disease: these investigations compare strategies such as expedited permanent pacemaker/ICD implantation versus extended medical optimization and outpatient follow-up for patients who have arrhythmia-related admissions with concurrent heart failure or ischemic heart disease. The population typically includes older adults with multiple comorbidities where the decision between procedural intervention during the index admission versus staged or noninvasive approaches is uncertain; endpoints measure readmission rates, procedure-related complications, functional status, and total 30–90 day costs. Payers and hospital decision-makers value this evidence because it informs resource-intensive choices that affect procedure utilization, readmissions, and bundled payment performance for DRG 309 patients.
Post-discharge outcomes and transitional care trials focused on secondary prevention, anticoagulation management, and remote monitoring: these studies evaluate structured discharge pathways, anticoagulation initiation and monitoring protocols for atrial arrhythmias, and use of ambulatory rhythm monitoring or telehealth follow-up to detect recurrence and prevent readmission in patients discharged after an arrhythmia or conduction disorder admission. The target population is patients recently discharged from the hospital with new or recurrent atrial fibrillation, flutter, or conduction device implantation, assessing outcomes such as 30- and 90-day readmission, stroke prevention metrics, adherence, and patient-reported quality of life. This area is important to providers and payers because effective transitional care can reduce preventable readmissions, improve guideline-concordant secondary prevention, and lower downstream costs associated with thromboembolic events and recurrent hospital care.

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.