Percutaneous Cardiovascular Procedures with Intraluminal Device without MCC: Inpatient Reimbursement Overview

DRG 322 encompasses percutaneous cardiovascular procedures with intraluminal device placement performed without a Major Complication or Comorbidity, covering common inpatient coronary interventions. This grouping matters for inpatient reimbursement because it standardizes payment for these procedures under Medicare, reflecting expected resource utilization and influencing hospital revenue for cardiovascular cases.

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DRG 322 Overview

DRG 322 covers hospital admissions for percutaneous cardiovascular procedures using intraluminal devices without a Major Complication or Comorbidity and typically includes elective coronary interventions such as percutaneous transluminal coronary angioplasty with stent placement when no severe comorbid conditions are present. This Diagnosis-Related Group groups cases by resource use and procedural complexity to determine Medicare payment for inpatient stays. It matters for Medicare payment because it allocates a specific inpatient reimbursement relative to other cardiovascular procedure groups, influencing hospital billing and case-mix considerations. Understanding the clinical scope and grouping criteria helps clarify which admissions qualify for this payment category.

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Percutaneous Cardiovascular Procedures with Intraluminal Device without MCC: Inpatient Reimbursement Overview

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DRG 322 Overview

National Payment Rates

Payer rates for DRG 322 range from about $14K (BCBS) to $29K (Cigna) in mean payments, with payer medians spanning roughly $6K to $29K across the four payers shown; Anthem and Aetna have mean values near $17K and $28K respectively. The widest spread between payer means is approximately $15K (BCBS to Cigna). See the table and chart below for detailed percentile and distribution information by payer.

The CMS 2023 data represent national Medicare fee-for-service inpatient payments published 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 322. Values in the CMS table reflect national averages and aggregate discharge counts for Medicare FFS in 2023.

Average Total Payment	Average Submitted Charges	Average Medicare Payment	Total Discharges
$17K	$110K	$13K	13K

Patient Population

DRG 322’s population skews toward a mixed-age cohort but is weighted toward Medicare-age beneficiaries given the procedural and inpatient setting reflected in Medicare claims data. Commercial payers (Cigna, Aetna, Anthem, BCBS) cover a meaningful share of working-age patients, so the mix includes both Medicare-age and working-age adults. Overall, the payer mix is mixed with a notable Medicare presence reflected in the CMS discharge counts.

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

In Alaska for DRG 322, payer rates span a wide range from approximately $7.5K at the low end up to $75K at the high end across payers. Cigna stands out with substantially higher central tendency (median $42K, mean $44K) compared with BCBS and Anthem (median $27K, mean $26K). This distribution displays a pronounced upper tail relative to national medians. See the table and chart below for the payer-level breakdown.

Key Insights for Alaska

Highest payer: Cigna (median $42K, mean $44K) while lowest reported payers: Blue Cross Blue Shield and Anthem (median $27K, mean $26K).
Alaska rates range from about $7.5K (min observed for BCBS/Anthem) up to $75K (max for Cigna), a notably wider and higher upper tail versus national medians where typical medians are much lower (national medians around $13K–$29K depending on payer).

Clinical Trials

Acute procedural optimization studies: randomized or pragmatic trials focusing on intraprocedural techniques and adjunctive pharmacotherapy during percutaneous cardiovascular interventions (PCI) for patients with symptomatic coronary artery disease or acute coronary syndromes who do not have major comorbid complications (no MCC). These studies enroll the typical inpatient population receiving percutaneous intraluminal devices (stents, balloons, atherectomy) and compare procedural endpoints such as acute vessel patency, peri-procedural myocardial injury, bleeding, and short-term complications. Results inform cardiology teams and hospital payers about best practices that reduce length of stay, complication-related costs, and readmission risk for DRG 322 patients.
Comparative effectiveness and device selection studies: cohort studies or randomized trials comparing types of intraluminal devices or implantation strategies (for example, newer-generation stent platforms versus standard platforms, or different deployment methods) in elective or urgent PCI populations without major complications. These studies focus on mid-term outcomes like restenosis, target lesion revascularization, and resource use (repeat procedures, imaging, outpatient follow-up) in patients assigned to DRG 322-level care. Findings are relevant to providers for device choice and to payers and hospitals for cost-effectiveness and bundle payment considerations, because device selection can materially impact downstream utilization.
Post-discharge outcomes and care pathway research: observational and interventional studies evaluating transitional care, secondary prevention adherence, and outpatient monitoring strategies after hospital discharge for patients treated with percutaneous intraluminal devices who did not experience major complications. These studies target readmission rates, adherence to antiplatelet therapy and cardiac rehabilitation participation, and patient-reported outcomes in the typical post-DRG 322 cohort. Evidence from these studies helps health systems and payers design discharge protocols and outpatient management that reduce avoidable returns to inpatient care and improve long-term value for this population.

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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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.

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National Payment Rates

Mean Rates by Payer — National — DRG 322

Average Total Payment	Average Submitted Charges	Average Medicare Payment	Total Discharges
$17K	$110K	$13K	13K

Patient Population

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

Mean Rates by Payer — Alaska — DRG 322

Key Insights for Alaska

Highest payer: Cigna (median $42K, mean $44K) while lowest reported payers: Blue Cross Blue Shield and Anthem (median $27K, mean $26K).
Alaska rates range from about $7.5K (min observed for BCBS/Anthem) up to $75K (max for Cigna), a notably wider and higher upper tail versus national medians where typical medians are much lower (national medians around $13K–$29K depending on payer).

Clinical Trials

Acute procedural optimization studies: randomized or pragmatic trials focusing on intraprocedural techniques and adjunctive pharmacotherapy during percutaneous cardiovascular interventions (PCI) for patients with symptomatic coronary artery disease or acute coronary syndromes who do not have major comorbid complications (no MCC). These studies enroll the typical inpatient population receiving percutaneous intraluminal devices (stents, balloons, atherectomy) and compare procedural endpoints such as acute vessel patency, peri-procedural myocardial injury, bleeding, and short-term complications. Results inform cardiology teams and hospital payers about best practices that reduce length of stay, complication-related costs, and readmission risk for DRG 322 patients.
Comparative effectiveness and device selection studies: cohort studies or randomized trials comparing types of intraluminal devices or implantation strategies (for example, newer-generation stent platforms versus standard platforms, or different deployment methods) in elective or urgent PCI populations without major complications. These studies focus on mid-term outcomes like restenosis, target lesion revascularization, and resource use (repeat procedures, imaging, outpatient follow-up) in patients assigned to DRG 322-level care. Findings are relevant to providers for device choice and to payers and hospitals for cost-effectiveness and bundle payment considerations, because device selection can materially impact downstream utilization.
Post-discharge outcomes and care pathway research: observational and interventional studies evaluating transitional care, secondary prevention adherence, and outpatient monitoring strategies after hospital discharge for patients treated with percutaneous intraluminal devices who did not experience major complications. These studies target readmission rates, adherence to antiplatelet therapy and cardiac rehabilitation participation, and patient-reported outcomes in the typical post-DRG 322 cohort. Evidence from these studies helps health systems and payers design discharge protocols and outpatient management that reduce avoidable returns to inpatient care and improve long-term value for this population.

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.