DRG 291

Medical DRG

Heart Failure and Shock with MCC

TypeMedicalMDC05Dx Codes29

What is MS-DRG 291?

MS-DRG 291 is a Medical Medicare Severity Diagnosis Related Group under Major Diagnostic Category 05 (MDC 05) with a Major Complication or Comorbidity (MCC). It maps to 29 ICD-10-CM diagnosis codes. For FY 2026 it carries a relative weight of 1.2838 with a geometric mean length of stay of 3.8 days and an arithmetic mean of 5 days. Hospitals use this grouping to determine reimbursement for inpatient stays under Medicare.

Classification

Medical DRG

Diagnosis-driven grouping

MDC

Major Diagnostic Category 05

Linked Codes

29 diagnosis

Billable Dx

100%

29 of 29 shown

FY 2026 Payment Data

Official values from Table 5 of the FY 2026 IPPS Final Rule (CMS).

Relative Weight

1.2838

Payment multiplier vs. average case (1.0)

Geometric Mean LOS

3.8 days

Used for transfer payment calculations

Arithmetic Mean LOS

5 days

Average length of stay

Post-Acute Transfer

Yes

Subject to the post-acute care transfer policy

Related MS-DRGs in This Severity Group

The same clinical condition is split into separate DRGs by complication severity. MCC pays more than CC, which pays more than no CC/MCC.

DRG	Title	Rel. Weight	GMLOS
291	Heart Failure and Shock with MCCThis page	1.2838	3.8 days
292	Heart Failure and Shock with CC	0.8490	2.9 days
293	Heart Failure and Shock without CC/MCC	0.5660	2.1 days

Linked ICD-10-CM Diagnosis Mappings

I09.81
Rheumatic heart failure
BillableChapter 9
I11.0
Hypertensive heart disease with heart failure
BillableChapter 9
I13.0
Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
BillableChapter 9
I13.10
Hypertensive heart and chronic kidney disease without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
BillableChapter 9
I50.1
Left ventricular failure, unspecified
BillableChapter 9
I50.20
Unspecified systolic (congestive) heart failure
BillableChapter 9
I50.21
Acute systolic (congestive) heart failure
BillableChapter 9
I50.22
Chronic systolic (congestive) heart failure
BillableChapter 9
I50.23
Acute on chronic systolic (congestive) heart failure
BillableChapter 9
I50.30
Unspecified diastolic (congestive) heart failure
BillableChapter 9
I50.31
Acute diastolic (congestive) heart failure
BillableChapter 9
I50.32
Chronic diastolic (congestive) heart failure
BillableChapter 9
I50.33
Acute on chronic diastolic (congestive) heart failure
BillableChapter 9
I50.40
Unspecified combined systolic (congestive) and diastolic (congestive) heart failure
BillableChapter 9
I50.41
Acute combined systolic (congestive) and diastolic (congestive) heart failure
BillableChapter 9
I50.42
Chronic combined systolic (congestive) and diastolic (congestive) heart failure
BillableChapter 9
I50.43
Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure
BillableChapter 9
I50.810
Right heart failure, unspecified
BillableChapter 9
I50.811
Acute right heart failure
BillableChapter 9
I50.812
Chronic right heart failure
BillableChapter 9
I50.813
Acute on chronic right heart failure
BillableChapter 9
I50.814
Right heart failure due to left heart failure
BillableChapter 9
I50.82
Biventricular heart failure
BillableChapter 9
I50.83
High output heart failure
BillableChapter 9
I50.84
End stage heart failure
BillableChapter 9
I50.89
Other heart failure
BillableChapter 9
I50.9
Heart failure, unspecified
BillableChapter 9
R57.0
Cardiogenic shock
BillableChapter 18
R57.9
Shock, unspecified
BillableChapter 18