Heart Failure and Shock without CC/MCC
Major Diagnostic Category 05·Grouped by diagnosis·FY 2027
MS-DRG 293 is a Medical Medicare Severity Diagnosis Related Group under Major Diagnostic Category 05 (MDC 05) without a significant Complication or Comorbidity. It maps to 29 ICD-10-CM diagnosis codes. For FY 2027 it carries a relative weight of 0.5462 with a geometric mean length of stay of 2.1 days and an arithmetic mean of 2.5 days. Hospitals use this grouping to determine reimbursement for inpatient stays under Medicare.
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FY 2027 payment data
From Table 5 of the FY 2027 IPPS Final Rule (CMS).
- Relative weight:
- 0.5462 (payment multiplier vs. the average case (1.0))
- Geometric mean stay:
- 2.1 days (used for transfer payments)
- Average stay:
- 2.5 days (arithmetic mean)
- Post-acute transfer policy:
- Yes (early transfers can be paid less)
Same condition, other severity levels
CMS splits one condition into separate DRGs by how sick the patient is. With MCC pays more than with CC, which pays more than without CC/MCC.
Diagnosis codes (29)
As the principal diagnosis, these ICD-10-CM codes can group to DRG 293. 100% of the codes listed are billable.
- I09.81Rheumatic heart failure
- I11.0Hypertensive heart disease with heart failure
- I13.0Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
- I13.10Hypertensive heart and chronic kidney disease without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
- I50.1Left ventricular failure, unspecified
- I50.20Unspecified systolic (congestive) heart failure
- I50.21Acute systolic (congestive) heart failure
- I50.22Chronic systolic (congestive) heart failure
- I50.23Acute on chronic systolic (congestive) heart failure
- I50.30Unspecified diastolic (congestive) heart failure
- I50.31Acute diastolic (congestive) heart failure
- I50.32Chronic diastolic (congestive) heart failure
- I50.33Acute on chronic diastolic (congestive) heart failure
- I50.40Unspecified combined systolic (congestive) and diastolic (congestive) heart failure
- I50.41Acute combined systolic (congestive) and diastolic (congestive) heart failure
- I50.42Chronic combined systolic (congestive) and diastolic (congestive) heart failure
- I50.43Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure
- I50.810Right heart failure, unspecified
- I50.811Acute right heart failure
- I50.812Chronic right heart failure
- I50.813Acute on chronic right heart failure
- I50.814Right heart failure due to left heart failure
- I50.82Biventricular heart failure
- I50.83High output heart failure
- I50.84End stage heart failure
- I50.89Other heart failure
- I50.9Heart failure, unspecified
- R57.0Cardiogenic shock
- R57.9Shock, unspecified
