MS-DRG · FY 2026 v43.0

MS-DRG 269 – Aortic and Heart Assist Procedures Except Pulsation Balloon without MCC

A Surgical DRG in MDC 05 (Diseases & Disorders of the Circulatory System). Inpatient cases group to DRG 269 when one of the 133 ICD-10-PCS operating-room procedures listed below is reported. Its FY 2026 relative weight is 4.2232 with a geometric mean length of stay of 1.5 days.

Surgical DRG – assigned by operating-room procedure✓ Official CMS v43.0 dataset
4.2232
Relative Weight
1.5
Geometric Mean LOS (days)
2.0
Arithmetic Mean LOS (days)
133
Procedure Codes

Severity family

DRG 268with MCCWeight 6.8779 · GMLOS 6.1 daysDRG 269without MCCWeight 4.2232 · GMLOS 1.5 days
How a case is assigned to DRG 269

The grouper first assigns the case to MDC 05 from the principal diagnosis, then matches a qualifying operating-room procedure from the ICD-10-PCS list below (this is a Surgical DRG), then applies the severity split from secondary diagnoses: with MCC → 268; without MCC → 269.

ICD-10-PCS

Procedure Codes 133 codes · 23 categories

133 of 133 shown
02BW Heart and Great Vessels, Excision2 codes
  • 02BW0ZZ Excision of Thoracic Aorta, Descending, Open Approach
  • 02BW4ZZ Excision of Thoracic Aorta, Descending, Percutaneous Endoscopic Approach
02BX Heart and Great Vessels, Excision2 codes
  • 02BX0ZZ Excision of Thoracic Aorta, Ascending/Arch, Open Approach
  • 02BX4ZZ Excision of Thoracic Aorta, Ascending/Arch, Percutaneous Endoscopic Approach
02CW Heart and Great Vessels, Extirpation3 codes
  • 02CW0ZZ Extirpation of Matter from Thoracic Aorta, Descending, Open Approach
  • 02CW3ZZ Extirpation of Matter from Thoracic Aorta, Descending, Percutaneous Approach
  • 02CW4ZZ Extirpation of Matter from Thoracic Aorta, Descending, Percutaneous Endoscopic Approach
02CX Heart and Great Vessels, Extirpation3 codes
  • 02CX0ZZ Extirpation of Matter from Thoracic Aorta, Ascending/Arch, Open Approach
  • 02CX3ZZ Extirpation of Matter from Thoracic Aorta, Ascending/Arch, Percutaneous Approach
  • 02CX4ZZ Extirpation of Matter from Thoracic Aorta, Ascending/Arch, Percutaneous Endoscopic Approach
02PA Heart and Great Vessels, Removal9 codes
  • 02PA0QZ Removal of Implantable Heart Assist System from Heart, Open Approach
  • 02PA0RS Removal of Biventricular Short-term External Heart Assist System from Heart, Open Approach
  • 02PA0RZ Removal of Short-term External Heart Assist System from Heart, Open Approach
  • 02PA3QZ Removal of Implantable Heart Assist System from Heart, Percutaneous Approach
  • 02PA3RS Removal of Biventricular Short-term External Heart Assist System from Heart, Percutaneous Approach
  • 02PA3RZ Removal of Short-term External Heart Assist System from Heart, Percutaneous Approach
  • 02PA4QZ Removal of Implantable Heart Assist System from Heart, Percutaneous Endoscopic Approach
  • 02PA4RS Removal of Biventricular Short-term External Heart Assist System from Heart, Percutaneous Endoscopic Approach
  • 02PA4RZ Removal of Short-term External Heart Assist System from Heart, Percutaneous Endoscopic Approach
02PW Heart and Great Vessels, Removal1 code
  • 02PW3RZ Removal of Short-term External Heart Assist System from Thoracic Aorta, Descending, Percutaneous Approach
02QW Heart and Great Vessels, Repair3 codes
  • 02QW0ZZ Repair Thoracic Aorta, Descending, Open Approach
  • 02QW3ZZ Repair Thoracic Aorta, Descending, Percutaneous Approach
  • 02QW4ZZ Repair Thoracic Aorta, Descending, Percutaneous Endoscopic Approach
02QX Heart and Great Vessels, Repair3 codes
  • 02QX0ZZ Repair Thoracic Aorta, Ascending/Arch, Open Approach
  • 02QX3ZZ Repair Thoracic Aorta, Ascending/Arch, Percutaneous Approach
  • 02QX4ZZ Repair Thoracic Aorta, Ascending/Arch, Percutaneous Endoscopic Approach
02U0 Heart and Great Vessels, Supplement2 codes
  • 02U00JZ Supplement Coronary Artery, One Artery with Synthetic Substitute, Open Approach
  • 02U04JZ Supplement Coronary Artery, One Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
02U1 Heart and Great Vessels, Supplement2 codes
  • 02U10JZ Supplement Coronary Artery, Two Arteries with Synthetic Substitute, Open Approach
  • 02U14JZ Supplement Coronary Artery, Two Arteries with Synthetic Substitute, Percutaneous Endoscopic Approach
02U2 Heart and Great Vessels, Supplement2 codes
  • 02U20JZ Supplement Coronary Artery, Three Arteries with Synthetic Substitute, Open Approach
  • 02U24JZ Supplement Coronary Artery, Three Arteries with Synthetic Substitute, Percutaneous Endoscopic Approach
02U3 Heart and Great Vessels, Supplement2 codes
  • 02U30JZ Supplement Coronary Artery, Four or More Arteries with Synthetic Substitute, Open Approach
  • 02U34JZ Supplement Coronary Artery, Four or More Arteries with Synthetic Substitute, Percutaneous Endoscopic Approach
02UA Heart and Great Vessels, Supplement3 codes
  • 02UA0JZ Supplement Heart with Synthetic Substitute, Open Approach
  • 02UA3JZ Supplement Heart with Synthetic Substitute, Percutaneous Approach
  • 02UA4JZ Supplement Heart with Synthetic Substitute, Percutaneous Endoscopic Approach
0410 Lower Arteries, Bypass30 codes
  • 0410093 Bypass Abdominal Aorta to Right Renal Artery with Autologous Venous Tissue, Open Approach
  • 0410094 Bypass Abdominal Aorta to Left Renal Artery with Autologous Venous Tissue, Open Approach
  • 0410095 Bypass Abdominal Aorta to Bilateral Renal Artery with Autologous Venous Tissue, Open Approach
  • 04100A3 Bypass Abdominal Aorta to Right Renal Artery with Autologous Arterial Tissue, Open Approach
  • 04100A4 Bypass Abdominal Aorta to Left Renal Artery with Autologous Arterial Tissue, Open Approach
  • 04100A5 Bypass Abdominal Aorta to Bilateral Renal Artery with Autologous Arterial Tissue, Open Approach
  • 04100J3 Bypass Abdominal Aorta to Right Renal Artery with Synthetic Substitute, Open Approach
  • 04100J4 Bypass Abdominal Aorta to Left Renal Artery with Synthetic Substitute, Open Approach
  • 04100J5 Bypass Abdominal Aorta to Bilateral Renal Artery with Synthetic Substitute, Open Approach
  • 04100K3 Bypass Abdominal Aorta to Right Renal Artery with Nonautologous Tissue Substitute, Open Approach
  • 04100K4 Bypass Abdominal Aorta to Left Renal Artery with Nonautologous Tissue Substitute, Open Approach
  • 04100K5 Bypass Abdominal Aorta to Bilateral Renal Artery with Nonautologous Tissue Substitute, Open Approach
  • 04100Z3 Bypass Abdominal Aorta to Right Renal Artery, Open Approach
  • 04100Z4 Bypass Abdominal Aorta to Left Renal Artery, Open Approach
  • 04100Z5 Bypass Abdominal Aorta to Bilateral Renal Artery, Open Approach
  • 0410493 Bypass Abdominal Aorta to Right Renal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach
  • 0410494 Bypass Abdominal Aorta to Left Renal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach
  • 0410495 Bypass Abdominal Aorta to Bilateral Renal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach
  • 04104A3 Bypass Abdominal Aorta to Right Renal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
  • 04104A4 Bypass Abdominal Aorta to Left Renal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
  • 04104A5 Bypass Abdominal Aorta to Bilateral Renal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
  • 04104J3 Bypass Abdominal Aorta to Right Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
  • 04104J4 Bypass Abdominal Aorta to Left Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
  • 04104J5 Bypass Abdominal Aorta to Bilateral Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
  • 04104K3 Bypass Abdominal Aorta to Right Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
  • 04104K4 Bypass Abdominal Aorta to Left Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
  • 04104K5 Bypass Abdominal Aorta to Bilateral Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
  • 04104Z3 Bypass Abdominal Aorta to Right Renal Artery, Percutaneous Endoscopic Approach
  • 04104Z4 Bypass Abdominal Aorta to Left Renal Artery, Percutaneous Endoscopic Approach
  • 04104Z5 Bypass Abdominal Aorta to Bilateral Renal Artery, Percutaneous Endoscopic Approach
0413 Lower Arteries, Bypass30 codes
  • 0413093 Bypass Hepatic Artery to Right Renal Artery with Autologous Venous Tissue, Open Approach
  • 0413094 Bypass Hepatic Artery to Left Renal Artery with Autologous Venous Tissue, Open Approach
  • 0413095 Bypass Hepatic Artery to Bilateral Renal Artery with Autologous Venous Tissue, Open Approach
  • 04130A3 Bypass Hepatic Artery to Right Renal Artery with Autologous Arterial Tissue, Open Approach
  • 04130A4 Bypass Hepatic Artery to Left Renal Artery with Autologous Arterial Tissue, Open Approach
  • 04130A5 Bypass Hepatic Artery to Bilateral Renal Artery with Autologous Arterial Tissue, Open Approach
  • 04130J3 Bypass Hepatic Artery to Right Renal Artery with Synthetic Substitute, Open Approach
  • 04130J4 Bypass Hepatic Artery to Left Renal Artery with Synthetic Substitute, Open Approach
  • 04130J5 Bypass Hepatic Artery to Bilateral Renal Artery with Synthetic Substitute, Open Approach
  • 04130K3 Bypass Hepatic Artery to Right Renal Artery with Nonautologous Tissue Substitute, Open Approach
  • 04130K4 Bypass Hepatic Artery to Left Renal Artery with Nonautologous Tissue Substitute, Open Approach
  • 04130K5 Bypass Hepatic Artery to Bilateral Renal Artery with Nonautologous Tissue Substitute, Open Approach
  • 04130Z3 Bypass Hepatic Artery to Right Renal Artery, Open Approach
  • 04130Z4 Bypass Hepatic Artery to Left Renal Artery, Open Approach
  • 04130Z5 Bypass Hepatic Artery to Bilateral Renal Artery, Open Approach
  • 0413493 Bypass Hepatic Artery to Right Renal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach
  • 0413494 Bypass Hepatic Artery to Left Renal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach
  • 0413495 Bypass Hepatic Artery to Bilateral Renal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach
  • 04134A3 Bypass Hepatic Artery to Right Renal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
  • 04134A4 Bypass Hepatic Artery to Left Renal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
  • 04134A5 Bypass Hepatic Artery to Bilateral Renal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
  • 04134J3 Bypass Hepatic Artery to Right Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
  • 04134J4 Bypass Hepatic Artery to Left Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
  • 04134J5 Bypass Hepatic Artery to Bilateral Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
  • 04134K3 Bypass Hepatic Artery to Right Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
  • 04134K4 Bypass Hepatic Artery to Left Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
  • 04134K5 Bypass Hepatic Artery to Bilateral Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
  • 04134Z3 Bypass Hepatic Artery to Right Renal Artery, Percutaneous Endoscopic Approach
  • 04134Z4 Bypass Hepatic Artery to Left Renal Artery, Percutaneous Endoscopic Approach
  • 04134Z5 Bypass Hepatic Artery to Bilateral Renal Artery, Percutaneous Endoscopic Approach
0450 Lower Arteries, Destruction3 codes
  • 04500ZZ Destruction of Abdominal Aorta, Open Approach
  • 04503ZZ Destruction of Abdominal Aorta, Percutaneous Approach
  • 04504ZZ Destruction of Abdominal Aorta, Percutaneous Endoscopic Approach
04B0 Lower Arteries, Excision3 codes
  • 04B00ZZ Excision of Abdominal Aorta, Open Approach
  • 04B03ZZ Excision of Abdominal Aorta, Percutaneous Approach
  • 04B04ZZ Excision of Abdominal Aorta, Percutaneous Endoscopic Approach
04C0 Lower Arteries, Extirpation3 codes
  • 04C00ZZ Extirpation of Matter from Abdominal Aorta, Open Approach
  • 04C03ZZ Extirpation of Matter from Abdominal Aorta, Percutaneous Approach
  • 04C04ZZ Extirpation of Matter from Abdominal Aorta, Percutaneous Endoscopic Approach
04L0 Lower Arteries, Occlusion11 codes
  • 04L00CZ Occlusion of Abdominal Aorta with Extraluminal Device, Open Approach
  • 04L00DJ Occlusion of Abdominal Aorta with Intraluminal Device, Temporary, Open Approach
  • 04L00DZ Occlusion of Abdominal Aorta with Intraluminal Device, Open Approach
  • 04L00ZZ Occlusion of Abdominal Aorta, Open Approach
  • 04L03CZ Occlusion of Abdominal Aorta with Extraluminal Device, Percutaneous Approach
  • 04L03DJ Occlusion of Abdominal Aorta with Intraluminal Device, Temporary, Percutaneous Approach
  • 04L03DZ Occlusion of Abdominal Aorta with Intraluminal Device, Percutaneous Approach
  • 04L03ZZ Occlusion of Abdominal Aorta, Percutaneous Approach
  • 04L04CZ Occlusion of Abdominal Aorta with Extraluminal Device, Percutaneous Endoscopic Approach
  • 04L04DZ Occlusion of Abdominal Aorta with Intraluminal Device, Percutaneous Endoscopic Approach
  • 04L04ZZ Occlusion of Abdominal Aorta, Percutaneous Endoscopic Approach
04R0 Lower Arteries, Replacement6 codes
  • 04R007Z Replacement of Abdominal Aorta with Autologous Tissue Substitute, Open Approach
  • 04R00JZ Replacement of Abdominal Aorta with Synthetic Substitute, Open Approach
  • 04R00KZ Replacement of Abdominal Aorta with Nonautologous Tissue Substitute, Open Approach
  • 04R047Z Replacement of Abdominal Aorta with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
  • 04R04JZ Replacement of Abdominal Aorta with Synthetic Substitute, Percutaneous Endoscopic Approach
  • 04R04KZ Replacement of Abdominal Aorta with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04U0 Lower Arteries, Supplement3 codes
  • 04U03JZ Supplement Abdominal Aorta with Synthetic Substitute, Percutaneous Approach
  • 04U03LZ Supplement Abdominal Aorta with Intraluminal Device, Endovascular Anchors, Percutaneous Approach
  • 04U04JZ Supplement Abdominal Aorta with Synthetic Substitute, Percutaneous Endoscopic Approach
04V0 Lower Arteries, Restriction6 codes
  • 04V03DZ Restriction of Abdominal Aorta with Intraluminal Device, Percutaneous Approach
  • 04V03EZ Restriction of Abdominal Aorta with Branched or Fenestrated Intraluminal Device, One or Two Arteries, Percutaneous Approach
  • 04V03FZ Restriction of Abdominal Aorta with Branched or Fenestrated Intraluminal Device, Three or More Arteries, Percutaneous Approach
  • 04V04DZ Restriction of Abdominal Aorta with Intraluminal Device, Percutaneous Endoscopic Approach
  • 04V04EZ Restriction of Abdominal Aorta with Branched or Fenestrated Intraluminal Device, One or Two Arteries, Percutaneous Endoscopic Approach
  • 04V04FZ Restriction of Abdominal Aorta with Branched or Fenestrated Intraluminal Device, Three or More Arteries, Percutaneous Endoscopic Approach
X2CP New Technology, Cardiovascular System, Extirpation1 code
  • X2CP3T7 Extirpation of Matter from Abdominal Aorta using Computer-aided Mechanical Aspiration, Percutaneous Approach, New Technology Group 7
ICD-10-CM

Qualifying Diagnosis Codes

Diagnosis codes do not drive assignment for this DRG. Cases group here from the ICD-10-PCS procedure list below.

Frequently Asked Questions

What is MS-DRG 269?

MS-DRG 269 (Aortic and Heart Assist Procedures Except Pulsation Balloon without MCC) is a surgical DRG in MDC 05 (Diseases & Disorders of the Circulatory System). Its FY 2026 relative weight is 4.2232 with a geometric mean length of stay of 1.5 days.

What is the difference between DRG 268, 269?

All 2 share the same base category; the severity of secondary diagnoses separates them: 268 (with MCC), 269 (without MCC). A major complication or comorbidity (MCC) places the case in the highest-weighted DRG of the family; a CC in the middle; neither in the lowest.

How many procedure codes group to DRG 269?

133 ICD-10-PCS operating-room procedure codes group to this DRG.

What is the relative weight of DRG 269?

The FY 2026 relative weight of this DRG is 4.2232, meaning reimbursement of roughly 4.22 times the average Medicare inpatient case. Multiply by a hospital's blended base rate for the approximate payment.

← PreviousDRG 268 – Aortic and Heart Assist Procedures Except Pulsation Balloon
Source: CMS ICD-10 MS-DRG v43.0 Definitions Manual and the FY 2026 IPPS Final Rule (Table 5), effective October 1, 2025 through September 30, 2026. We publish the DRG assignments as CMS defines them and add the navigation, search, and code links.