MS-DRG 291 – Heart Failure and Shock with MCC
A Medical DRG in MDC 05 (Diseases & Disorders of the Circulatory System). Inpatient cases group to DRG 291 when the ICD-10-CM principal diagnosis is one of the 29 codes listed below and a secondary diagnosis on the major complication or comorbidity (MCC) list is present. Its FY 2026 relative weight is 1.2838 with a geometric mean length of stay of 3.8 days.
Severity family
The grouper first assigns the case to MDC 05 from the principal diagnosis and finds no qualifying operating-room procedure (this is a Medical DRG; ICD-10-PCS codes do not drive assignment here), then applies the severity split from secondary diagnoses: with MCC → 291; with CC → 292; without CC/MCC → 293.
Principal Diagnosis Codes 29 codes · 5 categories
I09 Other rheumatic heart diseases1 code
- I09.81 Rheumatic heart failure
I11 Hypertensive heart disease1 code
- I11.0 Hypertensive heart disease with heart failure
I13 Hypertensive heart and chronic kidney disease2 codes
I50 Heart failure23 codes
- I50.1 Left ventricular failure, unspecified
- I50.20 Unspecified systolic (congestive) heart failure
- I50.21 Acute systolic (congestive) heart failure
- I50.22 Chronic systolic (congestive) heart failure
- I50.23 Acute on chronic systolic (congestive) heart failure
- I50.30 Unspecified diastolic (congestive) heart failure
- I50.31 Acute diastolic (congestive) heart failure
- I50.32 Chronic diastolic (congestive) heart failure
- I50.33 Acute on chronic diastolic (congestive) heart failure
- I50.40 Unspecified combined systolic (congestive) and diastolic (congestive) heart failure
- I50.41 Acute combined systolic (congestive) and diastolic (congestive) heart failure
- I50.42 Chronic combined systolic (congestive) and diastolic (congestive) heart failure
- I50.43 Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure
- I50.810 Right heart failure, unspecified
- I50.811 Acute right heart failure
- I50.812 Chronic right heart failure
- I50.813 Acute on chronic right heart failure
- I50.814 Right heart failure due to left heart failure
- I50.82 Biventricular heart failure
- I50.83 High output heart failure
- I50.84 End stage heart failure
- I50.89 Other heart failure
- I50.9 Heart failure, unspecified
Procedure Codes
Frequently Asked Questions
What is MS-DRG 291?
MS-DRG 291 (Heart Failure and Shock with MCC) is a medical DRG in MDC 05 (Diseases & Disorders of the Circulatory System). Its FY 2026 relative weight is 1.2838 with a geometric mean length of stay of 3.8 days.
What is the difference between DRG 291, 292, 293?
All 3 share the same base category; the severity of secondary diagnoses separates them: 291 (with MCC), 292 (with CC), 293 (without CC/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 diagnosis codes group to DRG 291?
29 ICD-10-CM principal diagnosis codes group to this DRG, spanning 5 three-character categories.
What is the relative weight of DRG 291?
The FY 2026 relative weight of this DRG is 1.2838, meaning reimbursement of roughly 1.28 times the average Medicare inpatient case. Multiply by a hospital's blended base rate for the approximate payment.
