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MS-DRG 292 · MDC 05 · Medical

MS-DRG 292: Heart Failure and Shock with CC

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Data effective
Data currency: IPPS Table 5 FY2027 final rule (effective October 1, 2026); Definitions Manual v44 (effective October 1, 2026). Next CMS release: April 1, 2027 (v44.1 mid-year update), then the FY2028 final rule in August 2027.

Key facts for DRG 292

FY2027 relative weight
0.8610
Higher than 14% of all MS-DRGs
Change vs FY2026
+1.4%
FY2026 weight 0.8490
Geometric mean LOS
2.9 days
Arithmetic mean 3.7 days
MDC
05
Assignment of Diagnosis Codes
Severity level
with CC (complication or comorbidity)
Transfer policy
Post-acute transfer DRG

TL;DR

MS-DRG 292 is a medical group in MDC 05 (Assignment of Diagnosis Codes) at the middle severity level of its family. CMS assigns it a FY2027 relative weight of 0.8610 with a geometric mean length of stay of 2.9 days and an arithmetic mean of 3.7. Its weight moved up 1.4% from FY2026 (0.8490). That weight is higher than 14% of all medical and surgical MS-DRGs. Its CC/MCC family (DRG 291, DRG 293) spans weights 0.5460 to 1.2680. The v44 Definitions Manual assigns it through 29 principal diagnosis codes.

What changed from FY2026 to FY2027

CMS recalibrates every MS-DRG weight annually from the prior year's MedPAR claims. For DRG 292 the FY2027 relative weight is 0.8610 against 0.8490 in FY2026, a rise of 1.41%.

FY2026 versus FY2027 payment factors for MS-DRG 292
MetricFY2026FY2027Change
Relative weight0.84900.8610+0.0120
Geometric mean LOS (days)2.92.9+0.0
Arithmetic mean LOS (days)3.73.7+0.0
Weights shown are the FY2027 final values after the 10% cap on year-over-year reductions where applicable.

CC and MCC family

DRG 292 shares its base definition with 2 other MS-DRGs split by severity. The family's weights span 0.5460 to 1.2680, a 2.32× spread, which is the payment effect of documenting qualifying complications and comorbidities.

MS-DRGs in the same base group as DRG 292
DRGTitleFY2027 weightGMLOS
291Heart Failure and Shock with MCC1.26803.8
292Heart Failure and Shock with CC0.86102.9
293Heart Failure and Shock without CC/MCC0.54602.1

Grouper logic (v44 Definitions Manual)

Principal Diagnosis: 29 ICD-10 codes drive assignment to this group; the first 12 are shown.

Principal Diagnosis codes assigned to DRG 292 (sample)
ICD-10 codeDescription
I0981Rheumatic heart failure
I110Hypertensive heart disease with heart failure
I130Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I132Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease
I501Left ventricular failure, unspecified
I5020Unspecified systolic (congestive) heart failure
I5021Acute systolic (congestive) heart failure
I5022Chronic systolic (congestive) heart failure
I5023Acute on chronic systolic (congestive) heart failure
I5030Unspecified diastolic (congestive) heart failure
I5031Acute diastolic (congestive) heart failure
I5032Chronic diastolic (congestive) heart failure

Documentation and denial exposure

As a medical DRG, assignment depends on the principal diagnosis sequenced from the attending's documentation; a secondary condition sequenced first, or a symptom code in place of the confirmed diagnosis, changes the MDC or the DRG. Because this family splits by severity, auditors target CC and MCC capture: each secondary diagnosis must be documented as present, monitored, evaluated or treated during the stay to survive a DRG-validation review. Typical inpatient denial codes for this group: CARC 16 (claim lacks information needed to group the stay), CARC 50 (the admission or procedure is judged not medically necessary), CARC 97 (a service is bundled into the DRG payment).

How QuickIntell uses DRG 292 data

QuickCode groups inpatient encounters against the current v44 logic, flags CC and MCC candidates that lack supporting documentation, and shows the weight difference across the family before the claim drops. QuickScribe captures the attending's language that supports severity, and QuickRCM works DRG-validation denials with the grouper evidence attached.

Frequently asked questions — DRG 292

What is MS-DRG 292?

MS-DRG 292 is "Heart Failure and Shock with CC", a medical Medicare Severity Diagnosis-Related Group in MDC 05, Assignment of Diagnosis Codes. Medicare pays inpatient stays grouped here at the hospital's base rate multiplied by the DRG relative weight.

What is the FY2027 relative weight for DRG 292?

The FY2027 relative weight is 0.8610 (IPPS final rule Table 5, effective October 1, 2026). In FY2026 it was 0.8490, a change of +1.4%.

What is the average length of stay for DRG 292?

CMS reports a geometric mean length of stay of 2.9 days and an arithmetic mean of 3.7 days for FY2027. The geometric mean is used for transfer-payment calculations.

Which DRGs are in the same CC/MCC family as 292?

DRG 291 (Heart Failure and Shock with MCC, weight 1.2680); DRG 293 (Heart Failure and Shock without CC/MCC, weight 0.5460). The family's weights range from 0.5460 to 1.2680, so documented complications and comorbidities change payment materially.

What documentation supports the severity level of DRG 292?

DRG 292 is reached when the stay carries a secondary diagnosis from the CMS Complication or Comorbidity list but none from the MCC list. Common CC captures include chronic kidney disease stage 3 and above, uncontrolled diabetes with manifestations, malnutrition of specified severity and heart failure of a stated type. Each must be documented by the treating clinician and show clinical relevance in the record; a condition listed only in the problem list without assessment is the most frequent reason a CC is removed on audit and the stay drops to the base DRG.

Which codes group to DRG 292?

The v44 Definitions Manual lists 29 principal diagnosis codes for this group. Examples from the principal diagnosis list: I0981 (Rheumatic heart failure); I110 (Hypertensive heart disease with heart failure); I130 (Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease); I132 (Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease).

Is DRG 292 a post-acute transfer DRG?

Yes. CMS flags DRG 292 under the post-acute care transfer policy, so a discharge to a qualifying post-acute setting before the geometric mean length of stay is paid a per-diem amount rather than the full DRG payment.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-01. Verify against the primary file before billing or contracting decisions.

Disclaimer

This page is an operational reference compiled from the CMS IPPS FY2027 final rule (Table 5) and the v44 ICD-10 MS-DRG Definitions Manual. Relative weights are national factors; actual payment depends on each hospital's wage-adjusted base rate, add-ons, outliers and transfer adjustments. Nothing here is legal, clinical or billing advice; verify grouping against your encoder and the published CMS files.