BACKGROUND: Among Medicare value-based payment programs for acute myocardial infarction (AMI), the Hospital Readmissions Reduction Program (HRRP) uses ICD-10 codes to identify the program denominator, while the Bundled Payments for Care Improvement Advanced (BPCIA) program uses DRGs. The extent to which these programs target similar patients, whether they target the intended population (Type 1 myocardial infarction), and whether outcomes are comparable between cohorts is not known. METHODS: In a retrospective study of 2,176 patients hospitalized in an integrated health system, a cohort of patients assigned a principal ICD-10 diagnosis of AMI and a cohort of patients assigned an AMI DRG were compared according to patient-level agreement and outcomes such as mortality and readmission. RESULTS: 1,935 patients were included in the ICD-10 cohort compared to 662 patients in the DRG cohort. Only 421 patients were included in both AMI cohorts (19.3% agreement). DRG cohort patients were older (70 vs. 65 years, p