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    v1.0.28
    OpenPayerBilling CodesPre-MDCDRG 006-liver-transplant-without-mcc
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    Liver Transplant without Major Complication or Comorbidity: Inpatient Reimbursement Overview

    DRG 006 addresses liver transplantation cases without a Major Complication or Comorbidity, encompassing the transplant procedure and standard postoperative care. The designation matters for inpatient reimbursement because it drives the Medicare bundled payment rate for hospitals based on the expected resource consumption for uncomplicated transplant admissions.

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    DRG 006 Overview

    DRG 006 covers inpatient episodes involving liver transplantation without a Major Complication or Comorbidity. This Diagnosis-Related Group captures the resource use associated with the transplant procedure, perioperative care, and typical postoperative management when no major complicating conditions are present. It matters for Medicare payment because it defines the bundled prospective payment amount that hospitals receive for these cases. Precise coding and documentation determine assignment to this group and influence reimbursement.

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    Clinical Trials

    • Perioperative immunosuppression optimization studies: randomized or observational trials that compare different immunosuppressive drug regimens, dosing strategies, or timing around the transplant admission to reduce early rejection and infection. These studies enroll adult patients undergoing liver transplant without major complications (no MCC) and focus on immediate post-transplant outcomes such as graft function, infection rates, and length of stay. Results inform inpatient management protocols and can reduce readmissions and costly complications, directly impacting payer costs and hospital resource utilization.
    • Comparative effectiveness research on surgical and anesthetic approaches during transplant: studies that evaluate differences in operative techniques (for example, vessel reconstruction strategies, use of cell-sparing devices, or specific anesthesia protocols) or intraoperative transfusion and fluid-management strategies. These trials typically include elective liver transplant recipients without severe comorbid conditions, aiming to measure intraoperative blood loss, transfusion requirements, perioperative morbidity, and short-term graft survival. Findings guide clinical pathways to shorten operative time and ICU/hospital stays, which is important for providers optimizing perioperative care and payers monitoring episode costs.
    • Post-discharge outcomes and care-transition studies: prospective cohort studies or interventional trials testing structured discharge planning, early outpatient surveillance, telehealth monitoring, or adherence support to detect complications and manage immunosuppression after hospital discharge. The population consists of liver transplant recipients who left the index hospitalization without major complications; outcomes include 30- and 90-day readmissions, outpatient resource use, patient-reported outcomes, and medication adherence. This research is relevant for reducing avoidable readmissions and downstream costs, improving long-term graft survival, and informing bundled-payment or value-based care strategies.

    Related Codes

    001-HEART-TRANSPLANT-OR-IMPLANT-OF-HEART-ASSIST-SYSTEM-WITH-MCC

    Heart Transplant or Implant of Heart Assist System with MCC: Inpatient Reimbursement Overview

    002-HEART-TRANSPLANT-OR-IMPLANT-OF-HEART-ASSIST-SYSTEM-WITHOUT-MCC

    Heart Transplant or Implant of Heart Assist System without MCC: Inpatient Reimbursement Overview

    003-ECMO-OR-TRACHEOSTOMY-WITH-MV-96-HOURS-OR-PRINCIPAL-DIAGNOSIS-EXCEPT-FACE-MOUTH-AND-NECK-WITH-MAJOR-O-R-PROCEDURES

    ECMO or Tracheostomy with MV >96 Hours: Inpatient Reimbursement Overview

    004-TRACHEOSTOMY-WITH-MV-96-HOURS-OR-PRINCIPAL-DIAGNOSIS-EXCEPT-FACE-MOUTH-AND-NECK-WITHOUT-MAJOR-O-R-PROCEDURES

    Tracheostomy with Mechanical Ventilation >96 Hours: Inpatient Reimbursement Overview

    005-LIVER-TRANSPLANT-WITH-MCC-OR-INTESTINAL-TRANSPLANT

    Liver Transplant with MCC or Intestinal Transplant: Inpatient Reimbursement Overview

    007-LUNG-TRANSPLANT

    Lung Transplant: Inpatient Reimbursement Overview

    008-SIMULTANEOUS-PANCREAS-AND-KIDNEY-TRANSPLANT

    Simultaneous Pancreas and Kidney Transplant: Inpatient Reimbursement Overview

    010-PANCREAS-TRANSPLANT

    Pancreas Transplant: Inpatient Reimbursement Overview

    011-TRACHEOSTOMY-FOR-FACE-MOUTH-AND-NECK-DIAGNOSES-OR-LARYNGECTOMY-WITH-MCC

    Tracheostomy/Laryngectomy with MCC: Inpatient Reimbursement Overview

    012-TRACHEOSTOMY-FOR-FACE-MOUTH-AND-NECK-DIAGNOSES-OR-LARYNGECTOMY-WITH-CC

    Tracheostomy and Laryngectomy with CC: Inpatient Reimbursement Overview

    Showing 1–10 of 16

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.