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    v1.0.28
    OpenPayerBilling CodesPre-MDCDRG 019-simultaneous-pancreas-and-kidney-transplant-with-hemodialysis
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    Simultaneous Pancreas and Kidney Transplant with Hemodialysis: Inpatient Reimbursement Overview

    DRG 019 represents simultaneous pancreas and kidney transplant performed in patients receiving hemodialysis and captures a complex, high-resource inpatient clinical episode. Accurate assignment matters for inpatient reimbursement because it aligns payment with the substantial surgical, transplant care, and dialysis services required.

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    DRG 019 Overview

    DRG 019 covers simultaneous pancreas and kidney transplant procedures performed with maintenance hemodialysis in patients who require renal replacement therapy perioperatively. This Diagnosis-Related Group reflects a high-resource, complex surgical and medical course involving multi-organ transplantation and perioperative dialysis management. It matters for Medicare payment because reimbursement is intended to account for the intensive operative, transplant immunology, and dialysis-related costs associated with these cases. Accurate classification affects hospital revenue and compliance with Centers for Medicare & Medicaid Services inpatient payment rules.

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    Clinical Trials

    • Perioperative immunosuppression optimization trials: randomized or prospective cohort studies comparing different immunosuppressive regimens, dosing strategies, or induction agents in simultaneous pancreas-kidney transplant recipients who require perioperative hemodialysis. These studies enroll patients with end-stage renal disease and insulin-dependent diabetes undergoing combined transplant to determine early graft function, rates of acute rejection, and complications related to dialysis timing. Results are directly relevant to transplant centers and payers because they can influence length of stay, readmission rates, and short-term graft survival, which drive inpatient resource use and reimbursement under this DRG.
    • Comparative effectiveness studies of dialysis management strategies around transplant: pragmatic observational studies or controlled trials comparing immediate perioperative hemodialysis versus delayed or alternative renal replacement approaches (e.g., continuous therapies) in patients undergoing simultaneous pancreas-kidney transplant. The patient population includes individuals with varying degrees of residual renal function and comorbid cardiovascular instability, and the research question focuses on cardiovascular events, fluid balance, metabolic control, and early graft perfusion. Findings inform clinical pathways that affect ICU utilization, complication rates, and downstream costs, helping providers and payers optimize care coordination and resource allocation for this complex DRG.
    • Longitudinal outcomes and health services research on post-discharge graft survival, quality of life, and cost-effectiveness: prospective cohort studies or registry-based analyses following recipients of simultaneous pancreas-kidney transplants who required perioperative hemodialysis to assess one- to five-year graft function, diabetes independence, infection rates, and health-related quality of life. These studies target the full spectrum of patients discharged after the index hospitalization and examine factors such as readmissions, outpatient dialysis needs, and immunosuppression-related complications. This research is critical for payers and hospitals because it links inpatient care decisions to long-term outcomes and total cost of care, informing reimbursement strategies, care pathways, and value-based contracting for the DRG.

    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

    006-LIVER-TRANSPLANT-WITHOUT-MCC

    Liver Transplant without Major Complication or Comorbidity: 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

    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 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.