Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.30
    OpenPayerBilling CodesDiseases and Disorders of the Musculoskeletal System and Connective TissueDRG 427-multiple-level-combined-anterior-and-posterior-spinal-fusion-except-cervical-with-cc
    Ask Trek AI about this page

    Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with CC: Inpatient Reimbursement Overview

    DRG 427 encompasses multiple level combined anterior and posterior spinal fusion procedures except cervical when a Complication or Comorbidity is present, covering complex thoracic and lumbar reconstruction. This Diagnosis-Related Group matters for inpatient reimbursement because it reflects higher resource utilization and drives adjusted Medicare payment for lengthy, multi-approach spinal surgery with associated complications or comorbid conditions.

    Customize your policy alerts

    Sign up for drg 427 policy alerts

    Get alerted when payer policies referencing 427 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    DRG 427 Overview

    DRG 427 covers multiple level combined anterior and posterior spinal fusion procedures outside the cervical region when a Complication or Comorbidity is present. This Diagnosis-Related Group captures complex thoracic and lumbar fusion surgeries performed through both anterior and posterior approaches that increase resource use compared with single-approach fusions. It matters for Medicare payment because inpatient reimbursement is adjusted for the higher surgical complexity, length of stay, and perioperative resource needs associated with combined approaches and the presence of a Complication or Comorbidity. Accurate coding and clinical documentation determine assignment to this Diagnosis-Related Group and therefore the relative payment for the inpatient stay.

    Table of contents

    Progress1 / 3

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical Trials

    • Trials evaluating perioperative strategies to reduce intraoperative blood loss and transfusion requirements in multilevel combined anterior-posterior thoracolumbar and lumbosacral fusion patients with significant comorbidity. These studies typically enroll adults undergoing staged or same-setting combined anterior and posterior fusion for deformity, trauma, infection, or multilevel degenerative disease, and compare agents or protocols (for example, dosing regimens of antifibrinolytics, cell-sparing blood-salvage techniques, and standardized hemostasis bundles). Research in this area is relevant to providers because effective blood-conservation can reduce operative time, complications, and length of stay; it is relevant to payers because transfusions and bleeding-related reoperations drive high resource use and cost in DRG 427 cases.
    • Comparative effectiveness trials of surgical approach, instrumentation strategies, and fusion extent looking at functional recovery, reoperation rates, and complication profiles in complex multilevel combined anterior-posterior fusions. These studies enroll patients with complex spinal pathology who require both anterior and posterior access (e.g., adult deformity, high-grade spondylolisthesis, or multilevel degenerative disease) and compare outcomes of different fixation constructs, use of osteotomies, graft types, and staged versus single-session procedures. The findings inform surgeons about trade-offs between stability, fusion rate, and complication risk, and inform payers and hospital managers about likely downstream resource utilization, readmission risk, and cost-effectiveness for bundled payment or case-rate planning.
    • Post-discharge outcomes and utilization studies assessing recovery trajectories, long-term functional outcomes, opioid use, and readmissions in patients after multiple-level combined anterior and posterior spinal fusion. These observational or pragmatic cohort studies follow patients from discharge through 90 days to 1 year to measure rehabilitation needs, durable pain control, fusion success (radiographic and clinical), and health-care utilization including home health services and revision surgery. Results are important for providers to tailor discharge planning and rehabilitation pathways and for payers to predict post-acute care costs, readmission drivers, and the value of interventions that reduce long-term complications in DRG 427 populations.

    Related Codes

    402-SINGLE-LEVEL-COMBINED-ANTERIOR-AND-POSTERIOR-SPINAL-FUSION-EXCEPT-CERVICAL

    Single Level Combined Anterior and Posterior Spinal Fusion Except Cervical: Inpatient Reimbursement Overview

    426-MULTIPLE-LEVEL-COMBINED-ANTERIOR-AND-POSTERIOR-SPINAL-FUSION-EXCEPT-CERVICAL-WITH-MCC-OR-CUSTOM-MADE-ANATOMICALLY-DESIGNED-INTERBODY-FUSION-DEVICE

    Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with MCC or Custom-Made Anatomically Designed Interbody Fusion Device: Inpatient Reimbursement Overview

    428-MULTIPLE-LEVEL-COMBINED-ANTERIOR-AND-POSTERIOR-SPINAL-FUSION-EXCEPT-CERVICAL-WITHOUT-CC-MCC

    Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical without CC/MCC: Inpatient Reimbursement Overview

    429-COMBINED-ANTERIOR-AND-POSTERIOR-CERVICAL-SPINAL-FUSION-WITH-MCC

    Combined Anterior and Posterior Cervical Spinal Fusion with MCC: Inpatient Reimbursement Overview

    430-COMBINED-ANTERIOR-AND-POSTERIOR-CERVICAL-SPINAL-FUSION-WITHOUT-MCC

    Combined Anterior and Posterior Cervical Spinal Fusion without MCC: Inpatient Reimbursement Overview

    447-MULTIPLE-LEVEL-SPINAL-FUSION-EXCEPT-CERVICAL-WITH-MCC-OR-CUSTOM-MADE-ANATOMICALLY-DESIGNED-INTERBODY-FUSION-DEVICE

    Multiple Level Spinal Fusion Except Cervical with MCC: Inpatient Reimbursement Overview

    448-MULTIPLE-LEVEL-SPINAL-FUSION-EXCEPT-CERVICAL-WITHOUT-MCC

    Multiple Level Spinal Fusion Except Cervical without MCC: Inpatient Reimbursement Overview

    450-SINGLE-LEVEL-SPINAL-FUSION-EXCEPT-CERVICAL-WITH-MCC-OR-CUSTOM-MADE-ANATOMICALLY-DESIGNED-INTERBODY-FUSION-DEVICE

    Single Level Spinal Fusion Except Cervical with MCC or Custom-Made Device: Inpatient Reimbursement Overview

    451-SINGLE-LEVEL-SPINAL-FUSION-EXCEPT-CERVICAL-WITHOUT-MCC

    Single Level Spinal Fusion Except Cervical without MCC: Inpatient Reimbursement Overview

    456-SPINAL-FUSION-EXCEPT-CERVICAL-WITH-SPINAL-CURVATURE-MALIGNANCY-INFECTION-OR-EXTENSIVE-FUSIONS-WITH-MCC

    Spinal Fusion Except Cervical with MCC: Inpatient Reimbursement Overview

    Showing 1–10 of 104

    • More pages

    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.
    Published by

    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.