Summary & Overview
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.
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.