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    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Musculoskeletal System and Connective TissueDRG 541-osteomyelitis-without-cc-mcc
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    Osteomyelitis without CC/MCC: Inpatient Reimbursement Overview

    DRG 541 addresses hospital stays for osteomyelitis without a Complication or Comorbidity or Major Complication or Comorbidity, encompassing cases managed with surgical and medical therapy. Proper assignment of this Diagnosis-Related Group matters because it determines Medicare inpatient prospective payment and aligns reimbursement with expected resource consumption for these clinical encounters.

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    DRG 541 Overview

    DRG 541 covers inpatient admissions for osteomyelitis without a Complication or Comorbidity and without a Major Complication or Comorbidity, typically involving surgical debridement, targeted antimicrobial therapy, and hospital-level supportive care. This Diagnosis-Related Group groups cases with similar expected resource use and clinical complexity for Medicare reimbursement. Payment classification under this Diagnosis-Related Group affects hospital prospective payment rates and resource planning. Accurate coding of infection severity, surgical procedures, and comorbid diagnoses is essential to determine whether an admission is assigned to this Diagnosis-Related Group.

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    Clinical Trials

    • Acute surgical and debridement intervention trials: randomized or pragmatic studies comparing different intraoperative strategies (for example, timing of surgical debridement, extent of bone resection, or use of local antibiotic carriers versus standard irrigation) in hospitalized adults with osteomyelitis without CC/MCC who present with localized infection and stable comorbid status. These trials focus on immediate perioperative management and wound control, enrolling patients at the time of hospital admission to determine effects on short-term outcomes such as need for reoperation, length of stay, and early infection clearance. Results are directly relevant to providers for selecting operative approaches and to payers because changes in operative practice can alter resource use, readmission risk, and overall cost of inpatient care.
    • Comparative effectiveness studies of systemic antibiotic strategies in the inpatient period: prospective cohort studies or randomized trials evaluating duration, route (intravenous versus early switch to oral), or antibiotic stewardship approaches in medically stable adults with osteomyelitis without major complications. These studies target the inpatient-to-outpatient transition population—patients who are clinically improving and candidates for either continued IV therapy, step-down oral regimens, or outpatient parenteral antibiotic therapy—to assess treatment failure, readmission, adverse events, and total treatment days. Findings guide clinicians and payers on optimizing antimicrobial resource utilization, minimizing inpatient days, and reducing costs while maintaining clinical effectiveness.
    • Post-discharge outcomes and care-coordination trials: pragmatic studies and prospective registries assessing multidisciplinary discharge planning, home health support, and surveillance strategies for patients discharged after treatment for osteomyelitis without CC/MCC, including measures of functional recovery, wound healing, readmission rates, and long-term recurrence. These studies enroll patients at discharge and follow them through the post-acute period to evaluate which follow-up care models (telehealth monitoring, scheduled wound clinic visits, integrated home nursing) reduce complications and unplanned reuse of acute care. The evidence informs hospital discharge protocols and payer policies on coverage for post-acute services that can prevent costly readmissions and improve value of care for this DRG.

    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

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

    427-MULTIPLE-LEVEL-COMBINED-ANTERIOR-AND-POSTERIOR-SPINAL-FUSION-EXCEPT-CERVICAL-WITH-CC

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

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    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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