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 Kidney and Urinary TractDRG 657-kidney-and-ureter-procedures-for-neoplasm-with-cc
    Ask Trek AI about this page

    Kidney and Ureter Procedures for Neoplasm with CC: Inpatient Reimbursement Overview

    DRG 657 applies to inpatient kidney and ureter procedures performed for neoplasm when a Complication or Comorbidity is present; it defines the clinical scope as oncologic urologic surgeries with additional complexity that increases resource needs. This matters for inpatient reimbursement because Diagnosis-Related Group assignment by the Centers for Medicare & Medicaid Services drives payment weighting and reflects the higher expected hospital resource use for these cases.

    Customize your policy alerts

    Sign up for drg 657 policy alerts

    Get alerted when payer policies referencing 657 are released or updated.

    Monitor payer policy activity

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

    DRG 657 Overview

    DRG 657 covers inpatient admissions for kidney and ureter surgical procedures performed for neoplasm when a Complication or Comorbidity is present. This Diagnosis-Related Group groups cases by procedure and clinical complexity to determine Medicare payment relative to resource use. It is used by the Centers for Medicare & Medicaid Services to classify and reimburse hospitals for higher-acuity oncologic urologic surgeries. Accurate coding of the principal procedure and the presence of Complication or Comorbidity affects payment assignment.

    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

    • Perioperative complication reduction trials examining enhanced recovery protocols and minimally invasive surgical approaches: studies in this area compare laparoscopic, robotic-assisted, and open nephrectomy or ureterectomy techniques and adjunct perioperative bundles (analgesia strategies, fluid management, thromboprophylaxis) to reduce intraoperative blood loss, transfusion requirements, and short-term complications. The patient population includes adults undergoing surgery for kidney or ureter neoplasms with comorbidities that place them in the CC (complication or comorbidity) category, such as renal insufficiency, cardiac disease, or obesity; trials often stratify by tumor stage and baseline renal function. This research is relevant to providers and payers because lower complication rates and shorter length of stay directly affect resource use, readmission risk, and episode costs for DRG 657 hospitalizations.
    • Comparative effectiveness studies of nephron-sparing versus radical procedures on oncologic and renal outcomes: these observational cohorts and randomized designs evaluate partial nephrectomy or segmental ureteral resection versus radical nephrectomy/nephroureterectomy in patients with localized renal or upper tract urothelial neoplasms, focusing on cancer control, preservation of glomerular filtration, and progression to chronic kidney disease. The target population includes patients with small or moderate-sized tumors where nephron preservation is feasible but complicated by baseline comorbid conditions that increase postoperative risk; studies may include subgroup analyses by baseline renal function and age. Findings inform surgical decision-making and payer coverage strategies because trade-offs between long-term dialysis risk, downstream costs of chronic kidney disease, and short-term surgical resource utilization are central to value assessment under this DRG.
    • Post-discharge outcomes and survivorship research assessing functional status, renal function trajectory, and readmission drivers: prospective cohort studies and quality-improvement trials follow patients after discharge to quantify rates and causes of 30- and 90-day readmission, declines in renal function, need for dialysis, and patient-reported functional recovery and quality of life. These studies focus on the high-risk subgroup within DRG 657 who have CC-level comorbidities (e.g., diabetes, pre-existing CKD, or cardiovascular disease) that predispose them to adverse post-acute events, and they evaluate interventions such as targeted discharge planning, early nephrology follow-up, or transitional care models. Results are directly relevant to hospitals and payers aiming to reduce costly readmissions, optimize post-acute resource allocation, and improve long-term outcomes that influence total episode cost and patient-centered care metrics.

    Related Codes

    650-KIDNEY-TRANSPLANT-WITH-HEMODIALYSIS-WITH-MCC

    Kidney Transplant with Hemodialysis with Major Complication or Comorbidity: Inpatient Reimbursement Overview

    651-KIDNEY-TRANSPLANT-WITH-HEMODIALYSIS-WITHOUT-MCC

    Kidney Transplant with Hemodialysis without MCC: Inpatient Reimbursement Overview

    652-KIDNEY-TRANSPLANT

    Kidney Transplant: Inpatient Reimbursement Overview

    653-MAJOR-BLADDER-PROCEDURES-WITH-MCC

    Major Bladder Procedures with MCC: Inpatient Reimbursement Overview

    654-MAJOR-BLADDER-PROCEDURES-WITH-CC

    Major Bladder Procedures with CC: Inpatient Reimbursement Overview

    655-MAJOR-BLADDER-PROCEDURES-WITHOUT-CC-MCC

    Major Bladder Procedures without CC/MCC: Inpatient Reimbursement Overview

    656-KIDNEY-AND-URETER-PROCEDURES-FOR-NEOPLASM-WITH-MCC

    Kidney and Ureter Procedures for Neoplasm with MCC: Inpatient Reimbursement Overview

    658-KIDNEY-AND-URETER-PROCEDURES-FOR-NEOPLASM-WITHOUT-CC-MCC

    Kidney and Ureter Procedures for Neoplasm without CC/MCC: Inpatient Reimbursement Overview

    659-KIDNEY-AND-URETER-PROCEDURES-FOR-NON-NEOPLASM-WITH-MCC

    Kidney and Ureter Procedures for Non-Neoplasm with MCC: Inpatient Reimbursement Overview

    660-KIDNEY-AND-URETER-PROCEDURES-FOR-NON-NEOPLASM-WITH-CC

    Kidney and Ureter Procedures for Non-Neoplasm with CC: Inpatient Reimbursement Overview

    Showing 1–10 of 41

    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.