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

DRG 661 includes kidney and ureter procedures for non-neoplasm cases without Complication or Comorbidity or Major Complication or Comorbidity, focusing on surgical treatment of benign urologic conditions. It matters for inpatient reimbursement because it defines the bundled payment level under the Centers for Medicare & Medicaid Services system and influences hospital revenue for these procedures.

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DRG 661 Overview

DRG 661 covers inpatient cases involving kidney and ureter procedures for non-neoplastic conditions without a Complication or Comorbidity or Major Complication or Comorbidity. Typical encounters include surgical management of stones, obstructions, or repair of urinary tract injury when no significant secondary diagnoses are present. This Diagnosis-Related Group is important for Medicare payment because it groups similar resource use and sets a bundled payment rate for the hospital stay. Accurate assignment affects hospital reimbursement and case-mix reporting.

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

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Get alerted when payer policies referencing 661 are released or updated.

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DRG 661 Overview

National Payment Rates

Across commercial payers the payment distribution for DRG 661 ranges from about $370 to $41K, with payers’ medians clustering between $10K and $19K (see the table and chart below). The widest spread is observed between Anthem (max $41K) and BCBS (min $370), yielding the largest payer-to-payer range. Benchmarks show Aetna, Cigna, BCBS and Anthem medians and quartiles that vary notably, indicating significant commercial market dispersion.

The CMS 2023 data represent national Medicare fee‑for‑service inpatient payments reported under the CMS Provider Utilization and Payment Data program. The table below shows average total payment ($9.7k), average submitted covered charges ($53.7k), average Medicare payment ($7.0k), and total discharges (9.9k).

Average Total Payment	Average Submitted Charges	Average Medicare Payment	Total Discharges
$9.7K	$54K	$7K	9.9K

Patient Population

This DRG’s population includes both Medicare‑age and working‑age patients, producing a mixed payer mix. Medicare likely represents a substantial share given typical inpatient use among older adults, while commercial payers cover a meaningful portion of younger, working‑age patients. The distribution therefore skews neither exclusively Medicare nor exclusively commercial but spans both payer groups.

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

Alaska payer means for DRG 661 range from $16K to $25K across payers, with Anthem and Blue Cross Blue Shield clustered at $16K and Cigna notably higher at $25K. The spread reflects a substantial deviation from many national averages, where means are generally lower or more compressed. See the table and chart below for payer-specific distributions.

Key Insights for Alaska

Highest payer: Cigna (mean $25K); Lowest payers: Anthem and BCBS (mean $16K).
Cigna’s mean payment (~$25K) meaningfully exceeds the other Alaska payers and is notably above typical national means for comparable payers.

Clinical Trials

Acute perioperative management trials: randomized or prospective cohort studies evaluating interventions to reduce intraoperative complications, blood loss, or postoperative renal dysfunction in adult patients undergoing kidney or ureter procedures for non-neoplastic indications (e.g., stone extraction, reconstructive ureteral surgery, obstruction relief). These studies typically enroll medically heterogeneous inpatients—including older adults and those with baseline chronic kidney disease—to test procedural techniques, anesthesia approaches, or perioperative fluid and hemodynamic protocols. Results are relevant to providers and payers because improved perioperative protocols can shorten length of stay, reduce ICU transfers and readmissions, and lower inpatient costs associated with complications and escalation of care.
Comparative effectiveness studies of surgical and endourologic techniques: pragmatic trials or registry-based comparative analyses that compare outcomes, resource use, and complication rates between approaches such as open vs. minimally invasive (laparoscopic/robotic) repair, percutaneous vs. ureteroscopic stone removal, or stent-first vs. definitive repair strategies. These studies focus on adult inpatients with symptomatic obstruction, complex stones, or ureteral injuries and assess metrics such as procedure success, need for repeat interventions, hospital length of stay, and short-term morbidity. Payers and hospital systems use this evidence to inform procedure selection, reimbursement policy, and bundled payment models by identifying approaches that offer equivalent or better clinical outcomes with lower total cost of care.
Post-discharge outcomes and readmission prevention research: prospective observational studies and intervention trials that evaluate discharge planning, outpatient follow-up, pain management, and complication surveillance to reduce 30-day readmissions and emergency visits after inpatient kidney or ureter procedures for non-neoplastic disease. These studies enroll patients at discharge—often those with comorbidities like diabetes, CKD, or obesity—and test care-coordination interventions, telehealth monitoring, or protocolized stent removal schedules to detect and address complications early. Findings help providers optimize transition of care and help payers estimate and mitigate post-acute costs tied to readmissions, unplanned imaging or procedures, and prolonged recovery.

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

657-KIDNEY-AND-URETER-PROCEDURES-FOR-NEOPLASM-WITH-CC

Kidney and Ureter Procedures for Neoplasm with CC: 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

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References

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.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.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.

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National Payment Rates

Mean Rates by Payer — National — DRG 661

Average Total Payment	Average Submitted Charges	Average Medicare Payment	Total Discharges
$9.7K	$54K	$7K	9.9K

Patient Population

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

Mean Rates by Payer — Alaska — DRG 661

Key Insights for Alaska

Highest payer: Cigna (mean $25K); Lowest payers: Anthem and BCBS (mean $16K).
Cigna’s mean payment (~$25K) meaningfully exceeds the other Alaska payers and is notably above typical national means for comparable payers.

Clinical Trials

Acute perioperative management trials: randomized or prospective cohort studies evaluating interventions to reduce intraoperative complications, blood loss, or postoperative renal dysfunction in adult patients undergoing kidney or ureter procedures for non-neoplastic indications (e.g., stone extraction, reconstructive ureteral surgery, obstruction relief). These studies typically enroll medically heterogeneous inpatients—including older adults and those with baseline chronic kidney disease—to test procedural techniques, anesthesia approaches, or perioperative fluid and hemodynamic protocols. Results are relevant to providers and payers because improved perioperative protocols can shorten length of stay, reduce ICU transfers and readmissions, and lower inpatient costs associated with complications and escalation of care.
Comparative effectiveness studies of surgical and endourologic techniques: pragmatic trials or registry-based comparative analyses that compare outcomes, resource use, and complication rates between approaches such as open vs. minimally invasive (laparoscopic/robotic) repair, percutaneous vs. ureteroscopic stone removal, or stent-first vs. definitive repair strategies. These studies focus on adult inpatients with symptomatic obstruction, complex stones, or ureteral injuries and assess metrics such as procedure success, need for repeat interventions, hospital length of stay, and short-term morbidity. Payers and hospital systems use this evidence to inform procedure selection, reimbursement policy, and bundled payment models by identifying approaches that offer equivalent or better clinical outcomes with lower total cost of care.
Post-discharge outcomes and readmission prevention research: prospective observational studies and intervention trials that evaluate discharge planning, outpatient follow-up, pain management, and complication surveillance to reduce 30-day readmissions and emergency visits after inpatient kidney or ureter procedures for non-neoplastic disease. These studies enroll patients at discharge—often those with comorbidities like diabetes, CKD, or obesity—and test care-coordination interventions, telehealth monitoring, or protocolized stent removal schedules to detect and address complications early. Findings help providers optimize transition of care and help payers estimate and mitigate post-acute costs tied to readmissions, unplanned imaging or procedures, and prolonged recovery.

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

657-KIDNEY-AND-URETER-PROCEDURES-FOR-NEOPLASM-WITH-CC

Kidney and Ureter Procedures for Neoplasm with CC: 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

Showing 1–10 of 41

References

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.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.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.

OpenPayer

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

Sign up for drg 661 policy alerts

DRG 661 Overview

OpenPayer

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

Sign up for drg 661 policy alerts

DRG 661 Overview

National Payment Rates

Patient Population

State Payment Rates

Alaska Benchmarks

Key Insights for Alaska

Clinical Trials

Related Codes

References

National Payment Rates

Patient Population

State Payment Rates

Alaska Benchmarks

Key Insights for Alaska

Clinical Trials

Related Codes

References