Other Kidney and Urinary Tract Diagnoses with MCC: Inpatient Reimbursement Overview

DRG 698 encompasses other kidney and urinary tract diagnoses accompanied by a Major Complication or Comorbidity, reflecting higher clinical severity and resource needs. This classification matters for inpatient reimbursement because it drives higher Medicare payment relative to less severe groupings and impacts hospital case-mix and billing processes.

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DRG 698 Overview

DRG 698 covers inpatient admissions for other kidney and urinary tract diagnoses when a Major Complication or Comorbidity is present, capturing complex medical conditions such as severe infections, acute renal failure superimposed on chronic disease, or significant electrolyte disturbances. This Diagnosis-Related Group groups cases with higher resource use and clinical severity, which influences Medicare inpatient payment rates. Hospitals receive adjusted reimbursement to account for the increased intensity of care associated with Major Complication or Comorbidity. The classification affects billing, case-mix indexing, and payment reconciliation under Medicare inpatient prospective payment systems.

Clinical Trials

Trials of acute management strategies for severe urinary tract infections and urosepsis in patients with multiple comorbidities: these studies evaluate rapid diagnostic pathways, timing and intensity of supportive care (eg, fluid resuscitation, vasopressor use), and adjunctive interventions to reduce organ dysfunction in hospitalized adults who present with complicated UTIs or urosepsis and have major comorbid conditions. The patient population typically includes older adults and patients with chronic kidney disease, diabetes, or immunosuppression who are at high risk for progression to acute kidney injury; the findings inform in-hospital care bundles that can shorten length of stay and prevent escalation to intensive care. This research is directly relevant to providers and payers because effective acute protocols can decrease complication rates, readmissions, and high-cost resource utilization associated with DRG 698 admissions.
Comparative effectiveness trials of interventions to prevent or treat acute kidney injury (AKI) associated with urinary tract pathology in medically complex inpatients: these studies compare approaches such as conservative fluid management versus protocolized kidney-protective strategies, timing of renal consults, or use of temporary renal replacement modalities in patients who develop AKI in the context of obstructive uropathy, severe infection, or nephrotoxic exposure. The studied population is hospitalized patients under DRG 698 with MCCs that predispose to AKI (eg, pre-existing CKD, heart failure, or exposure to nephrotoxic agents), and the trials assess renal recovery, need for dialysis, and resource utilization. Outcomes from these trials help clinicians choose cost-effective care pathways and help payers anticipate intensity of services and potential cost offsets from interventions that reduce progression to dialysis-dependent renal failure.
Post-discharge outcomes and care-transition studies focusing on preventing readmissions and optimizing outpatient kidney and urinary tract management: these observational cohorts and interventional studies test multidisciplinary discharge bundles, outpatient monitoring protocols, and nephrology/urology follow-up timing for patients discharged after hospitalization for complex urinary tract diagnoses with major comorbidities. The target population includes survivors of DRG 698 episodes who have residual renal impairment, recurrent urinary tract issues, or high risk for medication-related complications; endpoints include 30- and 90-day readmissions, functional status, and outpatient healthcare utilization. Evidence from this research is important to providers and payers because improved transitions can reduce costly readmissions, align outpatient resource deployment, and improve long-term outcomes for a high-risk, high-cost patient group.

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.

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Clinical Trials

Trials of acute management strategies for severe urinary tract infections and urosepsis in patients with multiple comorbidities: these studies evaluate rapid diagnostic pathways, timing and intensity of supportive care (eg, fluid resuscitation, vasopressor use), and adjunctive interventions to reduce organ dysfunction in hospitalized adults who present with complicated UTIs or urosepsis and have major comorbid conditions. The patient population typically includes older adults and patients with chronic kidney disease, diabetes, or immunosuppression who are at high risk for progression to acute kidney injury; the findings inform in-hospital care bundles that can shorten length of stay and prevent escalation to intensive care. This research is directly relevant to providers and payers because effective acute protocols can decrease complication rates, readmissions, and high-cost resource utilization associated with DRG 698 admissions.
Comparative effectiveness trials of interventions to prevent or treat acute kidney injury (AKI) associated with urinary tract pathology in medically complex inpatients: these studies compare approaches such as conservative fluid management versus protocolized kidney-protective strategies, timing of renal consults, or use of temporary renal replacement modalities in patients who develop AKI in the context of obstructive uropathy, severe infection, or nephrotoxic exposure. The studied population is hospitalized patients under DRG 698 with MCCs that predispose to AKI (eg, pre-existing CKD, heart failure, or exposure to nephrotoxic agents), and the trials assess renal recovery, need for dialysis, and resource utilization. Outcomes from these trials help clinicians choose cost-effective care pathways and help payers anticipate intensity of services and potential cost offsets from interventions that reduce progression to dialysis-dependent renal failure.
Post-discharge outcomes and care-transition studies focusing on preventing readmissions and optimizing outpatient kidney and urinary tract management: these observational cohorts and interventional studies test multidisciplinary discharge bundles, outpatient monitoring protocols, and nephrology/urology follow-up timing for patients discharged after hospitalization for complex urinary tract diagnoses with major comorbidities. The target population includes survivors of DRG 698 episodes who have residual renal impairment, recurrent urinary tract issues, or high risk for medication-related complications; endpoints include 30- and 90-day readmissions, functional status, and outpatient healthcare utilization. Evidence from this research is important to providers and payers because improved transitions can reduce costly readmissions, align outpatient resource deployment, and improve long-term outcomes for a high-risk, high-cost patient group.

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.

Other Kidney and Urinary Tract Diagnoses with MCC: Inpatient Reimbursement Overview

Sign up for drg 698 policy alerts

DRG 698 Overview

Other Kidney and Urinary Tract Diagnoses with MCC: Inpatient Reimbursement Overview

Sign up for drg 698 policy alerts

DRG 698 Overview

Clinical Trials

Related Codes

References

Clinical Trials

Related Codes

References