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    v1.0.30
    OpenPayerBilling CodesDiseases and Disorders of the Male Reproductive SystemDRG 710-penis-procedures-without-cc-mcc
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    Penis Procedures without CC/MCC: Inpatient Reimbursement Overview

    DRG 710 encompasses inpatient penile procedures performed without Complication or Comorbidity or Major Complication or Comorbidity, focusing on uncomplicated surgical management. It matters for inpatient reimbursement because grouping determines base Medicare payment rates for admissions with similar expected resource use.

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    DRG 710 Overview

    DRG 710 covers inpatient admissions for surgical procedures on the penis when no Complication or Comorbidity or Major Complication or Comorbidity is present. Typical cases include straightforward reconstructive, excisional, or prosthetic procedures without significant perioperative medical issues. This Diagnosis-Related Group matters for Medicare payment because it groups similar resource use and sets the base reimbursement level for uncomplicated penile surgical admissions. Accurate coding of diagnoses and procedures determines assignment to this Diagnosis-Related Group and thus affects hospital inpatient payment.

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    National Payment Rates

    Across commercial payers the observed 25th–75th percentile payment range runs from about $1.1K to $32K with payer medians spanning roughly $13K to $24K; the full payer range extends from as low as $370 up to $54K. The widest spread is seen between Anthem (min $390 / max $54K) and BCBS (min $370 / max $38K), reflecting significant variability across insurers. See the table and chart below for payer-level detail.

    The CMS 2023 data reflect national Medicare fee-for-service inpatient payments published under the CMS Provider Utilization and Payment Data program. The table below shows average total payment ($14.8k), average submitted covered charges ($72.4k), average Medicare payment ($11.0k), and total discharges (148) for DRG 710.

    Average Total PaymentAverage Submitted ChargesAverage Medicare PaymentTotal Discharges
    $15K$72K$11K150

    Patient Population

    This DRG’s patient mix is typically mixed but leans toward working-age adults rather than being primarily Medicare-age; commercial payers (Cigna, Aetna, Anthem, BCBS) commonly cover a substantial portion of cases alongside Medicare. The presence of 148 Medicare discharges in CMS data indicates a meaningful Medicare cohort, but private/commercial payers represent a large share of utilization overall. Payer demographics therefore span both working-age and Medicare-age populations.

    State Payment Rates

    State: Alaska1 / 49

    Alaska Benchmarks

    Alaska shows a payer rate range from $22K to $34K across reported payers, with most payers clustered at $22K and Cigna as the clear outlier at $34K. This represents a notable upward deviation from many national averages where means more commonly fall near $22K–$23K. See the table and chart below for the underlying payer-level benchmarks.

    Key Insights for Alaska

    • The highest payer in Alaska is Cigna at $34K mean, while Blue Cross Blue Shield and Anthem both report a mean of $22K, making them the lowest-paying payers in the state.
    • Cigna’s mean of $34K sits notably above the state cluster at $22K and also exceeds the national mean range for many payers, indicating a meaningful upward deviation from typical national rates.

    Clinical Trials

    • Acute perioperative management studies evaluating anesthesia techniques and perioperative complication reduction in patients undergoing inpatient penis procedures (e.g., penile prosthesis implantation, repair of traumatic injury, or complex reconstructive surgeries). These trials typically enroll adult men requiring definitive surgical intervention during the index hospitalization and compare protocols such as regional versus general anesthesia, multimodal analgesia bundles, or thromboprophylaxis strategies to reduce short-term complications like bleeding, infection, or urinary retention. Results are relevant to providers and payers because improved perioperative protocols can shorten length of stay, lower complication-related readmissions, and reduce direct inpatient costs for this DRG.
    • Comparative effectiveness and device-outcome studies examining different surgical techniques or implant types used in penile procedures, including open versus minimally invasive approaches and variations in prosthetic design or fixation methods. These studies enroll patients receiving elective or reconstructive penile surgery and evaluate outcomes such as functional success, infection rates, need for revision, patient-reported sexual function, and procedure durability over months to years. Evidence from these trials informs surgical choice, implant selection, and expected long-term resource use, helping providers optimize care pathways and payers assess value and reimbursement policies for durable versus higher-risk options.
    • Post-discharge outcomes and health services research focused on recovery trajectories, complication surveillance, and quality-of-life outcomes after inpatient penile procedures, often using prospective cohorts or registry data to track readmissions, secondary procedures, and patient-reported outcomes over 30–365 days. These studies include diverse populations such as older men with comorbidities, patients with prior pelvic trauma, or those with reconstructive needs after cancer, and aim to identify predictors of poor recovery and opportunities for transitional care interventions. Findings are important for care teams and payers because they can highlight targets for discharge planning, outpatient follow-up intensity, and preventive measures that reduce costly readmissions and improve long-term functional outcomes for this DRG.

    Related Codes

    707-MAJOR-MALE-PELVIC-PROCEDURES-WITH-CC-MCC

    Major Male Pelvic Procedures with CC/MCC: Inpatient Reimbursement Overview

    708-MAJOR-MALE-PELVIC-PROCEDURES-WITHOUT-CC-MCC

    Major Male Pelvic Procedures without CC/MCC: Inpatient Reimbursement Overview

    709-PENIS-PROCEDURES-WITH-CC-MCC

    Penis Procedures with CC/MCC: Inpatient Reimbursement Overview

    711-TESTES-PROCEDURES-WITH-CC-MCC

    Testes Procedures with CC/MCC: Inpatient Reimbursement Overview

    712-TESTES-PROCEDURES-WITHOUT-CC-MCC

    Testes Procedures without CC/MCC: Inpatient Reimbursement Overview

    713-TRANSURETHRAL-PROSTATECTOMY-WITH-CC-MCC

    Transurethral Prostatectomy with CC/MCC: Inpatient Reimbursement Overview

    714-TRANSURETHRAL-PROSTATECTOMY-WITHOUT-CC-MCC

    Transurethral Prostatectomy without CC/MCC: Inpatient Reimbursement Overview

    715-OTHER-MALE-REPRODUCTIVE-SYSTEM-O-R-PROCEDURES-FOR-MALIGNANCY-WITH-CC-MCC

    Other Male Reproductive System O.R. Procedures for Malignancy with CC/MCC: Inpatient Reimbursement Overview

    716-OTHER-MALE-REPRODUCTIVE-SYSTEM-O-R-PROCEDURES-FOR-MALIGNANCY-WITHOUT-CC-MCC

    Other Male Reproductive System O.R. Procedures for Malignancy without CC/MCC: Inpatient Reimbursement Overview

    717-OTHER-MALE-REPRODUCTIVE-SYSTEM-O-R-PROCEDURES-EXCEPT-MALIGNANCY-WITH-CC-MCC

    Other Male Reproductive System O.R. Procedures Except Malignancy with CC/MCC: Inpatient Reimbursement Overview

    Showing 1–10 of 20

    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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    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.

    Mean Rates by Payer — National — DRG 710
    Mean Rates by Payer — Alaska — DRG 710