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    v1.0.30
    OpenPayerBilling CodesDiseases and Disorders of the Male Reproductive SystemDRG 713-transurethral-prostatectomy-with-cc-mcc
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    Transurethral Prostatectomy with CC/MCC: Inpatient Reimbursement Overview

    DRG 713 includes inpatient transurethral prostatectomy cases with a Major Complication or Comorbidity, covering higher-acuity surgical admissions for obstructive prostatic disease. This Diagnosis-Related Group matters for inpatient reimbursement because the presence of a Major Complication or Complication or Comorbidity increases Resource Intensity and leads to higher Medicare payment under inpatient prospective payment policies.

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    DRG 713 Overview

    DRG 713 covers inpatient admissions for transurethral prostatectomy procedures performed for benign prostatic hyperplasia or other obstructive prostatic conditions when a Major Complication or Comorbidity is present. This Diagnosis-Related Group groups cases with higher resource use due to complicating diagnoses or perioperative issues that increase length of stay, intensity of care, and cost. It is important for Centers for Medicare & Medicaid Services payment because hospitals receive higher reimbursement under Medicare inpatient payment rules for cases assigned to this Diagnosis-Related Group compared with similar procedures without complications. Accurate documentation and coding of the surgical procedure and any Major Complication or Complication or Comorbidity affect assignment to this Diagnosis-Related Group and thus impact Medicare inpatient reimbursement.

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    Clinical Trials

    • Perioperative risk-reduction and complication-prevention trials: randomized or prospective cohort studies that test protocols (e.g., optimized perioperative fluid management, antibiotic prophylaxis strategies, or bleeding-control measures) to reduce immediate complications like hemorrhage, urinary retention, infection, or cardiovascular events in patients undergoing transurethral prostatectomy with significant comorbidity. These studies focus on older men with benign prostatic hyperplasia or obstructive urinary symptoms who also carry CC/MCC-level comorbidities (cardiovascular disease, anticoagulant use, chronic kidney disease), assessing short-term morbidity, length of stay, and readmission rates. Results directly inform perioperative care pathways and risk stratification used by clinicians and payers to reduce costly complications and inpatient resource utilization.
    • Comparative effectiveness trials of surgical approaches and technologies: head-to-head studies comparing different transurethral techniques, energy sources, or adjunctive intraoperative devices (including resection versus enucleation approaches or different hemostatic methods) in patients with large prostates or those at higher risk for intraoperative bleeding. These trials enroll inpatient populations requiring TURP-level intervention with CC/MCC to evaluate outcomes such as operative time, transfusion need, catheter duration, functional urinary outcomes, and complication profiles. Findings help hospitals and payers decide which technologies or surgical pathways yield the best value for complex patients who drive higher DRG costs.
    • Post-discharge recovery, quality-of-life, and resource-utilization studies: observational cohorts or pragmatic trials that follow patients from discharge to 30–90 days to measure functional recovery, urinary symptom trajectories, rehospitalizations, outpatient visits, and cost outcomes, often stratified by baseline comorbidity burden. These studies examine which discharge planning, home care, or outpatient follow-up strategies reduce readmissions and improve patient-reported outcomes in the older, comorbid population typical of DRG 713. Evidence from this research supports care-management programs and payer policies aimed at lowering post-acute utilization and improving long-term value for high-risk inpatient surgical populations.

    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

    710-PENIS-PROCEDURES-WITHOUT-CC-MCC

    Penis Procedures without 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

    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

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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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    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.