Summary & Overview
Uterine and Adnexa Procedures for Non-Malignancy without CC/MCC: Inpatient Reimbursement Overview
DRG 743 encompasses inpatient uterine and adnexa procedures performed for non-malignant conditions without a Complication or Comorbidity or Major Complication or Comorbidity and captures typical benign gynecologic surgeries. It matters for inpatient reimbursement because the Diagnosis-Related Group assignment drives Medicare payment rates and reflects the expected resource use for straightforward surgical admissions.
DRG 743 Overview
DRG 743 covers inpatient hospital admissions for surgical procedures on the uterus and adnexa for non-malignant conditions without a Complication or Comorbidity or Major Complication or Comorbidity. Typical cases include hysterectomy, oophorectomy, salpingectomy, and related procedures performed for benign indications. This Diagnosis-Related Group matters for Medicare payment because grouping determines the fixed inpatient reimbursement and influences hospital resource allocation and coding specificity. Accurate assignment affects reimbursement level and compliance with Centers for Medicare & Medicaid Services billing rules.
National Payment Rates
Across commercial payers the observed rate range runs from a low near $370 (BCBS minimum) up to $39K (Anthem maximum), with mean payer benchmarks clustering between about $11K and $20K. The widest spread is seen in Anthem and BCBS where minimums are very low and maximums reach the upper tens of thousands, producing the largest payer-to-payer variability. See the table and chart below for payer-specific distributions and quartiles.