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    v1.0.28
    OpenPayerBilling CodesMyeloproliferative Diseases and Disorders, Poorly Differentiated NeoplasmsDRG 847-chemotherapy-without-acute-leukemia-as-secondary-diagnosis-with-cc
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    Chemotherapy without Acute Leukemia as Secondary Diagnosis with CC: Inpatient Reimbursement Overview

    DRG 847 covers inpatient chemotherapy admissions without acute leukemia as a secondary diagnosis but with a Complication or Comorbidity that affects resource use. This group is important for inpatient reimbursement because the Complication or Complication or Comorbidity designation alters payment weight and reflects higher expected resource consumption.

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    DRG 847 Overview

    DRG 847 covers inpatient admissions for chemotherapy administration where acute leukemia is not listed as a secondary diagnosis and a Complication or Comorbidity is present. This Diagnosis-Related Group applies to medical oncology encounters focused on cytotoxic, hormonal, or targeted anticancer therapies given during a hospital stay. It matters for Medicare payment because the presence of a Complication or Comorbidity influences relative payment weight and resource intensity compared with non-CC chemotherapy admissions. Accurate coding of the principal diagnosis, secondary conditions, and procedure codes determines assignment to this Diagnosis-Related Group and the associated inpatient reimbursement.

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    National Payment Rates

    Across commercial payers the payment distribution spans from about $11K (BCBS minimum) up to $46K (Anthem maximum), with mean values clustering in the $11K–$21K range. The widest spread is seen with Anthem (min $390 to max $46K), indicating the largest payer-level variability. See the table and chart below for payer-specific medians, quartiles, and extremes.

    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 ($14.6k), average submitted covered charges ($61.9k), average Medicare payment ($11.2k), and total discharges (7.9k).

    Average Total PaymentAverage Submitted ChargesAverage Medicare PaymentTotal Discharges
    $15K$62K$11K7.9K

    Patient Population

    This DRG’s population is mixed but leans toward Medicare-age patients, reflecting a substantial share of encounters billed to Medicare alongside private/commercial payers. Many hospitalizations fall into the older-adult age groups typical of Medicare coverage, while a smaller portion is covered by working-age commercial plans. The payer mix therefore represents both Medicare-dominant and commercially insured patients rather than exclusively one age cohort.

    State Payment Rates

    State: Alaska1 / 49

    Alaska Benchmarks

    Alaska’s DRG 847 mean payments range from $20K to $32K across the represented payers, with Blue Cross Blue Shield and Anthem clustered at $20K and Cigna at $32K. The most notable deviation from national patterns is Cigna’s substantially higher mean in Alaska relative to the other local payers and common national medians. See the table and chart below for payer-specific distributions.

    Key Insights for Alaska

    • Highest payer: Cigna (mean $32K) — notably above other payers in Alaska.
    • Lowest payers: BCBS and Anthem (means $20K) — both sit well below Cigna and align at the state minimum.
    • State-level mean spread ($20K–$32K) shows Cigna materially exceeds the other local benchmarks and is higher than typical national medians for some payers.

    Clinical Trials

    • Trials evaluating novel outpatient chemotherapy delivery models and supportive-care protocols for adult patients receiving cytotoxic or targeted systemic therapy without concurrent acute leukemia: these studies investigate methods such as shorter infusion schedules, ambulatory infusion centers, and enhanced antiemetic or growth-factor prophylaxis to reduce inpatient admission length and prevent chemotherapy-related complications. The patient population includes solid-tumor and non-leukemia hematologic malignancy patients admitted for chemotherapy complications or administration who have comorbidities (CC) increasing risk of toxicity. Findings are relevant to providers and payers because optimized delivery and supportive care can lower inpatient utilization, reduce complication rates, and inform pathway-based reimbursement and resource allocation.
    • Comparative effectiveness studies assessing dose-intensity strategies and toxicity management protocols in patients with cancer and significant comorbid conditions: these trials compare different dosing regimens, treatment intervals, or adjunctive supportive interventions (for example, primary prophylactic growth factors versus reactive use) to balance disease control against treatment-related morbidity. Target populations are hospitalized adults receiving systemic therapy without secondary acute leukemia but with comorbidities that classify them in the CC category; outcomes include hospitalization days, transfusion needs, infection rates, and functional status. Results guide clinicians and payers on which protocols achieve equivalent oncologic outcomes with fewer complications and lower inpatient costs, informing DRG utilization patterns and bundled-payment considerations.
    • Post-discharge and outcomes research focused on transitional care, readmission reduction, and quality-of-life measurement for chemotherapy patients with complications: these observational and interventional studies test post-discharge care bundles, home-based nursing follow-up, telemonitoring, and symptom-management education to prevent readmissions and identify late adverse events. The studies enroll patients recently discharged after inpatient chemotherapy encounters complicated by comorbid conditions, tracking 30- to 90-day readmissions, emergency visits, patient-reported outcomes, and total cost of care. Evidence from this area is crucial for providers and payers to develop discharge criteria, case management strategies, and payment models that reduce costly readmissions while maintaining patient safety and quality.

    Related Codes

    820-LYMPHOMA-AND-LEUKEMIA-WITH-MAJOR-O-R-PROCEDURES-WITH-MCC

    Lymphoma and Leukemia with Major O.R. Procedures with MCC: Inpatient Reimbursement Overview

    821-LYMPHOMA-AND-LEUKEMIA-WITH-MAJOR-O-R-PROCEDURES-WITH-CC

    Lymphoma and Leukemia with Major O.R. Procedures with CC: Inpatient Reimbursement Overview

    822-LYMPHOMA-AND-LEUKEMIA-WITH-MAJOR-O-R-PROCEDURES-WITHOUT-CC-MCC

    Lymphoma and Leukemia with Major O.R. Procedures without CC/MCC: Inpatient Reimbursement Overview

    823-LYMPHOMA-AND-NON-ACUTE-LEUKEMIA-WITH-OTHER-PROCEDURES-WITH-MCC

    Lymphoma and Non-Acute Leukemia with Other Procedures with MCC: Inpatient Reimbursement Overview

    824-LYMPHOMA-AND-NON-ACUTE-LEUKEMIA-WITH-OTHER-PROCEDURES-WITH-CC

    Lymphoma and Non-Acute Leukemia with Other Procedures with CC: Inpatient Reimbursement Overview

    825-LYMPHOMA-AND-NON-ACUTE-LEUKEMIA-WITH-OTHER-PROCEDURES-WITHOUT-CC-MCC

    Lymphoma and Non-Acute Leukemia with Other Procedures without CC/MCC: Inpatient Reimbursement Overview

    826-MYELOPROLIFERATIVE-DISORDERS-OR-POORLY-DIFFERENTIATED-NEOPLASMS-WITH-MAJOR-O-R-PROCEDURES-WITH-MCC

    Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures with MCC: Inpatient Reimbursement Overview

    827-MYELOPROLIFERATIVE-DISORDERS-OR-POORLY-DIFFERENTIATED-NEOPLASMS-WITH-MAJOR-O-R-PROCEDURES-WITH-CC

    Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures with CC: Inpatient Reimbursement Overview

    828-MYELOPROLIFERATIVE-DISORDERS-OR-POORLY-DIFFERENTIATED-NEOPLASMS-WITH-MAJOR-O-R-PROCEDURES-WITHOUT-CC-MCC

    Myeloproliferative Disorders or Poorly Differentiated Neoplasms: Inpatient Reimbursement Overview

    829-MYELOPROLIFERATIVE-DISORDERS-OR-POORLY-DIFFERENTIATED-NEOPLASMS-WITH-OTHER-PROCEDURES-WITH-CC-MCC

    Myeloproliferative Disorders or Poorly Differentiated Neoplasms: Inpatient Reimbursement Overview

    Showing 1–10 of 27

    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 847
    Mean Rates by Payer — Alaska — DRG 847