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    v1.0.30
    OpenPayerBilling CodesInfectious and Parasitic Diseases, Systemic or Unspecified SitesDRG 855-infectious-and-parasitic-diseases-with-o-r-procedures-without-cc-mcc
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    Infectious and Parasitic Diseases with O.R. Procedures without CC/MCC: Inpatient Reimbursement Overview

    DRG 855 groups inpatient cases for infectious and parasitic diseases that required operating room procedures without Complication or Comorbidity or Major Complication or Comorbidity, reflecting the clinical focus on operative management of infection. This classification matters for inpatient reimbursement because it determines payment relative to resource intensity and coding specificity under Medicare payment rules.

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    DRG 855 Overview

    DRG 855 covers hospital admissions for infectious and parasitic diseases that require operating room procedures and do not involve a Complication or Comorbidity or a Major Complication or Comorbidity. Typical cases include surgical management of severe infections such as abscess drainage or debridement for necrotizing soft tissue infections where no additional coded complications are present. This Diagnosis-Related Group groups inpatient stays by resource use tied to operative infectious disease management and directly affects Medicare payment assignment and hospital billing classification.

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    Clinical Trials

    • Trials evaluating efficacy and safety of surgical source-control techniques for severe intra-abdominal or soft-tissue infections requiring operative intervention. These studies enroll adults and sometimes pediatric patients who present with complicated bacterial or parasitic infections that necessitate urgent or scheduled O.R. procedures (for example, drainage, debridement, resection, or repair). Research compares technical approaches, timing of operation, adjunctive intraoperative therapies, and short-term complication rates, providing data that inform surgical decision-making, length of stay, and resource use that affect inpatient reimbursement and care pathways.
    • Comparative effectiveness studies of perioperative antimicrobial strategies and stewardship interventions in patients undergoing surgery for infectious and parasitic diseases. These trials investigate different perioperative antibiotic regimens, duration of post-op therapy, and stewardship protocols in populations with documented infections requiring O.R. procedures (e.g., complicated appendicitis, necrotizing soft-tissue infection, or parasitic complications). Results are directly relevant to clinicians and payers because optimized antimicrobial use can reduce postoperative complications, readmissions, and costs, and influence DRG-level outcomes and quality metrics.
    • Post-discharge outcomes and health services research tracking functional recovery, readmission risk, and long-term sequelae after operative management of infectious/parasitic conditions. Cohorts include patients discharged after an index hospitalization with an O.R. procedure for infection, followed for 30–365 days to assess wound healing, recurrent infection, need for additional procedures, and utilization of home health or outpatient services. This research helps hospitals and payers understand downstream resource needs, identify high-risk subgroups for care coordination, and design interventions to reduce preventable readmissions and improve value under DRG-based payment.

    Related Codes

    853-INFECTIOUS-AND-PARASITIC-DISEASES-WITH-O-R-PROCEDURES-WITH-MCC

    Infectious and Parasitic Diseases with O.R. Procedures with MCC: Inpatient Reimbursement Overview

    854-INFECTIOUS-AND-PARASITIC-DISEASES-WITH-O-R-PROCEDURES-WITH-CC

    Infectious and Parasitic Diseases with O.R. Procedures with CC: Inpatient Reimbursement Overview

    856-POSTOPERATIVE-OR-POST-TRAUMATIC-INFECTIONS-WITH-O-R-PROCEDURES-WITH-MCC

    Postoperative or Post-Traumatic Infections with O.R. Procedures with MCC: Inpatient Reimbursement Overview

    857-POSTOPERATIVE-OR-POST-TRAUMATIC-INFECTIONS-WITH-O-R-PROCEDURES-WITH-CC

    Postoperative or Post-Traumatic Infections with O.R. Procedures with CC: Inpatient Reimbursement Overview

    858-POSTOPERATIVE-OR-POST-TRAUMATIC-INFECTIONS-WITH-O-R-PROCEDURES-WITHOUT-CC-MCC

    Postoperative or Post-Traumatic Infections with O.R. Procedures without CC/MCC: Inpatient Reimbursement Overview

    862-POSTOPERATIVE-AND-POST-TRAUMATIC-INFECTIONS-WITH-MCC

    Postoperative and Post-Traumatic Infections with MCC: Inpatient Reimbursement Overview

    863-POSTOPERATIVE-AND-POST-TRAUMATIC-INFECTIONS-WITHOUT-MCC

    Postoperative and Post-Traumatic Infections without MCC: Inpatient Reimbursement Overview

    864-FEVER-AND-INFLAMMATORY-CONDITIONS

    Fever and Inflammatory Conditions: Inpatient Reimbursement Overview

    865-VIRAL-ILLNESS-WITH-MCC

    Viral Illness with MCC: Inpatient Reimbursement Overview

    866-VIRAL-ILLNESS-WITHOUT-MCC

    Viral Illness without MCC: Inpatient Reimbursement Overview

    Showing 1–10 of 16

    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.