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    OpenPayerBilling CodesInfectious and Parasitic Diseases, Systemic or Unspecified SitesDRG 857-postoperative-or-post-traumatic-infections-with-o-r-procedures-with-cc
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    Postoperative or Post-Traumatic Infections with O.R. Procedures with CC: Inpatient Reimbursement Overview

    DRG 857 covers postoperative or post-traumatic infections requiring operating room procedures and coded with a Complication or Comorbidity. It matters for inpatient reimbursement because the operating room procedure plus the documented Complication or Comorbidity increases resource use and influences Medicare payment under the inpatient prospective payment system.

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    DRG 857 Overview

    DRG 857 covers inpatient encounters for postoperative or post-traumatic infections that required an operating room procedure and are coded with a Complication or Comorbidity. These cases typically involve surgical debridement, drainage, or revision procedures for wound infections, hardware-related infections, or abscesses following trauma or prior surgery. This Diagnosis-Related Group is relevant to Medicare payment because the presence of a Complication or Comorbidity increases resource intensity compared with cases without such comorbid conditions, influencing Hospital reimbursement under the inpatient prospective payment system. Accurate documentation and coding of the infection, associated procedures, and comorbid conditions determine assignment to DRG 857 and the resulting payment weight.

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    Clinical Trials

    • Acute surgical intervention and antimicrobial timing trials: randomized or prospective cohort studies assessing the impact of different intraoperative source-control strategies (for example, extent of debridement, use of negative-pressure wound therapy adjuncts, or timing of reoperation) and the timing and route of empirical antibiotics in patients presenting with postoperative or post‑traumatic infections requiring OR procedures. These studies enroll adult and sometimes pediatric inpatients who require operative management for wound, soft-tissue, or deep surgical-site infections and aim to identify approaches that reduce ongoing sepsis, need for additional operations, and length of stay. Results inform surgeons and hospital payers about interventions that can shorten ICU/hospital days and reduce readmissions and resource utilization.
    • Comparative effectiveness and antibiotic stewardship studies: pragmatic trials or observational comparative-effectiveness research comparing shorter versus standard durations of systemic antimicrobial therapy, oral step-down strategies after source control, or institution-level stewardship bundles in patients with complicated postoperative or post‑traumatic infections that had operative management. These studies focus on heterogeneous hospital populations, including those with comorbidities or device-related infections, to evaluate clinical cure, adverse events, antimicrobial resistance emergence, and total inpatient costs. Findings are directly relevant to providers and payers because optimized antibiotic use can lower medication costs, decrease adverse event–related expenditures, and impact quality metrics and reimbursement tied to antimicrobial stewardship.
    • Post-discharge outcomes and care-transition studies: prospective cohort studies and care‑coordination interventions that follow patients after discharge from hospital for surgical-site infections treated with OR procedures, examining readmission rates, wound-healing trajectories, outpatient intravenous antibiotic needs, home health utilization, and patient-reported outcomes. The population includes patients with complicated postoperative or traumatic wound infections who may require prolonged outpatient care or device management (eg, drains, wound VACs); studies evaluate which discharge planning, telehealth follow‑up, or outpatient infusion models reduce rehospitalization and overall cost. This research helps hospitals and payers identify effective post-acute care pathways that improve outcomes while minimizing readmissions and high-cost inpatient care.

    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

    855-INFECTIOUS-AND-PARASITIC-DISEASES-WITH-O-R-PROCEDURES-WITHOUT-CC-MCC

    Infectious and Parasitic Diseases with O.R. Procedures without CC/MCC: 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

    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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