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    v1.0.30
    OpenPayerBilling CodesMultiple Significant TraumaDRG 959-other-o-r-procedures-for-multiple-significant-trauma-without-cc-mcc
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    Other O.R. Procedures for Multiple Significant Trauma without CC/MCC: Inpatient Reimbursement Overview

    DRG 959 includes other operating room procedures performed for patients with multiple significant trauma when there are no Major Complication or Comorbidity or Complication or Comorbidity present. It defines the inpatient clinical scope and payment grouping that affects hospital reimbursement under Medicare for trauma surgical care without additional coded severity.

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    DRG 959 Overview

    DRG 959 covers inpatient cases involving other operating room procedures performed for patients with multiple significant traumatic injuries when no Major Complication or Comorbidity or Complication or Comorbidity is present. Typical cases include various surgical interventions addressing trauma-related injuries that do not meet higher severity groupings. This Diagnosis-Related Group matters for Medicare payment because it groups resource use and sets reimbursement expectations for hospitals treating complex trauma without additional coded complications. Accurate coding and documentation determine assignment to this Diagnosis-Related Group and the associated payment level.

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    Clinical Trials

    • Acute operative techniques and timing trials: randomized or prospective cohort studies comparing different surgical approaches, timing of operative intervention (immediate vs staged), or damage-control surgery protocols in adult patients with multiple significant traumatic injuries requiring non-standard O.R. procedures. These studies enroll polytrauma patients classified without major comorbidities (no CC/MCC) who need operative management beyond routine fracture fixation, and assess short-term physiological stabilization, operative blood loss, transfusion use, and in-hospital complication rates. Results inform surgeons, trauma program leaders, and payers about resource intensity during the index admission, optimal operating room resource allocation, and potential short-term cost differences associated with alternative acute operative strategies.
    • Comparative effectiveness studies of perioperative care bundles and complication prevention: pragmatic trials or observational comparative studies evaluating components such as prophylactic antibiotics timing, VTE prophylaxis regimens, infection-control bundles for open wounds, and standardized protocols for ICU admission versus ward care after complex O.R. procedures. These studies focus on heterogeneous trauma patients who underwent other O.R. procedures (e.g., soft-tissue reconstruction, complex debridement, or vascular repairs) to reduce surgical site infections, thromboembolic events, and reoperations during the inpatient stay. For providers and payers, evidence in this area helps identify care processes that reduce length of stay, readmissions, and costly inpatient complications that drive reimbursement and quality metrics for DRG 959.
    • Post-discharge functional outcomes and utilization research: longitudinal cohort studies and registries following survivors of multiple significant trauma who had nonroutine O.R. procedures to measure functional recovery, return-to-work, rehabilitation needs, and post-acute healthcare utilization up to 12 months. These studies stratify by injury pattern and index inpatient care details to link specific operative interventions and in-hospital complications with downstream use of home health, inpatient rehab, readmissions, and durable medical equipment. Findings are relevant for discharge planners, case managers, and payers to forecast post-acute service needs, inform bundled-payment models, and target early interventions that may reduce long-term costs and improve patient-centered outcomes.

    Related Codes

    955-CRANIOTOMY-FOR-MULTIPLE-SIGNIFICANT-TRAUMA

    Craniotomy for Multiple Significant Trauma: Inpatient Reimbursement Overview

    956-LIMB-REATTACHMENT-HIP-AND-FEMUR-PROCEDURES-FOR-MULTIPLE-SIGNIFICANT-TRAUMA

    Limb Reattachment, Hip and Femur Procedures for Multiple Significant Trauma: Inpatient Reimbursement Overview

    957-OTHER-O-R-PROCEDURES-FOR-MULTIPLE-SIGNIFICANT-TRAUMA-WITH-MCC

    Other O.R. Procedures for Multiple Significant Trauma with MCC: Inpatient Reimbursement Overview

    958-OTHER-O-R-PROCEDURES-FOR-MULTIPLE-SIGNIFICANT-TRAUMA-WITH-CC

    Other O.R. Procedures for Multiple Significant Trauma with CC: Inpatient Reimbursement Overview

    963-OTHER-MULTIPLE-SIGNIFICANT-TRAUMA-WITH-MCC

    Other Multiple Significant Trauma with MCC: Inpatient Reimbursement Overview

    964-OTHER-MULTIPLE-SIGNIFICANT-TRAUMA-WITH-CC

    Other Multiple Significant Trauma with CC: Inpatient Reimbursement Overview

    965-OTHER-MULTIPLE-SIGNIFICANT-TRAUMA-WITHOUT-CC-MCC

    Other Multiple Significant Trauma without CC/MCC: Inpatient Reimbursement Overview

    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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