What do procedure group and DRG mean?
Hospitals use a “procedure group” to generate their bill when a patient leaves the hospital after an inpatient stay. Hospitals don’t bill for all the procedures they perform for their inpatients. Instead, they bill for the one “procedure group” that includes the principal procedure performed during the hospitalization. Hospitals have about 500 procedure groups to choose from. Each has a number and a name. For example, procedure group #471 includes hip replacement, knee replacement, and four other operations. So if a patient undergoes a hip replacement operation, the hospital submits a bill for procedure group #471. If another patient undergoes a knee replacement, the hospital also submits a bill for procedure group #471. But if a patient has their spleen removed, the hospital submits a bill for a different procedure group: #233. If a patient undergoes a knee replacement and a heart transplant during the same hospital admission, the hospital will bill for procedure group #103 because th