Claim import and validation workbench: parse 837I, FHIR, JSON, XML and UB-04 claims, regroup the MS-DRG and check it against the billed DRG

Independent pricing tool. Not affiliated with, endorsed by, or operated by CMS or any government agency. Estimates are not a claims determination.

Intake

Claim files

Up to 4 MB per file and 50 files per worklist. Each file is read in your browser and sent once to the parser; nothing is saved, put in links or kept in browser storage. Use test or de-identified claims.

Or paste a claim
Format: waiting for text

Options

Blank uses the CCN on each claim. A hospital is needed to price; grouping doesn't need one.

Picks the MS-DRG manual (grouper version). Blank uses the date on each claim.

Worklist

Saved sample results for three synthetic test claims, imported Oct 19, 2026 with the same parser and grouper. Add your own files, or press Process with a sample selected to run it live.
Imported claim files. Select a row to see its detail.
#FileClaimBilledRegroupedAgreesPaymentStatusRemove

Claim detail

Checks

Findings

    Actions

    Free tier

    Parsing, MS-DRG regrouping and DRG validation are free. Pricing inside an import counts toward the 40 priced claims a day without an API key, and covers a set of common MS-DRGs; other DRGs still group and validate, with a note in place of the price.

    Get an API key for every MS-DRG and higher limits

    Formats this reads

    837I (X12 5010 institutional)
    Bill type, diagnoses with POA, procedures, the billed DRG (HI DR), discharge status, dates, charges and SV2 service lines.
    FHIR R4 Claim (JSON or XML)
    Diagnoses, procedures, billing period and total. FHIR carries no discharge status or age, so add them before relying on transfer or age logic.
    JSON or XML claim
    A flat claim with diagnoses, procedures, age, sex, discharge status and DRG. Unrecognized XML is swept for code shapes and marked for review.
    UB-04 PDF
    Text-layer PDFs only (no scans). Codes are pattern-matched and always marked for review: confirm order, POA and the principal diagnosis.

    From claim file to validated DRG

    Drop one or more claim files. Each is parsed into its diagnoses, procedures, discharge status and service lines, then regrouped under the MS-DRG manual in force on its discharge date. When the claim carries its own DRG, the verdict shows whether the regrouped DRG agrees with it.

    Outpatient bill types are not given an MS-DRG; their service lines are screened for outpatient edits and priced line by line instead. The worklist exports to CSV for review.

    Questions

    Which formats are supported?

    837I (X12), FHIR R4 Claim and other JSON, XML, and text-based UB-04 PDFs.

    Is the file stored?

    No. The file is sent only to the pricing API for that request and is not kept in links or browser storage.

    Why was my claim not grouped?

    Outpatient bill types price under the outpatient system, and claims without diagnoses cannot be grouped. The page says which applies.