Abstract: The present invention provides a system and method for calculating claim reimbursement recommendations. A medical claim is received and grouped to an rDRG or a median cost value. All similar hospital cases based on the same rDRG are identified. Costs of all comparison cases are then adjusted based on hospital's wage index. Using a pre-selected methodology, the initial target reimbursement amount is calculated. Any applicable override rules and/or inflation factors are then applied to arrive at the reimbursement amount. All relevant information on reimbursement amount and how the amount was calculated is presented to the user.