Vein Ligation and Stripping: Inpatient Reimbursement Overview

DRG 263 addresses inpatient admissions for vein ligation and stripping procedures used to treat varicose veins and related venous disorders. Understanding this Diagnosis-Related Group is important for inpatient reimbursement because it defines the bundled Medicare payment for the surgical episode and associated hospital resources.

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DRG 263 Overview

DRG 263 covers inpatient admissions for vein ligation and stripping procedures, typically performed to treat varicose veins and venous insufficiency. This Diagnosis-Related Group captures the surgical procedure, associated perioperative care, and any included inpatient stay. It matters for Medicare payment because the bundled reimbursement reflects expected resource use for the operation and recovery, influencing hospital classification and payment for these cases. Payers and hospitals monitor this DRG to align coding, billing, and case mix considerations with payment policies.

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Vein Ligation and Stripping: Inpatient Reimbursement Overview

Customize your policy alerts

Sign up for drg 263 policy alerts

Get alerted when payer policies referencing 263 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

DRG 263 Overview

National Payment Rates

Across commercial payers, negotiated rates range roughly from $370 to $90K, with payer medians spanning about $21K to $53K depending on insurer; the widest spread is seen between Anthem (min $390, max $90K) and Cigna (min $27K, max $87K). See the table and chart below for payer-specific distributions and quartiles. Payer-level medians highlight variation among Blue Cross Blue Shield, Cigna, Aetna, and Anthem.

The CMS 2023 data represent national Medicare fee-for-service inpatient payments reported under the CMS Provider Utilization and Payment Data program. The table below shows average total payment ($28.8k), average submitted covered charges ($137.0k), average Medicare payment ($21.4k), and total discharges (219).

Average Total Payment	Average Submitted Charges	Average Medicare Payment	Total Discharges
$29K	$140K	$21K	220

Patient Population

This DRG’s population includes a mix of Medicare-age and working-age patients, with a meaningful share captured in the Medicare fee-for-service data and additional volume reflected in commercial payer benchmarks. The presence of 219 Medicare discharges in the CMS dataset indicates moderate representation among Medicare beneficiaries, while commercial median payments suggest substantial non-Medicare activity among working-age insured populations. Overall, the population skews mixed between Medicare and private/commercial payers rather than exclusively Medicare-age.

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

In Alaska, mean rates for DRG 263 span from $48K to $74K across payers, with BCBS and Anthem clustered at $48K and Cigna markedly higher at $74K. This produces a wide state range driven mostly by Cigna’s higher mean, which deviates above several national benchmarks. See the table and chart below for payer-specific detail.

Key Insights for Alaska

Highest payer: Cigna at a mean of $74K; Lowest payers: BCBS and Anthem at a mean of $48K each.
Alaska’s payer mean range ($48K–$74K) shows Cigna paying notably above the state’s other payers and above national means for some payers, while BCBS and Anthem sit below or near national medians.

Clinical Trials

Surgical technique and perioperative complication reduction studies: trials comparing different operative approaches (open vein stripping versus minimally invasive ligation and endovenous thermal or non-thermal ablation adjuncts) or enhanced perioperative protocols focus on intraoperative blood loss, nerve injury, and wound infection rates. These studies enroll adult patients undergoing inpatient vein ligation and stripping for symptomatic varicose veins or venous insufficiency, often including those with large tributary varicosities or comorbidities that necessitate inpatient care. Results are directly relevant to surgeons and hospital administrators because they inform procedural choices, resource utilization, and short-term complication rates that drive length of stay and immediate reimbursement under DRG 263.
Comparative effectiveness and cost-consequence research across care settings: pragmatic trials and cohort studies comparing outcomes and total costs for inpatient vein ligation and stripping versus outpatient/ambulatory endovenous alternatives or staged hybrid procedures examine readmission, reintervention rates, and patient-reported symptom relief over 6–12 months. These studies typically enroll heterogeneous adult populations including older patients or those with cardiovascular or wound-healing comorbidities who might be preferentially treated as inpatients. Findings help payers and hospital finance teams assess whether shifting appropriate cases to outpatient pathways or selecting particular techniques reduces overall episode cost while maintaining quality, thus impacting authorization and bundled payment decisions for DRG-associated episodes.
Post-discharge functional outcomes and long-term recurrence studies: observational cohorts and registry-based research tracking wound healing, venous ulcer recurrence, chronic pain, and quality-of-life measures for 1–3 years after inpatient vein procedures focus on durability of symptom relief and late complications such as recurrent varicosities or chronic venous insufficiency progression. These studies target patients with advanced disease, venous ulcers, or significant comorbidity profiles who often generate higher post-acute care needs and follow-up utilization. The evidence informs clinicians and payers about expected long-term resource use, surveillance intervals, and potential need for additional interventions that influence total cost of care and readmission penalties tied to episodes initiated under DRG 263.

Related Codes

209-COMPLEX-AORTIC-ARCH-PROCEDURES

Complex Aortic Arch Procedures: Inpatient Reimbursement Overview

212-CONCOMITANT-AORTIC-AND-MITRAL-VALVE-PROCEDURES

Concomitant Aortic and Mitral Valve Procedures: Inpatient Reimbursement Overview

213-ENDOVASCULAR-ABDOMINAL-AORTA-WITH-ILIAC-BRANCH-PROCEDURES

Endovascular Abdominal Aorta with Iliac Branch Procedures: Inpatient Reimbursement Overview

215-OTHER-HEART-ASSIST-SYSTEM-IMPLANT

Other Heart Assist System Implant: Inpatient Reimbursement Overview

216-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITH-CARDIAC-CATHETERIZATION-WITH-MCC

Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with MCC: Inpatient Reimbursement Overview

217-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITH-CARDIAC-CATHETERIZATION-WITH-CC

Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with CC: Inpatient Reimbursement Overview

218-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITH-CARDIAC-CATHETERIZATION-WITHOUT-CC-MCC

Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization without CC/MCC: Inpatient Reimbursement Overview

219-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITHOUT-CARDIAC-CATHETERIZATION-WITH-MCC

Cardiac Valve and Other Major Cardiothoracic Procedures with MCC: Inpatient Reimbursement Overview

220-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITHOUT-CARDIAC-CATHETERIZATION-WITH-CC

Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization with CC: Inpatient Reimbursement Overview

221-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITHOUT-CARDIAC-CATHETERIZATION-WITHOUT-CC-MCC

Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization without CC/MCC: Inpatient Reimbursement Overview

Showing 1–10 of 100

References

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.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.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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Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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National Payment Rates

Mean Rates by Payer — National — DRG 263

Average Total Payment	Average Submitted Charges	Average Medicare Payment	Total Discharges
$29K	$140K	$21K	220

Patient Population

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

Mean Rates by Payer — Alaska — DRG 263

Key Insights for Alaska

Highest payer: Cigna at a mean of $74K; Lowest payers: BCBS and Anthem at a mean of $48K each.
Alaska’s payer mean range ($48K–$74K) shows Cigna paying notably above the state’s other payers and above national means for some payers, while BCBS and Anthem sit below or near national medians.

Clinical Trials

Surgical technique and perioperative complication reduction studies: trials comparing different operative approaches (open vein stripping versus minimally invasive ligation and endovenous thermal or non-thermal ablation adjuncts) or enhanced perioperative protocols focus on intraoperative blood loss, nerve injury, and wound infection rates. These studies enroll adult patients undergoing inpatient vein ligation and stripping for symptomatic varicose veins or venous insufficiency, often including those with large tributary varicosities or comorbidities that necessitate inpatient care. Results are directly relevant to surgeons and hospital administrators because they inform procedural choices, resource utilization, and short-term complication rates that drive length of stay and immediate reimbursement under DRG 263.
Comparative effectiveness and cost-consequence research across care settings: pragmatic trials and cohort studies comparing outcomes and total costs for inpatient vein ligation and stripping versus outpatient/ambulatory endovenous alternatives or staged hybrid procedures examine readmission, reintervention rates, and patient-reported symptom relief over 6–12 months. These studies typically enroll heterogeneous adult populations including older patients or those with cardiovascular or wound-healing comorbidities who might be preferentially treated as inpatients. Findings help payers and hospital finance teams assess whether shifting appropriate cases to outpatient pathways or selecting particular techniques reduces overall episode cost while maintaining quality, thus impacting authorization and bundled payment decisions for DRG-associated episodes.
Post-discharge functional outcomes and long-term recurrence studies: observational cohorts and registry-based research tracking wound healing, venous ulcer recurrence, chronic pain, and quality-of-life measures for 1–3 years after inpatient vein procedures focus on durability of symptom relief and late complications such as recurrent varicosities or chronic venous insufficiency progression. These studies target patients with advanced disease, venous ulcers, or significant comorbidity profiles who often generate higher post-acute care needs and follow-up utilization. The evidence informs clinicians and payers about expected long-term resource use, surveillance intervals, and potential need for additional interventions that influence total cost of care and readmission penalties tied to episodes initiated under DRG 263.

Related Codes

209-COMPLEX-AORTIC-ARCH-PROCEDURES

Complex Aortic Arch Procedures: Inpatient Reimbursement Overview

212-CONCOMITANT-AORTIC-AND-MITRAL-VALVE-PROCEDURES

Concomitant Aortic and Mitral Valve Procedures: Inpatient Reimbursement Overview

213-ENDOVASCULAR-ABDOMINAL-AORTA-WITH-ILIAC-BRANCH-PROCEDURES

Endovascular Abdominal Aorta with Iliac Branch Procedures: Inpatient Reimbursement Overview

215-OTHER-HEART-ASSIST-SYSTEM-IMPLANT

Other Heart Assist System Implant: Inpatient Reimbursement Overview

216-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITH-CARDIAC-CATHETERIZATION-WITH-MCC

Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with MCC: Inpatient Reimbursement Overview

217-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITH-CARDIAC-CATHETERIZATION-WITH-CC

Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with CC: Inpatient Reimbursement Overview

218-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITH-CARDIAC-CATHETERIZATION-WITHOUT-CC-MCC

Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization without CC/MCC: Inpatient Reimbursement Overview

219-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITHOUT-CARDIAC-CATHETERIZATION-WITH-MCC

Cardiac Valve and Other Major Cardiothoracic Procedures with MCC: Inpatient Reimbursement Overview

220-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITHOUT-CARDIAC-CATHETERIZATION-WITH-CC

Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization with CC: Inpatient Reimbursement Overview

221-CARDIAC-VALVE-AND-OTHER-MAJOR-CARDIOTHORACIC-PROCEDURES-WITHOUT-CARDIAC-CATHETERIZATION-WITHOUT-CC-MCC

Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization without CC/MCC: Inpatient Reimbursement Overview

Showing 1–10 of 100

References

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.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.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.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.