Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.30
    OpenPayerBilling CodesDiseases and Disorders of the Digestive SystemDRG 329-major-small-and-large-bowel-procedures-with-mcc
    Ask Trek AI about this page

    Major Small and Large Bowel Procedures with MCC: Inpatient Reimbursement Overview

    DRG 329 encompasses major small and large bowel procedures performed in the presence of a Major Complication or Comorbidity and is used to classify high-acuity surgical admissions for inpatient reimbursement. It matters for Medicare payment because the presence of a Major Complication or Comorbidity increases the Diagnosis-Related Group severity assignment and typically results in higher inpatient reimbursement to reflect greater resource use.

    Customize your policy alerts

    Sign up for drg 329 policy alerts

    Get alerted when payer policies referencing 329 are released or updated.

    Monitor payer policy activity

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

    DRG 329 Overview

    DRG 329 covers major small and large bowel surgical procedures when a Major Complication or Comorbidity is present, typically including extensive resections, anastomoses, or procedures for perforation, ischemia, obstruction, or severe inflammatory disease with significant physiologic instability. This Diagnosis-Related Group groups higher-resource cases with critical intraoperative or postoperative complexity, which increases allowable Medicare inpatient reimbursement relative to less complex bowel procedure groups. Accurate capture of principal procedure codes and documented Major Complication or Comorbidity drives appropriate payment assignment. The grouping reflects expected higher resource use, longer inpatient stays, and greater clinical intensity.

    Table of contents

    Progress1 / 5

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    National Payment Rates

    Across commercial payers the negotiated rate range for DRG 329 spans from $40K (BCBS min) up to $170K (Anthem max), with payer medians clustered between $42K and $80K. The widest spread between payer minimums and maximums is seen with Anthem versus BCBS at roughly $130K. See the table and chart below for payer-specific quartiles and distribution details.

    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, average submitted covered charges, average Medicare payment amount, and total discharges for DRG 329. These figures reflect Medicare FFS payment experience at the national level for 2023.

    Average Total PaymentAverage Submitted ChargesAverage Medicare PaymentTotal Discharges
    $42K$200K$36K31K

    Patient Population

    This DRG’s population skews toward Medicare-age beneficiaries rather than predominantly working-age adults, reflecting a higher share of hospitalizations among those 65 and older. Commercial payers (including Blue Cross Blue Shield, UnitedHealth, Cigna, Aetna, and Anthem) cover a minority portion of episodes relative to Medicare, indicating a mixed but Medicare-leaning payer mix. The age distribution therefore trends older, with working-age patients representing a smaller proportion of the population.

    State Payment Rates

    State: Alaska1 / 49

    Alaska Benchmarks

    In Alaska, rates for DRG 329 span from a low median of $71K (Blue Cross Blue Shield/Anthem) to a high median of $110K (Cigna), with mean values ranging roughly $64K–$110K across payers. The most notable deviation versus national averages is Cigna’s substantially higher median of $110K compared with typical national medians around $70K–$80K. See the table and chart below for payer-specific distributions.

    Key Insights for Alaska

    • Highest payer: Cigna with a median of $110K and a mean of $110K, representing the top compensation level in the state.
    • Lowest payer: BCBS/Anthem (both share the same AK benchmarks) with a median of $71K and a mean of $64K, representing the low end of the state range.
    • Meaningful deviation: Cigna’s median of $110K sits well above the AK medians for BCBS/Anthem ($71K) and is also notably higher than national medians for comparable payers, indicating a pronounced state-level spread.

    Clinical Trials

    • Acute perioperative intervention trials focusing on strategies to reduce surgical morbidity and mortality in patients undergoing major small and large bowel resections for emergent or complicated disease (for example ischemic bowel, perforation, or obstructive malignancy). These studies enroll high-acuity inpatients typically with sepsis risk, hemodynamic instability, or contamination of the peritoneal cavity and test interventions such as optimized fluid resuscitation protocols, timing of source control, intraoperative techniques to reduce anastomotic leak, or standardized sepsis bundles. Findings are directly relevant to surgeons, intensivists, and hospital payers because improvements can reduce ICU days, reoperation rates, complication-related coding changes (MCC attribution), and overall inpatient costs.
    • Comparative effectiveness trials evaluating surgical approaches and perioperative care pathways for elective or semi-elective major bowel procedures in patients with underlying malignancy, inflammatory bowel disease, or complex diverticular disease. These studies compare open versus minimally invasive techniques, primary anastomosis versus staged procedures with diversion, or enhanced recovery after surgery (ERAS) protocols, and typically enroll patients who are stable enough for definitive operations but have high comorbidity burdens. Results inform decisions about procedure selection and care standardization that affect length of stay, readmission risk, and resource utilization—key concerns for clinicians and payers seeking to optimize outcomes while controlling reimbursement-driven metrics.
    • Post-discharge and outcomes research focusing on long-term functional recovery, stoma reversal timing, and health-care utilization among survivors of major small and large bowel surgery who incurred major complications during the index admission. These cohort or pragmatic studies follow patients after discharge to measure readmissions, persistent organ dysfunction, return to baseline nutrition and mobility, and durable quality-of-life outcomes, often stratified by presence of MCC during the hospitalization. Providers and payers rely on this evidence to design transitional care programs, determine follow-up intensity, and predict downstream costs associated with chronic care needs or late complications stemming from the index DRG episode.

    Related Codes

    326-STOMACH-ESOPHAGEAL-AND-DUODENAL-PROCEDURES-WITH-MCC

    Stomach, Esophageal and Duodenal Procedures with MCC: Inpatient Reimbursement Overview

    327-STOMACH-ESOPHAGEAL-AND-DUODENAL-PROCEDURES-WITH-CC

    Stomach, Esophageal and Duodenal Procedures with CC: Inpatient Reimbursement Overview

    328-STOMACH-ESOPHAGEAL-AND-DUODENAL-PROCEDURES-WITHOUT-CC-MCC

    Stomach, Esophageal and Duodenal Procedures without CC/MCC: Inpatient Reimbursement Overview

    330-MAJOR-SMALL-AND-LARGE-BOWEL-PROCEDURES-WITH-CC

    Major Small and Large Bowel Procedures with CC: Inpatient Reimbursement Overview

    331-MAJOR-SMALL-AND-LARGE-BOWEL-PROCEDURES-WITHOUT-CC-MCC

    Major Small and Large Bowel Procedures without CC/MCC: Inpatient Reimbursement Overview

    332-RECTAL-RESECTION-WITH-MCC

    Rectal Resection with MCC: Inpatient Reimbursement Overview

    333-RECTAL-RESECTION-WITH-CC

    Rectal Resection with CC: Inpatient Reimbursement Overview

    334-RECTAL-RESECTION-WITHOUT-CC-MCC

    Rectal Resection without CC/MCC: Inpatient Reimbursement Overview

    335-PERITONEAL-ADHESIOLYSIS-WITH-MCC

    Peritoneal Adhesiolysis with MCC: Inpatient Reimbursement Overview

    336-PERITONEAL-ADHESIOLYSIS-WITH-CC

    Peritoneal Adhesiolysis with CC: Inpatient Reimbursement Overview

    Showing 1–10 of 57

    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.
    Published by

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

    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.

    Mean Rates by Payer — National — DRG 329
    Mean Rates by Payer — Alaska — DRG 329