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

DRG 330 includes major small and large bowel procedures with a Complication or Comorbidity and captures cases requiring higher resource intensity than uncomplicated bowel surgeries. This matters for inpatient reimbursement because assignment to this Diagnosis-Related Group influences payment levels under Medicare prospective payment policies.

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DRG 330 Overview

DRG 330 covers inpatient admissions for major small and large bowel procedures when a Complication or Comorbidity is present. Typical cases include resections, anastomoses, or other extensive bowel operations complicated by conditions such as infection, significant bleeding, or other comorbid illnesses that affect perioperative management. This Diagnosis-Related Group matters for Medicare payment because the presence of a Complication or Comorbidity adjusts payment relative to lower-severity groupings, reflecting higher expected resource use. Accurate coding of diagnoses and procedures determines assignment to this Diagnosis-Related Group and therefore impacts reimbursement.

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

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DRG 330 Overview

National Payment Rates

Across commercial payers the observed payment range spans from about $23K to $90K, with the widest spread between Anthem (max $90K) and BCBS (median $23K) evident in the table and chart below. National averages cluster around the mid-$30Ks to high-$30Ks for Aetna, Cigna, Anthem, and BCBS, with variation by payer percentile. See the table and chart below for payer-specific percentiles and distribution details.

The CMS 2023 dataset reflects national Medicare fee-for-service inpatient payments reported in the CMS Provider Utilization and Payment Data program. The table below shows average total payment ($22.3k), average submitted covered charges ($111.0k), average Medicare payment amount ($17.9k), and total discharges (39.9k).

Average Total Payment	Average Submitted Charges	Average Medicare Payment	Total Discharges
$22K	$110K	$18K	40K

Patient Population

This DRG’s population skews toward a mixed-age cohort but with a significant Medicare representation — many discharges are Medicare-age rather than exclusively working-age. Commercial payers (Anthem, Cigna, Aetna, BCBS) cover a substantial portion of younger, working-age patients, producing a mixed payer mix. Overall, the population includes both Medicare and private/commercial beneficiaries.

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

DRG 330 payments in Alaska span from $7.5K to $100K across payers, yielding a wide rate range driven largely by Cigna’s substantially higher reimbursements. Blue Cross Blue Shield and Anthem cluster at lower levels (mean ~$34K, median ~$37K), creating a pronounced split between payers. This distribution departs from national patterns where means are more compressed. See the table and chart below for payer-specific detail.

Key Insights for Alaska

Highest payer: Cigna (max $100K, mean $60K, median $57K) is the top-paying payer in Alaska; Lowest payer: Blue Cross Blue Shield (BCBS) and Anthem share the lowest observed minimums (min $7.5K, mean $34K, median $37K).
Alaska’s payer range spans from $7.5K to $100K, wider than typical national spreads; Cigna’s mean ($60K) and max ($100K) meaningfully exceed national averages, while BCBS/Anthem means (~$34K) sit below national mean benchmarks.

Clinical Trials

Acute perioperative management trials: Studies testing protocols to optimize intraoperative and immediate postoperative care for adults undergoing major small and large bowel resections for conditions such as diverticulitis, obstruction, ischemia, or malignancy. These trials evaluate interventions like enhanced fluid and hemodynamic management, opioid-sparing analgesia bundles, and infection-prevention strategies to reduce perioperative morbidity and time in the intensive care unit. Results inform surgeons and hospitalists about approaches that can decrease complication rates, length of stay, and short-term resource utilization relevant to inpatient reimbursement and DRG assignment.
Comparative effectiveness studies of surgical approach and anastomotic strategies: Trials comparing open versus minimally invasive (laparoscopic or robotic-assisted) colectomy and varied anastomotic techniques or stoma-creation strategies in heterogeneous adult populations, including high-risk, elderly, and immunocompromised patients. These studies measure outcomes such as leak rates, reoperation, hospital readmission, functional recovery, and costs within the inpatient episode and early post-discharge period. Findings help providers select approaches that balance clinical outcomes with procedural cost and complexity, directly impacting DRG-related resource use and payer decisions.
Post-discharge outcomes and care-transition research: Prospective cohort studies or randomized trials evaluating structured discharge pathways, early outpatient follow-up, home nursing, and rehabilitation programs for patients discharged after major bowel surgery, particularly those with postoperative complications or ostomies. These studies focus on readmission prevention, management of ostomy care, nutrition and wound healing, and patient-reported outcomes over 30–90 days, aiming to identify interventions that lower readmissions and downstream costs. Payers and hospital systems use this evidence to design care bundles that improve recovery metrics tied to payment penalties and overall episode cost under DRG-based reimbursement.

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

329-MAJOR-SMALL-AND-LARGE-BOWEL-PROCEDURES-WITH-MCC

Major Small and Large Bowel Procedures with MCC: 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.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

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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.

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National Payment Rates

Mean Rates by Payer — National — DRG 330

Average Total Payment	Average Submitted Charges	Average Medicare Payment	Total Discharges
$22K	$110K	$18K	40K

Patient Population

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

Mean Rates by Payer — Alaska — DRG 330

Key Insights for Alaska

Highest payer: Cigna (max $100K, mean $60K, median $57K) is the top-paying payer in Alaska; Lowest payer: Blue Cross Blue Shield (BCBS) and Anthem share the lowest observed minimums (min $7.5K, mean $34K, median $37K).
Alaska’s payer range spans from $7.5K to $100K, wider than typical national spreads; Cigna’s mean ($60K) and max ($100K) meaningfully exceed national averages, while BCBS/Anthem means (~$34K) sit below national mean benchmarks.

Clinical Trials

Acute perioperative management trials: Studies testing protocols to optimize intraoperative and immediate postoperative care for adults undergoing major small and large bowel resections for conditions such as diverticulitis, obstruction, ischemia, or malignancy. These trials evaluate interventions like enhanced fluid and hemodynamic management, opioid-sparing analgesia bundles, and infection-prevention strategies to reduce perioperative morbidity and time in the intensive care unit. Results inform surgeons and hospitalists about approaches that can decrease complication rates, length of stay, and short-term resource utilization relevant to inpatient reimbursement and DRG assignment.
Comparative effectiveness studies of surgical approach and anastomotic strategies: Trials comparing open versus minimally invasive (laparoscopic or robotic-assisted) colectomy and varied anastomotic techniques or stoma-creation strategies in heterogeneous adult populations, including high-risk, elderly, and immunocompromised patients. These studies measure outcomes such as leak rates, reoperation, hospital readmission, functional recovery, and costs within the inpatient episode and early post-discharge period. Findings help providers select approaches that balance clinical outcomes with procedural cost and complexity, directly impacting DRG-related resource use and payer decisions.
Post-discharge outcomes and care-transition research: Prospective cohort studies or randomized trials evaluating structured discharge pathways, early outpatient follow-up, home nursing, and rehabilitation programs for patients discharged after major bowel surgery, particularly those with postoperative complications or ostomies. These studies focus on readmission prevention, management of ostomy care, nutrition and wound healing, and patient-reported outcomes over 30–90 days, aiming to identify interventions that lower readmissions and downstream costs. Payers and hospital systems use this evidence to design care bundles that improve recovery metrics tied to payment penalties and overall episode cost under DRG-based reimbursement.

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

329-MAJOR-SMALL-AND-LARGE-BOWEL-PROCEDURES-WITH-MCC

Major Small and Large Bowel Procedures with MCC: 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.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

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

OpenPayer

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

Sign up for Major Small and Large Bowel Procedures with CC: Inpatient Reimbursement Overview policy alerts

DRG 330 Overview

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OpenPayer

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

Sign up for Major Small and Large Bowel Procedures with CC: Inpatient Reimbursement Overview policy alerts

DRG 330 Overview

National Payment Rates

Patient Population

State Payment Rates

Alaska Benchmarks

Key Insights for Alaska

Clinical Trials

Related Codes

References

National Payment Rates

Patient Population

State Payment Rates

Alaska Benchmarks

Key Insights for Alaska

Clinical Trials

Related Codes

References