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    OpenPayerBilling CodesDiseases and Disorders of the Digestive SystemDRG 331-major-small-and-large-bowel-procedures-without-cc-mcc
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    Major Small and Large Bowel Procedures without CC/MCC: Inpatient Reimbursement Overview

    DRG 331 applies to inpatient stays involving major small and large bowel procedures without Complication or Comorbidity or Major Complication or Comorbidity, defining a mid-range surgical complexity payment group. Correct assignment matters for inpatient reimbursement because it determines the standardized Medicare payment for these surgical admissions.

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    DRG 331 Overview

    DRG 331 covers inpatient admissions for major small and large bowel surgical procedures when no Complication or Comorbidity and no Major Complication or Comorbidity are present. Typical cases include resections, anastomoses, or other significant bowel operations performed without documented additional complicating diagnoses. This Diagnosis-Related Group matters because it groups cases of moderate surgical complexity into a standardized Medicare payment category that informs hospital reimbursement. Accurate clinical coding and documentation determine assignment to DRG 331 and thus affect payment.

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    National Payment Rates

    Across commercial payers the reported mean rates for DRG 331 span roughly from $16K (BCBS) up to $28K (Aetna/Cigna), with Anthem and Aetna/Cigna clustered in the mid-to-high $20Ks. The widest spread between payer means is about $12K (BCBS mean $16K vs Cigna/Aetna mean $28K). See the table and chart below for payer-level percentiles and distributions.

    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 331. These figures summarize nationwide Medicare payment activity for the DRG in 2023.

    Average Total PaymentAverage Submitted ChargesAverage Medicare PaymentTotal Discharges
    $16K$80K$12K19K

    Patient Population

    The patient population for DRG 331 skews toward Medicare-age beneficiaries rather than primarily working-age commercial enrollees. While commercial payers still cover a portion of cases, the distribution is weighted to older adults under Medicare fee-for-service. Overall the mix is more Medicare-heavy than predominantly working-age.

    State Payment Rates

    State: Alaska1 / 49

    Alaska Benchmarks

    In Alaska for DRG 331, reimbursements range from minimums as low as $7.5K up to maximums of $72K across payers, with Anthem and BCBS clustered around a mean of $25K and a median of $26K while Cigna shows a higher mean ($42K) and median ($40K). The most notable deviation from national averages is the wider local spread and lower minimums in Alaska compared with national benchmarks, suggesting greater variability in rates. See the table and chart below for the detailed payer distributions.

    Key Insights for Alaska

    • Anthem is the highest paying payer with a max of $41K and a mean of $25K; BCBS matches Anthem’s distribution in this state dataset.
    • Cigna is the lowest paying payer in terms of the median/mean range here (median $40K, mean $42K shows higher mean but wider spread), however BCBS/Anthem display the lowest minimums at $7.5K.
    • Compared with national benchmarks, Alaska’s payers show a wider spread between minimum and maximum rates (min as low as $7.5K vs national minimums generally higher), indicating greater local variability in reimbursements.

    Clinical Trials

    • Perioperative optimization and enhanced recovery pathway trials: randomized or pragmatic trials testing perioperative bundles (including goal-directed fluid therapy, multimodal analgesia, early feeding, and standardized mobilization) for adult patients undergoing major small and large bowel resections without CC/MCC. These studies enroll generally lower-acuity surgical patients to evaluate reductions in length of stay, postoperative ileus, and complication rates. Results are directly relevant to providers and payers because improved pathways can lower inpatient resource use, readmissions, and total episode costs for this DRG.
    • Comparative effectiveness studies of surgical approaches and anastomotic techniques: prospective cohort studies or randomized trials comparing minimally invasive versus open colectomy/enteric resection, different anastomotic configurations (stapled vs hand-sewn), or intraoperative adjuncts (e.g., bowel perfusion assessment) in patients with non-complicated indications such as neoplasia or benign obstruction. These trials focus on operative time, wound and intra-abdominal infection rates, return of bowel function, and short-term morbidity, informing which approaches yield better clinical outcomes for the relatively healthier population captured by this DRG. Payers and hospitals use this evidence to guide procedure selection, resource allocation, and benchmarking of surgical quality measures.
    • Post-discharge outcomes and health services research: observational studies and interventional trials examining post-discharge recovery, opioid use, functional status, and unplanned readmissions in patients discharged after major bowel procedures without complications. These investigations often target transition-of-care interventions (enhanced discharge instructions, telehealth follow-up, or targeted home nursing) and patient-reported outcomes to identify drivers of early readmission or poor recovery. Findings are important to clinicians and payers because reducing readmissions and improving functional recovery affects bundled payment performance, reimbursement risk, and overall value of care for this DRG.

    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

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

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

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

    Major Small and Large Bowel Procedures with CC: 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.
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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.

    Mean Rates by Payer — National — DRG 331
    Mean Rates by Payer — Alaska — DRG 331