Major Esophageal Disorders DRG 370 Reimbursement Rates

Summary & Overview

Major Esophageal Disorders without CC/MCC: Inpatient Reimbursement Overview

DRG 370 encompasses major esophageal disorders without a Complication or Comorbidity or Major Complication or Comorbidity and includes conditions such as motility disorders and uncomplicated strictures that require inpatient care. It matters for inpatient reimbursement because Medicare payment is grouped by Diagnosis-Related Group to reflect expected resource use for cases without higher-severity comorbidities.

Major Esophageal DisordersDRG Major Esophageal Disorders without CC/MCCDRG 370Diagnosis-Related GroupInpatient ReimbursementMedicareGastroenterologyThoracic SurgeryEsophageal MotilityEsophageal Stricture

DRG 370 Overview

DRG 370 covers hospital inpatient stays for major esophageal disorders that do not carry a Complication or Comorbidity or a Major Complication or Comorbidity. Typical clinical cases include esophageal motility disorders, non-perforated strictures, and other significant esophageal conditions treated medically or with non-complex procedures. This Diagnosis-Related Group matters for Medicare payment because it groups patients with similar clinical complexity and expected resource use to determine bundled reimbursement. Hospitals use the DRG assignment to anticipate payment relative to case mix and length of stay.

National Payment Rates

Across payers the negotiated rates for DRG 370 range roughly from $6.2K to $27K, with the widest spread driven by Anthem versus BCBS/Cigna/Aetna. Refer to the table and chart below for payer-level quartiles and the distribution of contracted rates. Payer variability highlights differing commercial reimbursement patterns across Aetna, Anthem, BCBS, and Cigna.

Mean Rates by Payer — National — DRG 370

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

Alaska exhibits a notable payer range for DRG 370, with Cigna paying up to $28K (mean $17K) while Anthem and Blue Cross Blue Shield are clustered at $11K across percentiles. This represents a sizable deviation from national central tendencies, where medians for comparable payers are generally lower and less dispersed. Reference the table and chart below for the full percentile breakdown by payer.

Key Insights for Alaska

Highest paying payer: Cigna (max $28K, mean $17K); Lowest paying payers: Anthem and Blue Cross Blue Shield (both mean $11K, max $11K).
Alaska’s mean reimbursement centers around Cigna at $17K versus Anthem/BCBS at $11K, a meaningful state-level spread that exceeds typical national medians and highlights a substantial payer-driven variation.

Clinical Trials

Acute endoscopic and perioperative management studies: randomized or prospective cohort studies focusing on timing, techniques, and perioperative care for patients undergoing endoscopic dilation, stenting, or surgical interventions for major esophageal disorders (eg, severe achalasia, refractory strictures, or large motility-related obstruction) during the index hospitalization. These trials enroll inpatients with acute obstructive symptoms or those requiring urgent procedural intervention and compare procedural approaches, sedation/anesthesia strategies, and short-term complication mitigation protocols. Results are directly relevant to providers and payers because they inform resource utilization, length of stay, complication rates, and immediate hospital costs tied to DRG payments.
Comparative effectiveness and quality-of-life trials for definitive therapies: pragmatic comparative studies evaluating longer-term outcomes of different definitive treatment strategies (eg, myotomy variants, endoscopic myotomy vs surgical options, or different dilation protocols) in patients who present electively or during hospitalization for major esophageal disease but require durable therapy. These studies follow patients across the care continuum to assess symptom control, readmission rates, downstream healthcare use, and functional outcomes over months to years, capturing real-world effectiveness rather than surrogate physiologic measures. Findings guide clinicians and payers on which approaches yield better long-term value, reduced rehospitalizations, and improved patient-reported outcomes relevant to bundled payment and post-acute care planning.
Post-discharge outcomes, readmission prevention, and care coordination research: observational cohorts and interventional studies testing discharge planning, outpatient monitoring, rehabilitation, and nutrition support strategies for patients discharged after treatment for major esophageal disorders, including those with feeding tube dependence or complex dysphagia. These studies target patients at high risk for early readmission, aspiration, or malnutrition and evaluate interventions such as structured follow-up, telemonitoring, and integrated multidisciplinary clinics to reduce complications after hospital discharge. This research area matters to hospital administrators and payers because reducing 30-day readmissions, preventing post-acute complications, and optimizing transitions of care can substantially affect total cost of care and DRG-based reimbursement performance.

Gastrointestinal Obstruction 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

355-HERNIA-PROCEDURES-EXCEPT-INGUINAL-AND-FEMORAL-WITHOUT-CC-MCC

Hernia Procedures Except Inguinal and Femoral without CC/MCC: Inpatient Reimbursement Overview

375-DIGESTIVE-MALIGNANCY-WITH-CC

Digestive Malignancy with CC: Inpatient Reimbursement Overview

351-INGUINAL-AND-FEMORAL-HERNIA-PROCEDURES-WITH-CC

Inguinal and Femoral Hernia Procedures with CC: Inpatient Reimbursement Overview

374-DIGESTIVE-MALIGNANCY-WITH-MCC

Digestive Malignancy with Major Complication or Comorbidity: Inpatient Reimbursement Overview

356-OTHER-DIGESTIVE-SYSTEM-O-R-PROCEDURES-WITH-MCC

Other Digestive System O.R. Procedures with MCC: Inpatient Reimbursement Overview

344-MINOR-SMALL-AND-LARGE-BOWEL-PROCEDURES-WITH-MCC

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

347-ANAL-AND-STOMAL-PROCEDURES-WITH-MCC

Anal and Stomal Procedures with Major Complication or Comorbidity: Inpatient Reimbursement Overview

376-DIGESTIVE-MALIGNANCY-WITHOUT-CC-MCC

Digestive Malignancy without CC/MCC: Inpatient Reimbursement Overview

Showing 1–10 of 57

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.

Average Total Payment	Average Submitted Charges	Average Medicare Payment	Total Discharges
$7.2K	$36K	$5.2K	340

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

Mean Rates by Payer — Alaska — DRG 370

Key Insights for Alaska

Highest paying payer: Cigna (max $28K, mean $17K); Lowest paying payers: Anthem and Blue Cross Blue Shield (both mean $11K, max $11K).
Alaska’s mean reimbursement centers around Cigna at $17K versus Anthem/BCBS at $11K, a meaningful state-level spread that exceeds typical national medians and highlights a substantial payer-driven variation.

Clinical Trials

Acute endoscopic and perioperative management studies: randomized or prospective cohort studies focusing on timing, techniques, and perioperative care for patients undergoing endoscopic dilation, stenting, or surgical interventions for major esophageal disorders (eg, severe achalasia, refractory strictures, or large motility-related obstruction) during the index hospitalization. These trials enroll inpatients with acute obstructive symptoms or those requiring urgent procedural intervention and compare procedural approaches, sedation/anesthesia strategies, and short-term complication mitigation protocols. Results are directly relevant to providers and payers because they inform resource utilization, length of stay, complication rates, and immediate hospital costs tied to DRG payments.
Comparative effectiveness and quality-of-life trials for definitive therapies: pragmatic comparative studies evaluating longer-term outcomes of different definitive treatment strategies (eg, myotomy variants, endoscopic myotomy vs surgical options, or different dilation protocols) in patients who present electively or during hospitalization for major esophageal disease but require durable therapy. These studies follow patients across the care continuum to assess symptom control, readmission rates, downstream healthcare use, and functional outcomes over months to years, capturing real-world effectiveness rather than surrogate physiologic measures. Findings guide clinicians and payers on which approaches yield better long-term value, reduced rehospitalizations, and improved patient-reported outcomes relevant to bundled payment and post-acute care planning.
Post-discharge outcomes, readmission prevention, and care coordination research: observational cohorts and interventional studies testing discharge planning, outpatient monitoring, rehabilitation, and nutrition support strategies for patients discharged after treatment for major esophageal disorders, including those with feeding tube dependence or complex dysphagia. These studies target patients at high risk for early readmission, aspiration, or malnutrition and evaluate interventions such as structured follow-up, telemonitoring, and integrated multidisciplinary clinics to reduce complications after hospital discharge. This research area matters to hospital administrators and payers because reducing 30-day readmissions, preventing post-acute complications, and optimizing transitions of care can substantially affect total cost of care and DRG-based reimbursement performance.

Gastrointestinal Obstruction 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

355-HERNIA-PROCEDURES-EXCEPT-INGUINAL-AND-FEMORAL-WITHOUT-CC-MCC

Hernia Procedures Except Inguinal and Femoral without CC/MCC: Inpatient Reimbursement Overview

375-DIGESTIVE-MALIGNANCY-WITH-CC

Digestive Malignancy with CC: Inpatient Reimbursement Overview

351-INGUINAL-AND-FEMORAL-HERNIA-PROCEDURES-WITH-CC

Inguinal and Femoral Hernia Procedures with CC: Inpatient Reimbursement Overview

374-DIGESTIVE-MALIGNANCY-WITH-MCC

Digestive Malignancy with Major Complication or Comorbidity: Inpatient Reimbursement Overview

356-OTHER-DIGESTIVE-SYSTEM-O-R-PROCEDURES-WITH-MCC

Other Digestive System O.R. Procedures with MCC: Inpatient Reimbursement Overview

344-MINOR-SMALL-AND-LARGE-BOWEL-PROCEDURES-WITH-MCC

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

347-ANAL-AND-STOMAL-PROCEDURES-WITH-MCC

Anal and Stomal Procedures with Major Complication or Comorbidity: Inpatient Reimbursement Overview

376-DIGESTIVE-MALIGNANCY-WITHOUT-CC-MCC

Digestive Malignancy without CC/MCC: Inpatient Reimbursement Overview

Showing 1–10 of 57

OpenPayer

Summary & Overview

Major Esophageal Disorders without CC/MCC: Inpatient Reimbursement Overview

DRG 370 Overview

National Payment Rates

State Payment Rates

Alaska Benchmarks

Key Insights for Alaska

Clinical Trials

Related Codes

Patient Population

State Payment Rates

Alaska Benchmarks

Key Insights for Alaska

Clinical Trials

Related Codes