Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • 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.

    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Digestive SystemDRG 372-major-gastrointestinal-disorders-and-peritoneal-infections-with-cc
    Ask Trek AI about this page

    Major Gastrointestinal Disorders and Peritoneal Infections with CC: Inpatient Reimbursement Overview

    DRG 372 encompasses major gastrointestinal disorders and peritoneal infections with Complication or Comorbidity, capturing complex abdominal infectious and inflammatory conditions that increase inpatient resource use. This Diagnosis-Related Group matters for inpatient reimbursement because the Complication or Comorbidity designation elevates payment relative to cases without such complications, impacting hospital revenue and case-mix indexing under Medicare.

    Customize your policy alerts

    Sign up for drg 372 policy alerts

    Get alerted when payer policies referencing 372 are released or updated.

    Monitor payer policy activity

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

    DRG 372 Overview

    DRG 372 covers major gastrointestinal disorders and peritoneal infections with Complication or Comorbidity, including significant abdominal infections, severe inflammatory bowel disease exacerbations, and complex gastrointestinal surgical complications that require inpatient medical or surgical management. This Diagnosis-Related Group is important for Medicare payment because the presence of a Complication or Comorbidity raises relative resource use and payment compared with cases without such comorbidity, affecting hospital reimbursement and case-mix classification. Accurate documentation of diagnoses, procedures, and complications determines assignment to this Diagnosis-Related Group and thereby influences payment for inpatient stays.

    Table of contents

    Progress1 / 3

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • 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

    Clinical Trials

    • Acute surgical and critical care intervention trials: randomized or pragmatic studies evaluating timing, technique, and perioperative management for patients with major gastrointestinal disorders (such as perforated viscus, ischemic bowel, or severe diverticulitis) and peritoneal infections who require emergency laparotomy or source-control procedures. These trials enroll adults presenting with acute abdomen and sepsis, comparing approaches like damage-control surgery versus definitive repair, variations in peritoneal lavage or drain strategies, and optimized resuscitation protocols during the immediate inpatient period. Results inform surgeons, intensivists, and payers about outcomes tied to length of stay, complication rates, and resource intensity that drive DRG utilization and reimbursement for high-acuity admissions.
    • Comparative effectiveness and antimicrobial stewardship studies: observational cohorts and randomized trials comparing antibiotic selection, duration, and route (IV-to-oral switch) for complicated intra-abdominal infections and peritonitis in medically complex patients, including those with coexisting organ dysfunction or immunosuppression. These studies focus on clinical cure, recurrence, antimicrobial resistance patterns, and adverse events across heterogeneous inpatient populations receiving source control plus antimicrobial therapy. Evidence from these investigations guides inpatient antibiotic protocols and stewardship programs that can reduce readmissions, antibiotic-related costs, and downstream expenditures important to hospital case-mix management and payer risk adjustments.
    • Post-discharge outcomes and care-transition research: prospective studies and quality-improvement trials assessing early discharge planning, outpatient parenteral antimicrobial therapy (OPAT) pathways, rehabilitation needs, and readmission prevention for survivors of major GI disorders and peritoneal infections who had CC-level complications. Patient populations include those discharged with drains, wounds, or ongoing nutritional support; interventions evaluate coordinated home health, telemonitoring, and standardized follow-up to reduce complications and unplanned returns. Findings are relevant to providers and payers because improved transitions can shorten inpatient stays, lower readmission rates, and optimize total episode-of-care costs associated with this high-resource 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

    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

    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.