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    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Digestive SystemDRG 390-gastrointestinal-obstruction-without-cc-mcc
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    Gastrointestinal Obstruction without CC/MCC: Inpatient Reimbursement Overview

    DRG 390 addresses inpatient admissions for gastrointestinal obstruction without Complication or Comorbidity or Major Complication or Comorbidity, encompassing cases managed conservatively or with limited procedures. It matters for inpatient reimbursement because it groups similar resource use and severity to set Medicare payment under the inpatient prospective payment system.

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    DRG 390 Overview

    DRG 390 covers hospital admissions for gastrointestinal obstruction without Complication or Comorbidity or Major Complication or Comorbidity. Typical cases include small bowel or large bowel obstructions managed medically or with limited procedural intervention when no significant comorbid conditions are present. This Diagnosis-Related Group is used to classify severity and determine inpatient prospective payment amounts under Medicare. Correct DRG assignment influences hospital reimbursement and reflects resource use for straightforward obstruction cases.

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    National Payment Rates

    Across payers, negotiated rates for DRG 390 range from about $370 to $22K, with payer medians clustered between roughly $5.4K and $9.9K. The widest spread is between BCBS (min/max roughly $370–$16K) and Anthem (min/max roughly $390–$22K), reflecting substantial variation in high-end contractual rates. See the table and chart below for payer-specific distributions and percentile 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 390. Values are presented as national aggregates for the reporting year.

    Average Total PaymentAverage Submitted ChargesAverage Medicare PaymentTotal Discharges
    $5.7K$27K$3.5K18K

    Patient Population

    The DRG 390 population is mixed but skews toward Medicare-age adults, reflecting a higher representation of older patients in inpatient Medicare claims compared with commercial payers. Commercial/private plans cover a meaningful share of working-age adults, so the overall population includes both Medicare-age and working-age patients. Payer mix typically shows Medicare as a substantial segment of discharges for this DRG.

    State Payment Rates

    State: Alaska1 / 49

    Alaska Benchmarks

    Alaska’s DRG 390 rates cluster between $8.5K and $13K across payers, with Blue Cross Blue Shield reporting a uniform $8.5K and Cigna showing a median around $13K and a max up to $22K. The spread reflects a compact low end dominated by Blue Cross Blue Shield and Anthem at $8.5K, while Cigna meaningfully exceeds national medians with its higher center and upper tail. See the table and chart below for payer-level detail.

    Key Insights for Alaska

    • Anthem is the highest paying payer in Alaska (median ~$13K) while Blue Cross Blue Shield is the lowest (uniform $8.5K).
    • Cigna’s median (~$13K) and wider range up to $22K represent a meaningful upside versus national medians, indicating notable deviation above national average rates.

    Clinical Trials

    • Acute procedural and device intervention trials assessing endoscopic and minimally invasive techniques for relieving bowel obstruction: studies focus on comparing outcomes of urgent endoscopic decompression, stent placement, or laparoscopic adhesiolysis versus open surgical approaches in adults hospitalized with small or large bowel obstruction without major complications (no CC/MCC). These trials enroll patients presenting with acute obstructive symptoms requiring immediate intervention to determine procedural success rates, time to oral intake, and short-term safety. Results inform providers on procedure selection and timing, and help payers evaluate resource utilization, length of stay, and cost-effectiveness of less invasive approaches in this DRG.
    • Comparative effectiveness studies of nonoperative management strategies in patients with partial obstruction or adhesive small bowel obstruction: research compares outcomes of structured conservative care pathways (nasogastric decompression, bowel rest, IV fluids, and standardized monitoring) against early surgical intervention in hemodynamically stable patients without major comorbidities. These studies target the common inpatient population coded to this DRG to identify predictors of nonoperative success, rates of eventual surgery, and complication profiles. Findings guide clinicians on patient selection for conservative care and help payers anticipate readmission risk, inpatient resource needs, and avoidable surgeries.
    • Post-discharge outcomes and care-coordination studies examining recovery, readmission, and rehabilitation needs after hospitalization for gastrointestinal obstruction without CC/MCC: observational cohorts and interventional care-transition studies evaluate discharge planning, outpatient follow-up strategies, and patient education interventions aimed at reducing 30- and 90-day readmissions and optimizing functional recovery. They enroll patients discharged after noncomplicated obstruction management to assess predictors of recurrent obstruction, medication and diet adherence, and quality of life. This research is relevant to providers and payers by identifying high-risk patients for targeted interventions, informing outpatient resource allocation, and supporting value-based reimbursement models focused on reducing avoidable return hospitalizations.

    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.
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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 390
    Mean Rates by Payer — Alaska — DRG 390