Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders: Inpatient Reimbursement Overview

DRG 392 encompasses esophagitis, gastroenteritis, and miscellaneous digestive disorders without Major Complication or Comorbidity, covering primarily non-severe inflammatory and infectious digestive conditions. This grouping matters for inpatient reimbursement because it assigns a single prospective payment for typical lower-severity digestive admissions under Medicare.

Customize your policy alerts

Sign up for drg 392 policy alerts

Get alerted when payer policies referencing 392 are released or updated.

Monitor payer policy activity

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

DRG 392 Overview

DRG 392 covers hospitalizations for esophagitis, gastroenteritis, and a range of miscellaneous digestive disorders without a Major Complication or Comorbidity. Typical cases include inflammatory or infectious conditions of the esophagus and stomach, acute gastroenteritis, and other non-severe digestive diagnoses that do not trigger higher-severity payment. This Diagnosis-Related Group is important for Medicare payment because it groups clinically related lower-severity digestive admissions into a single prospective payment rate, affecting hospital reimbursement and resource classification. Accurate coding and documentation determine assignment to this Diagnosis-Related Group rather than higher-severity groups.

Explore openpayer tools

View all tools

Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders: Inpatient Reimbursement Overview

Customize your policy alerts

Sign up for drg 392 policy alerts

Get alerted when payer policies referencing 392 are released or updated.

Monitor payer policy activity

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

DRG 392 Overview

National Payment Rates

Payer rates range from a low of $1.1K (BCBS p25) up to $27K (Anthem max) across the commercial benchmarks, with mean rates clustered between roughly $7.2K and $13K depending on payer. Anthem and Aetna show the highest upper-end maximums, while BCBS reports the lowest median-level values. The widest spread between payer extremes is between the $1.1K benchmark point and the $27K maximum shown in the table and chart below.

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 ($7.5k), average submitted covered charges ($38.3k), average Medicare payment amount ($5.5k), and total discharges (91.1k).

Average Total Payment	Average Submitted Charges	Average Medicare Payment	Total Discharges
$7.5K	$38K	$5.5K	91K

Patient Population

This DRG’s patient population skews toward a mixed-age cohort with a meaningful portion of Medicare-age beneficiaries alongside working-age, commercially insured patients. Medicare fee-for-service volumes are substantial but commercial payers also contribute a sizable share of discharges, indicating a mixed payer mix rather than exclusively Medicare-aged or exclusively working-age.

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

State rates for DRG 392 in Alaska range from roughly $7.5K up to $33K across payers, with mean values clustering near $13K–$19K. Cigna sits at the high end (mean $19K, max $33K), while Anthem and Blue Cross Blue Shield report lower central tendencies (median $12K, p25 $7.5K). Compared with national averages, Alaska’s Cigna mean is a notable upward deviation. See the table and chart below for detailed payer-level benchmarks.

Key Insights for Alaska

Highest payer: Cigna (mean $19K, max $33K); Lowest payer: Anthem/BCBS (mean $13K, min $7.5K).
Alaska’s mean rates skew higher for Cigna relative to national means, with Cigna’s $19K mean notably above national Cigna mean (~$13K), indicating a meaningful positive deviation.
Anthem and Blue Cross Blue Shield in AK align with lower end of state distribution (medians $12K, p25 $7.5K), close to or slightly above national medians for those payers.

Clinical Trials

Acute management interventional studies: Trials testing rapid symptom control strategies for hospitalized patients presenting with severe esophagitis, gastroenteritis, or other acute digestive disorders (for example, studies of antiemetic protocols, IV rehydration regimens, or endoscopic hemostasis approaches). These studies enroll patients at presentation or during the inpatient stay to evaluate short‑term clinical endpoints such as time to symptom resolution, need for intensive care, length of stay, and readmission within 30 days. Results inform inpatient care pathways and resource use, helping providers optimize acute treatment and payers anticipate and manage short‑term costs associated with this DRG.
Comparative effectiveness and diagnostics studies: Prospective or pragmatic trials comparing diagnostic algorithms and medical management strategies for common non‑MCC digestive conditions (for instance, comparing early endoscopy versus conservative management in esophagitis with bleeding risk, or stool testing strategies for infectious gastroenteritis). These studies focus on heterogenous adult populations admitted for digestive complaints to determine which approaches yield better diagnostic yield, fewer complications, and lower unnecessary utilization. Findings guide evidence‑based selection of tests and treatments, influencing provider decision making and payer coverage policies to reduce variation and inappropriate use of high‑cost services.
Post‑discharge outcomes and health services research: Cohort studies and randomized implementation trials measuring post‑discharge outcomes such as 30‑ and 90‑day readmissions, outpatient follow‑up adherence, quality of life, and costs for patients hospitalized with esophagitis, gastroenteritis, or other non‑MCC digestive disorders. These studies often evaluate transitional care interventions (discharge education, care coordination, telehealth follow‑up) in older adults and patients with comorbidities who are at higher risk of return visits. Results are relevant to hospitals and payers seeking to reduce readmissions, improve outpatient management, and align reimbursement and care pathways for this DRG.

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.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.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.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.

Explore openpayer tools

View all tools

National Payment Rates

Mean Rates by Payer — National — DRG 392

Average Total Payment	Average Submitted Charges	Average Medicare Payment	Total Discharges
$7.5K	$38K	$5.5K	91K

Patient Population

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

Mean Rates by Payer — Alaska — DRG 392

Key Insights for Alaska

Highest payer: Cigna (mean $19K, max $33K); Lowest payer: Anthem/BCBS (mean $13K, min $7.5K).
Alaska’s mean rates skew higher for Cigna relative to national means, with Cigna’s $19K mean notably above national Cigna mean (~$13K), indicating a meaningful positive deviation.
Anthem and Blue Cross Blue Shield in AK align with lower end of state distribution (medians $12K, p25 $7.5K), close to or slightly above national medians for those payers.

Clinical Trials

Acute management interventional studies: Trials testing rapid symptom control strategies for hospitalized patients presenting with severe esophagitis, gastroenteritis, or other acute digestive disorders (for example, studies of antiemetic protocols, IV rehydration regimens, or endoscopic hemostasis approaches). These studies enroll patients at presentation or during the inpatient stay to evaluate short‑term clinical endpoints such as time to symptom resolution, need for intensive care, length of stay, and readmission within 30 days. Results inform inpatient care pathways and resource use, helping providers optimize acute treatment and payers anticipate and manage short‑term costs associated with this DRG.
Comparative effectiveness and diagnostics studies: Prospective or pragmatic trials comparing diagnostic algorithms and medical management strategies for common non‑MCC digestive conditions (for instance, comparing early endoscopy versus conservative management in esophagitis with bleeding risk, or stool testing strategies for infectious gastroenteritis). These studies focus on heterogenous adult populations admitted for digestive complaints to determine which approaches yield better diagnostic yield, fewer complications, and lower unnecessary utilization. Findings guide evidence‑based selection of tests and treatments, influencing provider decision making and payer coverage policies to reduce variation and inappropriate use of high‑cost services.
Post‑discharge outcomes and health services research: Cohort studies and randomized implementation trials measuring post‑discharge outcomes such as 30‑ and 90‑day readmissions, outpatient follow‑up adherence, quality of life, and costs for patients hospitalized with esophagitis, gastroenteritis, or other non‑MCC digestive disorders. These studies often evaluate transitional care interventions (discharge education, care coordination, telehealth follow‑up) in older adults and patients with comorbidities who are at higher risk of return visits. Results are relevant to hospitals and payers seeking to reduce readmissions, improve outpatient management, and align reimbursement and care pathways for this DRG.

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.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.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.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.

OpenPayer

Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders: Inpatient Reimbursement Overview

Sign up for drg 392 policy alerts

DRG 392 Overview

OpenPayer

Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders: Inpatient Reimbursement Overview

Sign up for drg 392 policy alerts

DRG 392 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