Esophagitis, Gastroenteritis and Misc Digestive DRG 392 Reimbursement

Summary & Overview

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.

EsophagitisGastroenteritisDRG Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders without MCCDRG 392Diagnosis-Related GroupInpatient ReimbursementMedicareGastroenterologyHospital CodingClinical Documentation

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.

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.

Mean Rates by Payer — National — DRG 392

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).

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 without CC/MCC: Inpatient Reimbursement Overview

354-HERNIA-PROCEDURES-EXCEPT-INGUINAL-AND-FEMORAL-WITH-CC

Hernia Procedures Except Inguinal and Femoral with CC: Inpatient Reimbursement Overview

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

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

349-ANAL-AND-STOMAL-PROCEDURES-WITHOUT-CC-MCC

Anal and Stomal Procedures without CC/MCC: Inpatient Reimbursement Overview

333-RECTAL-RESECTION-WITH-CC

Rectal Resection with CC: Inpatient Reimbursement Overview

346-MINOR-SMALL-AND-LARGE-BOWEL-PROCEDURES-WITHOUT-CC-MCC

Minor Small and Large Bowel Procedures without CC/MCC: Inpatient Reimbursement Overview

353-HERNIA-PROCEDURES-EXCEPT-INGUINAL-AND-FEMORAL-WITH-MCC

Hernia Procedures Except Inguinal and Femoral 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

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

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

345-MINOR-SMALL-AND-LARGE-BOWEL-PROCEDURES-WITH-CC

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

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OpenPayer

Summary & Overview

Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders: Inpatient Reimbursement Overview

DRG 392 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