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    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Hepatobiliary System and PancreasDRG 439-disorders-of-pancreas-except-malignancy-with-cc
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    Disorders of Pancreas Except Malignancy with CC: Inpatient Reimbursement Overview

    DRG 439 covers nonmalignant pancreatic disorders with one or more complication or comorbidity affecting inpatient resource needs. It matters for inpatient reimbursement because presence of complication or comorbidity elevates payment relative to cases without such conditions, reflecting increased clinical complexity and costs.

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    DRG 439 Overview

    DRG 439, Disorders of Pancreas Except Malignancy with Complication or Comorbidity, groups inpatient cases for nonmalignant pancreatic disorders such as acute pancreatitis or pancreatic cysts when a complication or comorbidity is present. This Diagnosis-Related Group matters for Medicare payment because it captures higher resource use driven by additional diagnoses, procedures, or prolonged monitoring. Accurate coding of the principal diagnosis and secondary conditions influences hospital reimbursement and case mix classification. Payers use this grouping to align payment with expected clinical complexity and resource consumption.

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    Clinical Trials

    • Acute management and procedural optimization trials: randomized or pragmatic studies comparing different acute interventions (such as endoscopic retrograde interventions, minimally invasive drainage techniques, or protocols for early versus delayed intervention) in hospitalized patients with nonmalignant pancreatic disorders complicated by organ dysfunction or local complications. These studies enroll adults admitted with acute pancreatitis, infected necrosis, or severe exacerbations of chronic pancreatitis requiring inpatient care, and examine short-term outcomes like infection control, need for ICU care, length of stay, and procedure-related complications. Results inform clinicians on best practices to reduce morbidity and resource use and help payers assess cost-effectiveness of competing acute care strategies for patients classified under this DRG.
    • Comparative effectiveness and medical management studies: trials or observational comparative studies evaluating pharmacologic and supportive care strategies (for example, different pain management regimens, fluid resuscitation protocols, nutritional approaches such as early enteral feeding versus parenteral support, or adjunctive antimicrobial stewardship) in patients hospitalized for nonmalignant pancreatic disorders with comorbidities. These studies target heterogeneous inpatient populations including those with comorbid cardiac, renal, or metabolic conditions that contribute to the presence of a CC, and measure outcomes like pain control, complication rates, readmission, and total hospital resource utilization. Findings are directly relevant to providers optimizing inpatient care pathways and to payers interested in interventions that reduce complications and downstream costs for DRG 439 admissions.
    • Post-discharge outcomes and transitional care studies: prospective cohort studies and randomized interventions focused on discharge planning, outpatient follow-up models, and secondary prevention strategies to reduce readmissions and long-term complications after hospital treatment for nonmalignant pancreatic disease. Populations include survivors of severe acute pancreatitis or patients with complicated chronic pancreatitis who often have high rates of readmission, ongoing pain, or nutritional deficits; studies evaluate care coordination, early outpatient clinic visits, patient education, and remote monitoring. These research efforts matter to clinicians and hospitals aiming to improve continuity of care and clinical outcomes, and to payers and health systems seeking to lower readmission rates and total episode-of-care expenditures associated with DRG 439.

    Related Codes

    405-PANCREAS-LIVER-AND-SHUNT-PROCEDURES-WITH-MCC

    Pancreas, Liver and Shunt Procedures with MCC: Inpatient Reimbursement Overview

    406-PANCREAS-LIVER-AND-SHUNT-PROCEDURES-WITH-CC

    Pancreas, Liver and Shunt Procedures with CC: Inpatient Reimbursement Overview

    407-PANCREAS-LIVER-AND-SHUNT-PROCEDURES-WITHOUT-CC-MCC

    Pancreas, Liver and Shunt Procedures without CC/MCC: Inpatient Reimbursement Overview

    408-BILIARY-TRACT-PROCEDURES-EXCEPT-ONLY-CHOLECYSTECTOMY-WITH-OR-WITHOUT-C-D-E-WITH-MCC

    Biliary Tract Procedures Except Only Cholecystectomy with or without C.D.E. with MCC: Inpatient Reimbursement Overview

    409-BILIARY-TRACT-PROCEDURES-EXCEPT-ONLY-CHOLECYSTECTOMY-WITH-OR-WITHOUT-C-D-E-WITH-CC

    Biliary Tract Procedures Except Only Cholecystectomy with or without C.D.E. with CC: Inpatient Reimbursement Overview

    410-BILIARY-TRACT-PROCEDURES-EXCEPT-ONLY-CHOLECYSTECTOMY-WITH-OR-WITHOUT-C-D-E-WITHOUT-CC-MCC

    Biliary Tract Procedures Except Only Cholecystectomy with or without C.D.E.: Inpatient Reimbursement Overview

    411-CHOLECYSTECTOMY-WITH-C-D-E-WITH-MCC

    Cholecystectomy with C.D.E. with MCC: Inpatient Reimbursement Overview

    412-CHOLECYSTECTOMY-WITH-C-D-E-WITH-CC

    Cholecystectomy with Common Duct Exploration with Complication or Comorbidity: Inpatient Reimbursement Overview

    413-CHOLECYSTECTOMY-WITH-C-D-E-WITHOUT-CC-MCC

    Cholecystectomy with C.D.E. without CC/MCC: Inpatient Reimbursement Overview

    414-CHOLECYSTECTOMY-EXCEPT-BY-LAPAROSCOPE-WITHOUT-C-D-E-WITH-MCC

    Cholecystectomy Except by Laparoscope without C.D.E. with MCC: Inpatient Reimbursement Overview

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    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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