Summary & Overview

Cesarean Section without Sterilization without CC/MCC: Inpatient Reimbursement Overview

DRG 788 encompasses uncomplicated cesarean section admissions without sterilization and without Major Complication or Comorbidity or Complication or Comorbidity. This classification defines the expected inpatient resource use and drives Centers for Medicare & Medicaid Services payment for routine cesarean deliveries.

Cesarean Section without Sterilization without CC/MCCDRG Cesarean Section without Sterilization without CC/MCCDRG 788Diagnosis-Related GroupInpatient ReimbursementMedicareObstetricsCesarean DeliveryHospital BillingPerinatal Care

DRG 788 Overview

DRG 788 covers inpatient hospital admissions for cesarean section without concurrent sterilization procedures and without any Major Complication or Comorbidity or Complication or Comorbidity present. This Diagnosis-Related Group applies to surgical obstetric deliveries where the patient’s course is uncomplicated by additional coded conditions that would raise resource use. It matters for Centers for Medicare & Medicaid Services payment because assignment to this DRG determines the base Medicare inpatient reimbursement and impacts hospital revenue for routine cesarean deliveries.

National Payment Rates

Across commercial payers the observed rate range spans roughly from $370 to $32K, with mean payments clustering between about $8.2K and $12K depending on payer. The widest spread is between the minimum and maximum reported values (about $370 to $32K), driven largely by Anthem and Cigna extremes. See the table and chart below for payer-specific distributions and percentile detail.

Mean Rates by Payer — National — DRG 788

The CMS 2023 data represent national Medicare fee-for-service inpatient payments published in the CMS Provider Utilization and Payment Data program. The table below shows average total payment ($8.8k), average submitted covered charges ($37.0k), average Medicare payment ($6.2k), and total discharges (692) for DRG 788.

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

AK rates for DRG 788 span from roughly $7.5K at the lower quartiles for Blue Cross Blue Shield and Anthem up to a $41K maximum reported for Cigna, with mean/median values of $15K for BCBS and Anthem and $24K/$23K for Cigna. The most notable deviation from national averages is Cigna’s substantially higher mean and max versus national medians near $12K. See the table and chart below for payer-level detail.

Key Insights for Alaska

Highest payer: Cigna (median $23K, mean $24K), lowest payers: Blue Cross Blue Shield and Anthem (median $15K, mean $15K). Cigna pays materially more than the other major carriers in the state.
State range across payers runs from about $7.5K (25th percentile for BCBS/Anthem) up to $41K (Cigna max), a wider spread than typical national medians and indicating a meaningful divergence from national averages where medians cluster around ~$12K.

Clinical Trials

Trials comparing surgical techniques and perioperative management during cesarean delivery: randomized or pragmatic studies assess outcomes of different incision types, methods for uterine closure, or anesthesia approaches (regional anesthesia variations and adjuncts) in term pregnant patients undergoing cesarean section without concurrent sterilization and without severe comorbidity. These studies focus on intraoperative metrics (blood loss, operative time), immediate maternal and neonatal outcomes (postpartum hemorrhage, infection, Apgar scores), and short-term resource use (length of stay, need for transfusion), informing clinicians about best practices to reduce complications and informing payers about expected costs and utilization patterns.
Comparative effectiveness research on strategies to prevent and manage common postoperative complications after cesarean: cohort studies or cluster-randomized trials examine interventions such as enhanced recovery protocols, antibiotic timing/duration, thromboprophylaxis strategies, or wound-care bundles in a general obstetric population without major complicating diagnoses. The goal is to quantify reductions in surgical site infection, readmission, thromboembolism, and prolonged hospitalization among typical cesarean patients, which is directly relevant to hospitals and payers trying to optimize quality metrics, reduce avoidable readmissions, and control inpatient reimbursement under the DRG.
Post-discharge observational and health outcomes studies evaluating maternal functional recovery, breastfeeding success, and infant health following uncomplicated cesarean: prospective registries and retrospective database analyses follow mothers and neonates from discharge through the postpartum period to measure pain trajectories, return to baseline activity, lactation outcomes, mental health, and outpatient utilization. These studies identify longer-term morbidity, outpatient service needs, and cost drivers after an uncomplicated cesarean, helping providers plan discharge counseling and care pathways and helping payers understand downstream costs associated with the index DRG admission.

Average Total Payment	Average Submitted Charges	Average Medicare Payment	Total Discharges
$8.8K	$37K	$6.2K	690

Trials comparing surgical techniques and perioperative management during cesarean delivery: randomized or pragmatic studies assess outcomes of different incision types, methods for uterine closure, or anesthesia approaches (regional anesthesia variations and adjuncts) in term pregnant patients undergoing cesarean section without concurrent sterilization and without severe comorbidity. These studies focus on intraoperative metrics (blood loss, operative time), immediate maternal and neonatal outcomes (postpartum hemorrhage, infection, Apgar scores), and short-term resource use (length of stay, need for transfusion), informing clinicians about best practices to reduce complications and informing payers about expected costs and utilization patterns.
Comparative effectiveness research on strategies to prevent and manage common postoperative complications after cesarean: cohort studies or cluster-randomized trials examine interventions such as enhanced recovery protocols, antibiotic timing/duration, thromboprophylaxis strategies, or wound-care bundles in a general obstetric population without major complicating diagnoses. The goal is to quantify reductions in surgical site infection, readmission, thromboembolism, and prolonged hospitalization among typical cesarean patients, which is directly relevant to hospitals and payers trying to optimize quality metrics, reduce avoidable readmissions, and control inpatient reimbursement under the DRG.
Post-discharge observational and health outcomes studies evaluating maternal functional recovery, breastfeeding success, and infant health following uncomplicated cesarean: prospective registries and retrospective database analyses follow mothers and neonates from discharge through the postpartum period to measure pain trajectories, return to baseline activity, lactation outcomes, mental health, and outpatient utilization. These studies identify longer-term morbidity, outpatient service needs, and cost drivers after an uncomplicated cesarean, helping providers plan discharge counseling and care pathways and helping payers understand downstream costs associated with the index DRG admission.

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Summary & Overview

Cesarean Section without Sterilization without CC/MCC: Inpatient Reimbursement Overview

DRG 788 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