Vaginal Delivery with Sterilization and/or D&C DRG Reimbursement

Vaginal Delivery with Sterilization and/or D&C without CC/MCC: Inpatient Reimbursement Overview

DRG 798 applies to vaginal delivery admissions that include sterilization and/or dilation and curettage without Major Complication or Comorbidity or Complication or Comorbidity; it defines the clinical scope and procedure mix captured in the inpatient claim. Accurate assignment matters for inpatient reimbursement because it determines the Medicare Severity Diagnosis-Related Group payment weight used to settle the hospital claim.

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DRG 798 Overview

DRG 798 covers inpatient hospital stays for vaginal delivery combined with tubal sterilization and/or dilation and curettage without Major Complication or Comorbidity or Complication or Comorbidity. This grouping reflects procedures performed during the delivery admission that increase resource use relative to an uncomplicated vaginal delivery. It matters for Medicare payment because it assigns the episode to a distinct payment weight that affects reimbursement for the hospital stay. Classification into this Diagnosis-Related Group depends on documented procedures and the absence of higher-severity diagnoses.

Clinical Trials

Studies evaluating intraoperative techniques to reduce procedural complications during concurrent sterilization or uterine curettage at the time of vaginal delivery: these trials compare surgical approaches, anesthesia methods, or adjunctive measures (for example, techniques to minimize blood loss or reduce infection risk) in patients undergoing vaginal delivery with immediate tubal ligation and/or D&C. The patient population includes postpartum women electing permanent sterilization or requiring uterine evacuation during the same admission, and outcomes measured include intraoperative blood loss, operative time, transfusion rates, infection, and short-term recovery. Findings inform providers about safest, most efficient perioperative practices and help payers anticipate resource utilization and justify bundled payment components for the delivery admission.
Comparative effectiveness studies of postpartum care pathways and length of stay for patients undergoing vaginal delivery with concomitant sterilization/D&C: these observational or pragmatic randomized studies assess different inpatient care models (for example, enhanced recovery protocols, early mobilization, or standardized discharge criteria) and their impact on complications, readmissions, breastfeeding initiation, and patient satisfaction. The focus population is term postpartum patients who had uncomplicated vaginal births but required same-stay sterilization or uterine procedures, with subgroup analyses for comorbidities such as anemia or obesity. Results are relevant to providers for optimizing clinical pathways and to payers for identifying opportunities to reduce unnecessary inpatient days and downstream costs while maintaining quality.
Post-discharge outcomes and health services research examining long-term reproductive, psychosocial, and healthcare utilization outcomes after sterilization or D&C performed at the time of vaginal delivery: cohort studies and registry analyses follow patients for contraceptive efficacy, regret or counseling adequacy, pelvic pain, mental health outcomes, and subsequent healthcare encounters (including complications or additional procedures). The studied population includes diverse sociodemographic groups who underwent immediate postpartum sterilization or uterine evacuation, enabling assessment of equity, counseling practices, and barriers to follow-up care. These data help clinicians improve informed consent and counseling processes and help payers understand long-term costs and quality implications associated with immediate postpartum procedures performed during the delivery admission.

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.

Studies evaluating intraoperative techniques to reduce procedural complications during concurrent sterilization or uterine curettage at the time of vaginal delivery: these trials compare surgical approaches, anesthesia methods, or adjunctive measures (for example, techniques to minimize blood loss or reduce infection risk) in patients undergoing vaginal delivery with immediate tubal ligation and/or D&C. The patient population includes postpartum women electing permanent sterilization or requiring uterine evacuation during the same admission, and outcomes measured include intraoperative blood loss, operative time, transfusion rates, infection, and short-term recovery. Findings inform providers about safest, most efficient perioperative practices and help payers anticipate resource utilization and justify bundled payment components for the delivery admission.
Comparative effectiveness studies of postpartum care pathways and length of stay for patients undergoing vaginal delivery with concomitant sterilization/D&C: these observational or pragmatic randomized studies assess different inpatient care models (for example, enhanced recovery protocols, early mobilization, or standardized discharge criteria) and their impact on complications, readmissions, breastfeeding initiation, and patient satisfaction. The focus population is term postpartum patients who had uncomplicated vaginal births but required same-stay sterilization or uterine procedures, with subgroup analyses for comorbidities such as anemia or obesity. Results are relevant to providers for optimizing clinical pathways and to payers for identifying opportunities to reduce unnecessary inpatient days and downstream costs while maintaining quality.
Post-discharge outcomes and health services research examining long-term reproductive, psychosocial, and healthcare utilization outcomes after sterilization or D&C performed at the time of vaginal delivery: cohort studies and registry analyses follow patients for contraceptive efficacy, regret or counseling adequacy, pelvic pain, mental health outcomes, and subsequent healthcare encounters (including complications or additional procedures). The studied population includes diverse sociodemographic groups who underwent immediate postpartum sterilization or uterine evacuation, enabling assessment of equity, counseling practices, and barriers to follow-up care. These data help clinicians improve informed consent and counseling processes and help payers understand long-term costs and quality implications associated with immediate postpartum procedures performed during the delivery admission.

Vaginal Delivery with Sterilization and/or D&C without CC/MCC: Inpatient Reimbursement Overview

Sign up for drg 798 policy alerts

DRG 798 Overview

Vaginal Delivery with Sterilization and/or D&C without CC/MCC: Inpatient Reimbursement Overview

Sign up for drg 798 policy alerts

DRG 798 Overview

Clinical Trials

Related Codes

References

Clinical Trials

Related Codes

References