Vaginal Delivery without Sterilization or D&C DRG Reimbursement

Summary & Overview

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

DRG 807 addresses uncomplicated vaginal delivery without sterilization or dilation and curettage and without Complication or Comorbidity or Major Complication or Comorbidity; it encompasses routine inpatient obstetric care for term deliveries without additional documented complications. This classification matters for inpatient reimbursement because it assigns a lower payment weight reflective of typical resource use for straightforward vaginal births under Centers for Medicare & Medicaid Services payment policies.

DRG Vaginal Delivery without Sterilization or D&C without CC/MCCDRG 807Diagnosis-Related GroupInpatient ReimbursementMedicareObstetricsVaginal DeliveryMaternity Care

DRG 807 Overview

DRG 807 covers vaginal delivery without sterilization or dilation and curettage and without Complication or Comorbidity or Major Complication or Comorbidity. It applies to uncomplicated term deliveries where neither a concurrent sterilization procedure nor uterine curettage is performed, and no additional documented complications increase resource use. This Diagnosis-Related Group matters for Medicare payment because it classifies routine inpatient obstetric stays into a lower-weighted payment category, influencing hospital reimbursement for uncomplicated deliveries. Understanding the clinical scope helps hospitals and payers align coding and billing for straightforward vaginal births.

National Payment Rates

Across payers the observed payment range runs from about $370 up to $22K, with mean values clustering between roughly $5.8K and $9.3K depending on payer; the widest spread is seen between the lowest minimum ($370) and the highest maximum ($22K). Refer to the table and chart below for payer-specific distributions and percentile detail. Payer labels shown include Blue Cross Blue Shield, UnitedHealth Group, Cigna, Aetna, and Anthem.

Mean Rates by Payer — National — DRG 807

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

DRG 807 rates in Alaska range from roughly $7.5K up to $29K across payers, with most commercial payers clustered around the $10K–$17K range. Cigna stands out with notably higher mean and upper-percentile values compared with Blue Cross Blue Shield and Anthem. This state-level pattern departs from national averages, where medians are generally lower; see the table and chart below for payer-specific details.

Key Insights for Alaska

Highest payer: Cigna (max $29K, mean $17K) is the top-paying payer in Alaska; Lowest payer: Blue Cross Blue Shield (max $16K, mean $11K) and Anthem share the lower range (min $7.5K–$7.6K, mean $11K).
Alaska rates are generally higher than national medians for these payers, with Cigna in AK (median $16K) substantially above Cigna national median $9.1K, indicating a meaningful upward deviation from national rates.
Payer spread in AK is wide (roughly $7.5K–$29K), driven primarily by Cigna’s higher upper-end values compared with Blue Cross Blue Shield and Anthem.

Clinical Trials

Studies evaluating protocols to reduce intrapartum complications and optimize labor management for low-risk vaginal deliveries: randomized or pragmatic trials compare active labor management strategies (e.g., timing of labor augmentation, criteria for operative vaginal delivery) in term, singleton, cephalic pregnancies without significant comorbidity. These trials focus on otherwise healthy obstetric patients typical of DRG 807 and assess short-term maternal and neonatal outcomes such as perineal trauma, postpartum hemorrhage, neonatal resuscitation, and length of stay. Results inform providers on best practices that can decrease maternal morbidity and resource use, and help payers predict variability in inpatient costs and avoidable interventions.
Comparative effectiveness research on pain management and anesthesia approaches during vaginal delivery: cohort studies or randomized trials examine outcomes of different analgesic strategies (e.g., neuraxial versus alternative pain control methods, timing and dosing of epidural analgesia) among women electing or requiring analgesia during labor. The population includes term vaginal deliveries without complicating procedures, and outcomes include maternal satisfaction, labor duration, rates of assisted delivery, and neonatal breastfeeding initiation. Findings guide clinical protocols that affect staffing, anesthesia resource allocation, and downstream costs relevant to hospital reimbursement under this DRG.
Post-discharge observational and quality-of-care studies assessing postpartum recovery, readmission, and breastfeeding outcomes after uncomplicated vaginal delivery: prospective cohorts and registry analyses follow patients from discharge through the early postpartum period to measure readmission rates for issues such as infection or hemorrhage, maternal mental health screening uptake, and breastfeeding success. These studies target the typical DRG 807 population to identify predictors of readmission and unmet needs in outpatient follow-up, informing discharge planning, transitional care interventions, and payer strategies to reduce avoidable readmissions and improve value-based outcomes.

Other Antepartum Diagnoses with O.R. Procedures without CC/MCC: Inpatient Reimbursement Overview

783-CESAREAN-SECTION-WITH-STERILIZATION-WITH-MCC

Cesarean Section with Sterilization with MCC: Inpatient Reimbursement Overview

784-CESAREAN-SECTION-WITH-STERILIZATION-WITH-CC

Cesarean Section with Sterilization with CC: Inpatient Reimbursement Overview

787-CESAREAN-SECTION-WITHOUT-STERILIZATION-WITH-CC

Cesarean Section without Sterilization with CC: Inpatient Reimbursement Overview

805-VAGINAL-DELIVERY-WITHOUT-STERILIZATION-OR-D-C-WITH-MCC

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

769-POSTPARTUM-AND-POST-ABORTION-DIAGNOSES-WITH-O-R-PROCEDURES

Postpartum and Post Abortion Diagnoses with O.R. Procedures: Inpatient Reimbursement Overview

833-OTHER-ANTEPARTUM-DIAGNOSES-WITHOUT-O-R-PROCEDURES-WITHOUT-CC-MCC

Other Antepartum Diagnoses without O.R. Procedures without CC/MCC: Inpatient Reimbursement Overview

832-OTHER-ANTEPARTUM-DIAGNOSES-WITHOUT-O-R-PROCEDURES-WITH-CC

Other Antepartum Diagnoses without O.R. Procedures with CC: Inpatient Reimbursement Overview

776-POSTPARTUM-AND-POST-ABORTION-DIAGNOSES-WITHOUT-O-R-PROCEDURES

Postpartum and Post Abortion Diagnoses without O.R. Procedures: Inpatient Reimbursement Overview

831-OTHER-ANTEPARTUM-DIAGNOSES-WITHOUT-O-R-PROCEDURES-WITH-MCC

Other Antepartum Diagnoses without O.R. Procedures with MCC: Inpatient Reimbursement Overview

Showing 1–10 of 22

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.

OpenPayer

Summary & Overview

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

DRG 807 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