MS-DRG 321 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Diseases & Disorders of the Digestive System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 321 by major payers:
$31,896.08
$41,779.03
$44,151.38
$46,282.07
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for MS-DRG 321 | ||||||
United | 321 | $56611.46 | 1437622933 - MEDICAL UNIVERSITY HOSPITAL AUTHORITY, MUSC HEALTH CHESTER MEDICAL CENTER | 571098556 - (SC) MEDICAL UNIVERSITY HOSPITAL AUTHORITY | SC | General Acute Care Hospital (282N00000X) |
United | 321 | $24610.58 | 1477874337 - RCHP, NORTH ALABAMA MEDICAL CENTER | 272451336 | AL | General Acute Care Hospital (282N00000X) |
United | 321 | $41261.51 | 1295843753 - VALLEY BAPTIST MEDICAL CENTER | 452663071 | TX | General Acute Care Hospital (282N00000X) |
United | 321 | $32020.81 | 1831269539 - MISSOURI DELTA MEDICAL CENTER | 430633449 - MISSOURI DELTA MEDICAL CENTER | MO | General Acute Care Hospital (282N00000X) |
United | 321 | $62629.00 | 1689821944 - STATEN ISLAND UNIVERSITY HOSPITAL | 112868878 - (NY) STATEN ISLAND UNIVERSITY HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 321 | $24610.58 | 1477874337 - RCHP, NORTH ALABAMA MEDICAL CENTER | 272451336 | AL | General Acute Care Hospital (282N00000X) |
United | 321 | $41261.51 | 1295843753 - VALLEY BAPTIST MEDICAL CENTER | 452663071 | TX | General Acute Care Hospital (282N00000X) |
United | 321 | $57654.98 | 1346291309 - THE PRESBYTERIAN HOSPITAL, NOVANT HEALTH HUNTERSVILLE MEDICAL CENTER | 560554230 - PRESBYTERIAN HOSPITAL | NC | General Acute Care Hospital (282N00000X) |
United | 321 | $49665.26 | 1124007240 - VHS SAN ANTONIO PARTNERS LLC, BAPTIST HEALTH SYSTEM | 760714523 | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 321 | $48722.98 | 1285786228 - INOVA HEALTH CARE SERVICES, INOVA LOUDOUN HOSPITAL | 540620889 - INOVA HEALTH CARE SERVICES | VA | Psychiatric Hospital Unit (273R00000X) |
United | 321 | $52085.05 | 1528386737 - SAINT FRANCIS HOSPITAL | 752522262 | TN | General Acute Care Hospital (282N00000X) |
United | 321 | $52085.05 | 1528386737 - SAINT FRANCIS HOSPITAL | 752522262 | TN | General Acute Care Hospital (282N00000X) |
United | 321 | $51155.28 | 1649726738 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 321 | $27898.64 | 1730114703 - MAHNOMEN HEALTH CENTER | 416008946 - (MN) MAHNOMEN HEALTH CENTER | MN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 321 | $22774.40 | 1366431702 - HOLMES COUNTY HOSPITAL CORP, DOCTORS MEMORIAL HOSPITAL | 596031176 - (FL) HOLMES COUNTY HOSPITAL CORP | FL | Critical Access Hospital (282NC0060X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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MS-DRG 321 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 321 code is part of the Diseases & Disorders of the Digestive System services . It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The MS-DRG 321 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 321-MS-DRG | High | Percutaneous Cardiovascular Procedures with Intraluminal Device with MCC or 4+ Arteries/Intraluminal Devices |
| 322-APR-DRG | High | SHOULDER & ELBOW JOINT REPLACEMENT |
| 322-MS-DRG | High | Percutaneous Cardiovascular Procedures with Intraluminal Device without MCC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 321. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 321 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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