MS-DRG 322 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 322 by major payers:
$20,507.23
$29,027.25
$31,177.91
$30,918.02
| 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 322 | ||||||
United | 322 | $45500.00 | 1346282142 - MIDWEST DIVISION, RESEARCH MEDICAL CENTER | 542092552 - MIDWEST DIVISION | MO | Rehabilitation Hospital Unit (273Y00000X) |
United | 322 | $56023.00 | 1972013373 - VARIETY CHILDREN'S HOSPITAL, NICKLAUS CHILDREN'S HIALEAH OUTPATIENT CENTER | 590638499 - (FL) VARIETY CHILDRENS HOSPITAL | FL | General Acute Care Hospital (282N00000X) |
United | 322 | $28000.00 | 1164526786 - ASCENSION SETON, ASCENSION SETON MEDICAL CENTER AUSTIN | 741109643 - ASCENSION SETON | TX | General Acute Care Hospital (282N00000X) |
United | 322 | $20020.60 | 1073622007 - CHATTANOOGA HAMILTON COUNTY HOSPITAL AUTHORITY, ERLANGER BLEDSOE SWING BED | 883616696 - ERLANGER HEALTH | TN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 322 | $22059.00 | 1992776405 - HCA HEALTH SERVICES OF TENNESSEE, INC., TRISTAR STONECREST MEDICAL CENTER | 621113737 - HCA HEALTH SERVICES OF TENNESSEE INC | TN | General Acute Care Hospital (282N00000X) |
United | 322 | $25941.50 | 1609189604 - UNIVERSITY HOSPITALS AHUJA MEDICAL CENTER, INC, UH AHUJA MEDICAL CENTER | 264827222 - (OH) UNIVERSITY HOSPITALS HEALTH SYSTEM INC | OH | General Acute Care Hospital (282N00000X) |
United | 322 | $18839.19 | 1952766263 - INDIANA REGIONAL MEDICAL CENTER | 250965404 - (PA) INDIANA REGIONAL MEDICAL CENTER | PA | Rural Acute Care Hospital (282NR1301X) |
United | 322 | $46199.73 | 1013918960 - GASTON MEMORIAL HOSPITAL, INCORPORATED, CAROMONT REGIONAL MEDICAL CENTER | 560619359 - (NC) GASTON MEMORIAL HOSPITAL INC | NC | General Acute Care Hospital (282N00000X) |
United | 322 | $6520.00 | 1497988596 - ST. JOHN BROKEN ARROW, INC, ST. JOHN BROKEN ARROW | 383833117 - ST JOHN BROKEN ARROW INC | OK | General Acute Care Hospital (282N00000X) |
United | 322 | $27332.76 | 1396178356 - NORTHERN WESTCHESTER HOSPITAL ASSOCIATION, NORTHERN WESTCHESTER HOSPITAL TRANSITIONAL CARE UNIT | 131740118 - (NY) NORTHERN WESTCHESTER HOSPITAL ASSOCIATION | NY | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 322 | $18292.34 | 1801889969 - INDIANA REGIONAL MEDICAL CENTER | 250965404 - (PA) INDIANA REGIONAL MEDICAL CENTER | PA | Psychiatric Hospital Unit (273R00000X) |
United | 322 | $29359.69 | 1427752013 - LOYOLA UNIVERSITY MEDICAL CENTER, LOYOLA UNIVERSITY MEDICAL CENTER CANCER CENTER | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | General Acute Care Hospital (282N00000X) |
United | 322 | $10123.00 | 1205018439 - LAKE POINTE OPERATING COMPANY, LLC, BAYLOR SCOTT & WHITE MEDICAL CENTER LAKE POINTE | 260194016 - (TX) LAKE POINTE OPERATING COMPANY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 322 | $50903.00 | 1376733519 - METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO LTD LLP, NORTHEAST METHODIST HOSPITAL | 742730328 | TX | General Acute Care Hospital (282N00000X) |
United | 322 | $50903.00 | 1124218367 - METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO LTD LLP, METHODIST SPECIALTY AND TRANSPLANT HOSPITAL | 742730328 | TX | General Acute Care Hospital (282N00000X) |
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 322 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 322 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 322 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-APR-DRG | High | CERVICAL SPINAL FUSION & OTHER BACK/NECK PROC EXC DISC EXCIS/DECOMP |
| 321-MS-DRG | High | Percutaneous Cardiovascular Procedures with Intraluminal Device with MCC or 4+ Arteries/Intraluminal Devices |
| 322-MS-DRG | High | Percutaneous Cardiovascular Procedures with Intraluminal Device without MCC |
| 323-APR-DRG | High | Non-Elective Or Complex Hip Joint Replacement |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 322. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 322 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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