MS-DRG 323 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 323 by major payers:
$45,649.18
$62,428.72
$60,611.61
$69,032.76
| 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 323 | ||||||
United | 323 | $70041.57 | 1225130412 - MUNSTER MEDICAL RESEARCH FOUNDATION INC, COMMUNITY HOSPITAL | 351107009 - (IN) MUNSTER MEDICAL RESEARCH FOUNDATION INC | IN | General Acute Care Hospital (282N00000X) |
United | 323 | $12990.00 | 1497900781 - MONMOUTH MEDICAL CENTER INC | 223452412 | NJ | Psychiatric Hospital Unit (273R00000X) |
United | 323 | $88429.39 | 1215969787 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 323 | $12990.00 | 1497900781 - MONMOUTH MEDICAL CENTER INC | 223452412 | NJ | Psychiatric Hospital Unit (273R00000X) |
United | 323 | $42197.87 | 1215151154 - PORTER HOSPITAL LLC, NORTHWEST HEALTH-PORTER | 208473972 | IN | General Acute Care Hospital (282N00000X) |
United | 323 | $42197.87 | 1215151154 - PORTER HOSPITAL LLC, NORTHWEST HEALTH-PORTER | 208473972 | IN | General Acute Care Hospital (282N00000X) |
United | 323 | $67332.60 | 1679545966 - COMMUNITY HEALTH NETWORK, INC., COMMUNITY HOSPITAL NORTH | 743230935 | IN | Psychiatric Hospital Unit (273R00000X) |
United | 323 | $67332.60 | 1679545966 - COMMUNITY HEALTH NETWORK, INC., COMMUNITY HOSPITAL NORTH | 743230935 | IN | Psychiatric Hospital Unit (273R00000X) |
United | 323 | $108827.67 | 1588635973 - FOLEY HOSPITAL COMPANY LLC, SOUTH BALDWIN REGIONAL MEDICAL CENTER | 621811413 - (AL) FOLEY HOSPITAL CORPORATION | AL | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 323 | $67277.21 | 1265801302 - REGIONS HOSPITAL, REGIONS HOSPITAL BUNDLED SERVICES | 410956618 - REGIONS HOSPITAL | MN | General Acute Care Hospital (282N00000X) |
United | 323 | $7081.00 | 1568657583 - DOCTORS HOSPITAL AT RENAISSANCE, LTD, HOSPITAL - PSYCHIATRIC UNIT | 742802643 - (TX) DOCTORS HOSPITAL AT RENAISSANCE | TX | Psychiatric Hospital Unit (273R00000X) |
United | 323 | $52958.87 | 1730710898 - FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC, FROEDTERT COMMUNITY HOSPITAL | 843381796 | WI | General Acute Care Hospital (282N00000X) |
United | 323 | $52958.87 | 1730710898 - FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC, FROEDTERT COMMUNITY HOSPITAL | 843381796 | WI | General Acute Care Hospital (282N00000X) |
United | 323 | $91623.95 | 1780653618 - H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC. | 593238634 - (FL) H LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL INC | FL | Special Hospital (284300000X) |
United | 323 | $63056.16 | 1518945799 - FORT SANDERS REGIONAL MEDICAL CENTER, PATRICIA NEAL REHABILITATION CENTER | 620528340 - (TN) FORT SANDERS REGIONAL MEDICAL CENTER | TN | Rehabilitation Hospital Unit (273Y00000X) |
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 323 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 323 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 323 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 |
|---|---|---|
| 322-APR-DRG | High | SHOULDER & ELBOW JOINT REPLACEMENT |
| 322-MS-DRG | High | Percutaneous Cardiovascular Procedures with Intraluminal Device without MCC |
| 323-MS-DRG | High | Coronary Intravascular Lithotripsy with Intraluminal Device with MCC |
| 324-APR-DRG | High | Elective 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 323. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 323 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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