MS-DRG 326 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 326 by major payers:
$57,949.19
$64,873.64
$79,161.41
$81,629.02
| 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 326 | ||||||
United | 326 | $56941.53 | 1336150374 - ST BERNARDS HOSPITAL INC, ST BERNARDS MEDICAL CENTER | 710290019 - (AR) ST BERNARDS HOSPITAL INC | AR | General Acute Care Hospital (282N00000X) |
United | 326 | $54377.01 | 1639711294 - UOFL HEALTH-LOUISVILLE INC | 843178470 - UOFL HEALTH-LOUISVILLE INC | KY | General Acute Care Hospital (282N00000X) |
United | 326 | $52861.85 | 1154795581 - PRIME HEALTHCARE FOUNDATION, SOUTHERN REGIONAL MEDICAL CENTER | 300885567 | GA | General Acute Care Hospital (282N00000X) |
United | 326 | $52861.85 | 1154795581 - PRIME HEALTHCARE FOUNDATION, SOUTHERN REGIONAL MEDICAL CENTER | 300885567 | GA | General Acute Care Hospital (282N00000X) |
United | 326 | $59830.62 | 1023060472 - ST. JOSEPH HEALTH SYSTEM, LLC, LUTHERAN DOWNTOWN HOSPITAL | 510382045 | IN | General Acute Care Hospital (282N00000X) |
United | 326 | $55609.96 | 1306897335 - IOM HEALTH SYSTEM LP, LUTHERAN HOSPITAL OF INDIANA | 351963748 | IN | General Acute Care Hospital (282N00000X) |
United | 326 | $50824.57 | 1477537363 - VHS OF PHOENIX INC, ABRAZO CENTRAL CAMPUS | 621811285 | AZ | General Acute Care Hospital (282N00000X) |
United | 326 | $82767.38 | 1083612881 - ENGLEWOOD HOSPITAL AND MEDICAL CENTER | 221487173 - (NJ) ENGLEWOOD HOSPITAL AND MEDICAL CENTER A NEW JERSEY NONPROFIT CORP | NJ | General Acute Care Hospital (282N00000X) |
United | 326 | $89715.46 | 1710353339 - SMSJ TUCSON HOLDINGS LLC, ST. MARYS HOSPITAL | 474131755 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 326 | $504.00 | 1548488224 - NORTH SUNFLOWER MEDICAL CENTER | 646001408 | MS | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 326 | $89046.64 | 1801827670 - BROOKWOOD HEALTH SERVICES, INC., BROOKWOOD MEDICAL CENTER | 474757851 | AL | Rehabilitation Hospital Unit (273Y00000X) |
United | 326 | $57870.12 | 1942843610 - UOFL HEALTH-LOUISVILLE INC | 843178470 - UOFL HEALTH-LOUISVILLE INC | KY | Rehabilitation Hospital Unit (273Y00000X) |
United | 326 | $49962.12 | 1760549562 - SKAGGS COMMUNITY HOSPITAL ASSOCIATION, COX MEDICAL CENTER BRANSON | 440577118 - LESTER E COX MEDICAL CENTER | MO | Rehabilitation Hospital Unit (273Y00000X) |
United | 326 | $62736.01 | 1508964883 - CATHOLIC HEALTH INITIATIVES-IOWA CORP, MERCYONE DES MOINES MEDICAL CENTER | 420680448 - CATHOLIC HEALTH INITIATIVES-IOWA CORP | IA | General Acute Care Hospital (282N00000X) |
United | 326 | $69700.07 | 1144312430 - PRINCETON BAPTIST MEDICAL CENTER, PRINCETON BAPTIST MEDICAL CENTER | 474775351 | AL | 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 326 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 326 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 326 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 |
|---|---|---|
| 325-APR-DRG | High | Non-Elective Or Complex Knee Joint Replacement |
| 325-MS-DRG | High | Coronary Intravascular Lithotripsy without Intraluminal Device |
| 326-MS-DRG | High | Stomach, Esophageal and Duodenal Procedures with MCC |
| 327-MS-DRG | High | Stomach, Esophageal and Duodenal Procedures with CC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 326. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 326 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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