MS-DRG 355 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 355 by major payers:
$15,586.32
$17,646.71
$21,175.92
$21,812.85
| 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 355 | ||||||
United | 355 | $12076.24 | 1467608869 - CALHOUN HEALTH SERVICES | 813257997 - (MS) BAPTIST MEMORIAL HOSPITAL - CALHOUN INC | MS | Critical Access Hospital (282NC0060X) |
United | 355 | $22421.75 | 1245615772 - PARK NICOLLET METHODIST HOSPITAL, PN METHODIST HOSPITAL EPISODIC BUNDLE | 410132080 - (MN) PARK NICOLLET HEALTH SERVICES | MN | General Acute Care Hospital (282N00000X) |
United | 355 | $15705.09 | 1538110556 - DUPONT HOSPITAL LLC, DUPONT HOSPITAL | 621801445 - (IN) DUPONT HOSPITAL LLC | IN | General Acute Care Hospital (282N00000X) |
United | 355 | $11997.46 | 1215918560 - ENDLESS MOUNTAINS HEALTH SYSTEMS, INC. | 232720289 - (PA) ENDLESS MOUNTAINS HEALTH SYSTEMS INC | PA | Critical Access Hospital (282NC0060X) |
United | 355 | $14182.71 | 1043348808 - NORTON HOSPITALS INC | 610703799 - (KY) NORTON HOSPITALS INC | KY | General Acute Care Hospital (282N00000X) |
United | 355 | $25757.23 | 1093945412 - MISSION HOSPITAL REGIONAL MEDICAL CENTER, PROVIDENCE MISSION HOSPITAL | 951643360 - (CA) MISSION HOSPITAL REGIONAL MEDICAL CENTER | CA | Psychiatric Hospital Unit (273R00000X) |
United | 355 | $21982.86 | 1114473329 - EMERUS BHS SA THOUSAND OAKS LLC, BAPTIST NEIGHBORHOOD HOSPITAL SHAVANO PARK | 452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 355 | $28567.81 | 1629637608 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 355 | $14234.87 | 1770717167 - EAST TEXAS MEDICAL CENTER HENDERSON | 824019349 | TX | Rural Acute Care Hospital (282NR1301X) |
United | 355 | $20321.97 | 1902858152 - CLEVELAND CLINIC HEALTH SYSTEM, HILLCREST HOSPITAL | 340714593 - CLEVELAND CLINIC HEALTH SYSTEM EAST REGION | OH | General Acute Care Hospital (282N00000X) |
United | 355 | $14234.87 | 1770717167 - EAST TEXAS MEDICAL CENTER HENDERSON | 824019349 | TX | Rural Acute Care Hospital (282NR1301X) |
United | 355 | $16534.34 | 1881760759 - INTEGRIS BAPTIST MEDICAL CENTER INC, INTEGRIS MENTAL HEALTH CENTER ACUTE | 731034824 - (OK) INTEGRIS BAPTIST MEDICAL CENTER INC | OK | Psychiatric Hospital Unit (273R00000X) |
United | 355 | $26502.67 | 1982997763 - RICHMOND UNIVERSITY MEDICAL CENTER | 743177454 - (NY) RICHMOND MEDICAL CENTER | NY | Psychiatric Hospital (283Q00000X) |
United | 355 | $11380.20 | 1972585347 - JEFFERSON COUNTY HMA LLC, TENNOVA HEALTHCARE-JEFFERSON MEMORIAL HOSPITAL | 452528414 | TN | General Acute Care Hospital (282N00000X) |
United | 355 | $7345.00 | 1740981430 - NORTHEAST GEORGIA MEDICAL CENTER HABERSHAM LLC | 922451946 | GA | 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 355 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 355 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 355 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 |
|---|---|---|
| 354-MS-DRG | High | Hernia Procedures except Inguinal and Femoral with CC |
| 355-MS-DRG | High | Hernia Procedures except Inguinal and Femoral without CC/MCC |
| 356-MS-DRG | High | Other Digestive System O.R. Procedures with 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 355. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 355 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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