MS-DRG 356 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 356 by major payers:
$46,763.99
$54,633.27
$66,702.72
$68,576.21
| 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 356 | ||||||
United | 356 | $39274.30 | 1306921887 - DELTA HEALTH SYSTEM, DELTA REGIONAL MEDICAL CENTER | 640586958 - (MS) DELTA HEALTH SYSTEM | MS | Rural Acute Care Hospital (282NR1301X) |
United | 356 | $92808.84 | 1508687021 - NYU LANGONE HOSPITALS | 133971298 - NYU LANGONE HOSPITALS | NY | Psychiatric Hospital Unit (273R00000X) |
United | 356 | $118791.59 | 1043279565 - ST. FRANCIS HOSPITAL | 112050523 - (NY) ST FRANCIS HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 356 | $116838.46 | 1063657963 - BETH ISRAEL MEDICAL CENTER, MILTON AND CARROLL PETRIE DIVISION | 135564934 - (NY) BETH ISRAEL MEDICAL CENTER | NY | Psychiatric Hospital Unit (273R00000X) |
United | 356 | $74978.21 | 1124026273 - PROVIDENCE SAINT JOHN'S HEALTH CENTER | 951684082 - (CA) PROVIDENCE SAINT JOHNS HEALTH CENTER | CA | General Acute Care Hospital (282N00000X) |
United | 356 | $11042.00 | 1609983790 - MONMOUTH MEDICAL CENTER INC | 223452412 | NJ | General Acute Care Hospital (282N00000X) |
United | 356 | $43540.05 | 1932154705 - ST. LUKE'S MAGIC VALLEY REGIONAL MEDICAL CENTER, LTD., ST LUKES MAGIC VALLEY MEDICAL CENTER | 421009175 - TRINITY REGIONAL MEDICAL CENTER | ID | General Acute Care Hospital (282N00000X) |
United | 356 | $54443.12 | 1255668448 - ST. FRANCIS HOSPITAL | 992441755 | IL | General Acute Care Hospital (282N00000X) |
United | 356 | $50996.44 | 1801830500 - TRIAD OF ALABAMA LLC, FLOWERS HOSPITAL | 621762412 - (AL) TRIAD OF ALABAMA LLC | AL | General Acute Care Hospital (282N00000X) |
United | 356 | $91000.17 | 1942224696 - SVMC HOLDINGS, INC | 832550272 - (CT) SVMC HOLDINGS INC | CT | General Acute Care Hospital (282N00000X) |
United | 356 | $66067.15 | 1083696710 - MEDINA HOSPITAL | 340733166 - (OH) MEDINA HOSPITAL | OH | General Acute Care Hospital (282N00000X) |
United | 356 | $64456.46 | 1447218482 - HEALTHEAST ST. JOHN'S HOSPITAL | 411456897 - (MN) HEALTHEAST ST JOHNS HOSPITAL | MN | General Acute Care Hospital (282N00000X) |
United | 356 | $24125.57 | 1174021695 - REHABILITATION HOSPITAL, LLC | 823913174 | TX | Rehabilitation Hospital (283X00000X) |
United | 356 | $6649.00 | 1205047651 - UMDNJ UNIVERSITY HOSPITAL | 221775306 | NJ | General Acute Care Hospital (282N00000X) |
United | 356 | $52775.23 | 1730451899 - PRIME HEALTHCARE SERVICES ROXBOROUGH LLC, ROXBOROUGH MEMORIAL HOSPITAL | 454246163 - (PA) PRIME HEALTHCARE SERVICES ROXBOROUGH, LLC | PA | 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 356 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 356 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 356 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 |
|---|---|---|
| 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 |
| 357-MS-DRG | High | Other Digestive System O.R. 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 356. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 356 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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