MS-DRG 358 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 358 by major payers:
$17,018.25
$18,378.39
$21,340.14
$22,157.02
| 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 358 | ||||||
United | 358 | $17467.24 | 1790785996 - VIRGINIA HOSPITAL CENTER ARLINGTON HEALTH SYSTEM | 540505989 - (VA) VIRGINIA HOSPITAL CENTER ARLINGTON HEALTH SYSTEM | VA | General Acute Care Hospital (282N00000X) |
United | 358 | $14605.82 | 1710238639 - SAINT CLARE'S HOSPITAL INC | 463483967 | NJ | General Acute Care Hospital (282N00000X) |
United | 358 | $11334.04 | 1619163854 - COMMUNITY HEALTH NETWORK, INC, COMMUNITY HOSPITAL NORTH | 743230935 | IN | General Acute Care Hospital (282N00000X) |
United | 358 | $23104.46 | 1093705428 - JACKSON MADISON COUNTY GENERAL HOSPITAL | 626010402 - (TN) JACKSON MADISON COUNTY GENERAL HOSPITAL | TN | General Acute Care Hospital (282N00000X) |
United | 358 | $32636.01 | 1235218785 - ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC, PROVIDENCE QUEEN OF THE VALLEY MEDICAL CENTER | 814791043 - (CA) ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC | CA | General Acute Care Hospital (282N00000X) |
United | 358 | $32668.05 | 1205307378 - CHEROKEE MEDICAL CENTER, CMC WOUND SERVICES | 832531807 | SC | General Acute Care Hospital (282N00000X) |
United | 358 | $6977.41 | 1174522494 - CHAMBERS COUNTY PUBLIC HOSPITAL DISTRICT NO 1, OMNIPOINT HEALTH HOSPITAL | 760153629 | TX | Critical Access Hospital (282NC0060X) |
United | 358 | $18086.31 | 1962537407 - BATON ROUGE GENERAL MEDICAL CENTER | 721025017 - (LA) BATON ROUGE GENERAL MEDICAL CENTER | LA | General Acute Care Hospital (282N00000X) |
United | 358 | $15000.95 | 1467537506 - CARONDELET HEALTH NETWORK, ST. MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 358 | $24866.08 | 1003854688 - SCRIPPS HEALTH, SCRIPPS MEMORIAL HOSPITAL ENCINITAS REHAB UNIT | 951684089 - SCRIPPS HEALTH | CA | Rehabilitation Hospital Unit (273Y00000X) |
United | 358 | $12018.40 | 1275107344 - HMH HOSPITALS CORPORATION | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | Rehabilitation Hospital (283X00000X) |
United | 358 | $3558.00 | 1659590644 - SHRINERS HOSPITALS FOR CHILDREN, SHRINERS CHILDREN'S OHIO | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | OH | Children's Hospital (282NC2000X) |
United | 358 | $14949.84 | 1659456994 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 358 | $13189.19 | 1295777324 - LONE STAR HMA L P, DALLAS REGIONAL MEDICAL CENTER | 472177648 | TX | General Acute Care Hospital (282N00000X) |
United | 358 | $22125.88 | 1477537363 - VHS OF PHOENIX INC, ABRAZO CENTRAL CAMPUS | 621811285 | AZ | 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 358 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 358 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 358 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 |
|---|---|---|
| 357-MS-DRG | High | Other Digestive System O.R. Procedures with CC |
| 358-MS-DRG | High | Other Digestive System O.R. Procedures without CC/MCC |
| 368-MS-DRG | High | Major Esophageal Disorders 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 358. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 358 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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