MS-DRG 368 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 368 by major payers:
$20,511.60
$21,646.64
$26,373.87
$26,757.34
| 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 368 | ||||||
United | 368 | $21260.76 | 1598138919 - BT EAST DALLAS JV, LLP, BAYLOR SCOTT AND WHITE MEDICAL CENTER WHITE ROCK | 823626083 - (TX) PIPELINE EAST DALLAS, LLC | TX | General Acute Care Hospital (282N00000X) |
United | 368 | $42518.19 | 1548716665 - UPSTATE AFFILIATE ORGANIZATION, GHS CANCER INST-ANDREWS | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 368 | $35917.25 | 1457550840 - , PROVIDENCE ST PETER HOSPITAL | 910567732 | WA | Psychiatric Hospital Unit (273R00000X) |
United | 368 | $30819.53 | 1588697296 - WEST BOCA MEDICAL CENTER, INC., WEST BOCA MEDICAL CENTER | 752922710 | FL | General Acute Care Hospital (282N00000X) |
United | 368 | $15390.71 | 1063422053 - VALLEY MEDICAL FACILITIES INC, VALLEY MEDICAL FACILITIES INC DBA HERITAGE VALLEY BEAVER | 251801532 - (PA) HERITAGE VALLEY HEALTH SYSTEM | PA | General Acute Care Hospital (282N00000X) |
United | 368 | $20622.83 | 1528052578 - LECONTE MEDICAL CENTER | 621114867 - (TN) LECONTE MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | 368 | $7000.00 | 1205981552 - ST. MARY'S HOSPITAL | 463499370 | NJ | General Acute Care Hospital (282N00000X) |
United | 368 | $19959.83 | 1831450865 - ST JOSEPH HEALTH SERVICES OF RI, HOSPITALIST GROUP | 464661337 | RI | Hospitalist Physician (208M00000X) |
United | 368 | $64123.03 | 1437575040 - WESTCHESTER COUNTY HEALTH CARE CORPORATION, MID-HUDSON VALLEY DIVISION OF WESTCHESTER MEDICAL CENTER | 133964321 - (NY) PEO MID-HUDSON VALLEY STAFFCO | NY | Psychiatric Hospital Unit (273R00000X) |
United | 368 | $27555.00 | 1215951629 - AVERA MCKENNAN, AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTER - REHAB UNIT | 460224743 - AVERA MCKENNAN | SD | Rehabilitation Hospital Unit (273Y00000X) |
United | 368 | $27677.60 | 1154748416 - AGH LAVEEN LLC, DIGNITY HEALTH ARIZONA GENERAL HOSPITAL | 471587223 - (AZ) AGH LAVEEN LLC | AZ | General Acute Care Hospital (282N00000X) |
United | 368 | $30819.53 | 1588697296 - WEST BOCA MEDICAL CENTER, INC., WEST BOCA MEDICAL CENTER | 752922710 | FL | General Acute Care Hospital (282N00000X) |
United | 368 | $17613.49 | 1801896915 - PROVIDENCE MEDICAL CENTER, INC | 462162669 | KS | General Acute Care Hospital (282N00000X) |
United | 368 | $30517.58 | 1427447697 - VANDERBILT UNIVERSITY HOSPITAL | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | 368 | $4829.00 | 1487706214 - IASIS GLENWOOD REGIONAL MEDICAL CENTER LP | 994786140 | LA | 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 368 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 368 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 368 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 |
|---|---|---|
| 358-MS-DRG | High | Other Digestive System O.R. Procedures without CC/MCC |
| 368-MS-DRG | High | Major Esophageal Disorders with MCC |
| 369-MS-DRG | High | Major Esophageal Disorders 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 368. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 368 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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