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See a sample rate comparisonMS-DRG 368 Fee Schedule
Last Verified: October 2026
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.
MAJOR ESOPHAGEAL DISORDERS WITH MCC
| 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
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MS-DRG 368
5 of 25 sample ratesHigher to lower in this preview
Westchester County Health Care Corporation, Mid-Hudson Valley Division Of Westchester Medical Center
Peo Mid-Hudson Valley Staffco
$64,123.03Published rateWest Boca Medical Center, Inc., West Boca Medical Center
$30,819.53Published rateCatawba Valley Medical Center
$21,945.47Published rateIndiana Regional Medical Center
$18,051.02Published rateIasis Glenwood Regional Medical Center Lp
$4,829.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-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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