MS-DRG 375 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 375 by major payers:
$15,033.48
$16,082.50
$19,470.28
$19,909.57
| 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 375 | ||||||
United | 375 | $23792.05 | 1346247350 - SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER INC, SOUTHEASTERN MED | 314391798 - (OH) SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER INC | OH | Rural Acute Care Hospital (282NR1301X) |
United | 375 | $6098.00 | 1568669380 - IJKG OPCO LLC, BAYONNE HOSPITAL CENTER | 261442063 - (NJ) CAREPOINT HEALTH BAYONNE MEDICAL CENTER | NJ | Psychiatric Hospital Unit (273R00000X) |
United | 375 | $59428.53 | 1447269303 - JOHN MUIR HEALTH, JOHN MUIR WALNUT CREEK I/P REHAB UNIT | 941461843 - (CA) JOHN MUIR HEALTH | CA | Rehabilitation Hospital Unit (273Y00000X) |
United | 375 | $22224.86 | 1235196510 - FLORIDA HEALTH SCIENCES CENTER INC, TAMPA GENERAL HOSPITAL | 593458145 - FLORIDA HEALTH SCIENCES CENTER INC | FL | General Acute Care Hospital (282N00000X) |
United | 375 | $22534.44 | 1023587045 - KETTERING MEDICAL CENTER, KETTERING HEALTH TROY | 310621866 - (OH) KETTERING COLLEGE | OH | General Acute Care Hospital (282N00000X) |
United | 375 | $22635.10 | 1790285500 - COMMUNITY HEALTH NETWORK REHABILITATION HOSPITAL SOUTH, LLC, COMMUNITY HEALTH NETWORK REHABILITATION HOSPITAL SOUTH | 821385366 - (IN) COMMUNITY HEALTH NETWORK REHABILITATION HOSPITAL SOUTH LLC | IN | Rehabilitation Hospital (283X00000X) |
United | 375 | $19063.27 | 1154411338 - KING COUNTY PUBLIC HOSPITAL DISTRICT NO. 2, EVERGREENHEALTH MEDICAL CENTER | 910844563 | WA | Rehabilitation Hospital Unit (273Y00000X) |
United | 375 | $8161.00 | 1265772362 - SCOTT & WHITE HOSPITAL, BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | 274434451 - (TX) SCOTT & WHITE HOSPITAL - COLLEGE STATION | TX | General Acute Care Hospital (282N00000X) |
United | 375 | $22319.33 | 1861417362 - ASCENSION SE WISCONSIN HOSPITAL, INC, ASCENSION SE WISCONSIN HOSPITAL-ELMBROOK CAMPUS | 350868157 - SAINT JOSEPH REGIONAL MEDICAL CENTER-SOUTH BEND CAMPUS INC | WI | Rehabilitation Hospital Unit (273Y00000X) |
United | 375 | $15681.90 | 1184703019 - PRESENCE CHICAGO HOSPITALS NETWORK, SAINT JOSEPH HOSPITAL - CHICAGO-REHABILITATION UNIT | 992171028 | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 375 | $15681.90 | 1184703019 - PRESENCE CHICAGO HOSPITALS NETWORK, SAINT JOSEPH HOSPITAL - CHICAGO-REHABILITATION UNIT | 992171028 | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 375 | $29917.61 | 1942267869 - MARIN GENERAL HOSPITAL | 942823538 - (CA) MARIN GENERAL HOSPITAL | CA | Psychiatric Hospital Unit (273R00000X) |
United | 375 | $25215.83 | 1194209155 - IACC/EHI NW, LLC, INTEGRIS COMMUNITY HOSPITAL-COUNCIL CROSSING | 352635546 - (OK) IACCEHI NW LLC | OK | General Acute Care Hospital (282N00000X) |
United | 375 | $18438.81 | 1841335783 - ST. JOSEPH HEALTH SERVICES OF RI, EEG GROUP | 464661337 | RI | General Acute Care Hospital (282N00000X) |
United | 375 | $21703.75 | 1467537506 - CARONDELET HEALTH NETWORK, ST. MARY'S HOSPITAL | 474131755 | 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 375 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 375 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 375 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 |
|---|---|---|
| 374-MS-DRG | High | Digestive Malignancy with MCC |
| 375-MS-DRG | High | Digestive Malignancy with CC |
| 376-MS-DRG | High | Digestive Malignancy without CC/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 375. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 375 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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