MS-DRG 376 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 376 by major payers:
$11,197.96
$12,349.71
$14,182.15
$14,492.39
| 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 376 | ||||||
United | 376 | $7983.85 | 1225275928 - RIVERVIEW HOSPITAL, RIVERVIEW HEALTH | 351128943 - RIVERVIEW HOSPITAL | IN | General Acute Care Hospital (282N00000X) |
United | 376 | $11411.40 | 1154353993 - SOUTHWEST GENERAL HEALTH CENTER | 340753531 - (OH) SOUTHWEST GENERAL HEALTH CENTER | OH | General Acute Care Hospital (282N00000X) |
United | 376 | $15075.33 | 1083941678 - ASCENSION SACRED HEART GULF, ASCENSION SACRED HEART GULF | 300577249 - (FL) ASCENSION SACRED HEART GULF | FL | Rural Acute Care Hospital (282NR1301X) |
United | 376 | $19919.22 | 1558521070 - BANNER BOSWELL MEDICAL CENTER | 900389314 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 376 | $28958.01 | 1184691610 - CAPE CANAVERAL HOSPITAL, INC. | 592477479 - (FL) CAPE CANAVERAL HOSPITAL INC | FL | General Acute Care Hospital (282N00000X) |
United | 376 | $12601.29 | 1891222410 - METHODIST GERMANTOWN | 620479367 - METHODIST HEALTHCARE-MEMPHIS | TN | General Acute Care Hospital (282N00000X) |
United | 376 | $20829.56 | 1831103654 - INTEGRIS BAPTIST MEDICAL CENTER INC | 731034824 - (OK) INTEGRIS BAPTIST MEDICAL CENTER INC | OK | General Acute Care Hospital (282N00000X) |
United | 376 | $28965.64 | 1821026816 - EAST COOPER COMMUNITY HOSPITAL, INC., EAST COOPER MEDICAL CENTER | 953931540 | SC | General Acute Care Hospital (282N00000X) |
United | 376 | $8622.00 | 1265710412 - STATEN ISLAND UNIVERSITY HOSPITAL | 112868878 - (NY) STATEN ISLAND UNIVERSITY HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 376 | $9324.87 | 1477196145 - UOFL HEALTH-LOUISVILLE INC | 843178470 - UOFL HEALTH-LOUISVILLE INC | KY | Rehabilitation Hospital Unit (273Y00000X) |
United | 376 | $3558.00 | 1669513941 - SHRINERS HOSPITALS FOR CHILDREN | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | TX | Children's Hospital (282NC2000X) |
United | 376 | $4944.79 | 1033385083 - ELK REGIONAL HEALTH CENTER | 250585280 - (PA) ELK REGIONAL HEALTH CENTER | PA | General Acute Care Hospital (282N00000X) |
United | 376 | $6871.00 | 1619401528 - STEWARD SEBASTIAN RIVER MEDICAL CENTER, INC. | 994762475 | FL | General Acute Care Hospital (282N00000X) |
United | 376 | $4951.72 | 1710992433 - HOSPITAL AUTHORITY OF JEFFERSON COUNTY AND THE CITY OF LOUISVILLE, JEFFERSON HOSPITAL | 581309961 - (GA) HOSPITAL AUTHORITY OF JEFFERSON COUNTY AND THE CITY OF LOUISVILLE | GA | General Acute Care Hospital (282N00000X) |
United | 376 | $21467.50 | 1841248713 - SUNY HEALTHSCIENCE CENTER AT SYRACUSE, UPSTATE MEDICAL UNIVERSITY | 161469571 | NY | 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 376 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 376 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 376 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 |
|---|---|---|
| 375-MS-DRG | High | Digestive Malignancy with CC |
| 376-MS-DRG | High | Digestive Malignancy without CC/MCC |
| 377-MS-DRG | High | Gastrointestinal Hemorrhage 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 376. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 376 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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