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See a sample rate comparisonMS-DRG 380 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.
COMPLICATED PEPTIC ULCER 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 380 by major payers:
$22,043.42
$24,307.69
$30,301.79
$30,682.32
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MS-DRG 380
5 of 25 sample ratesHigher to lower in this preview
Newyork-Presbyterian-Queens
$64,194.64Published rateUniversity Of Colorado Hospital Authority
$36,399.92Published rateDlp Haywood Regional Medical Center LLC., Haywood Regional Medical Center
$27,550.19Published rateClarksdale Hma LLC, Northwest Mississippi Regional Medical Center
$17,939.83Published ratePrime Healthcare Services, Saint Clare'S Hospital
$6,500.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 380 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 380 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 380 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 |
|---|---|---|
| 379-MS-DRG | High | GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC |
| 380-MS-DRG | High | COMPLICATED PEPTIC ULCER WITH MCC |
| 381-APR-DRG | High | MAJOR SKIN DISORDERS |
| 381-MS-DRG | High | COMPLICATED PEPTIC ULCER 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 380. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 380 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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