MS-DRG 381 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 381 by major payers:
$12,965.10
$14,596.36
$17,199.41
$17,612.99
| 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 381 | ||||||
United | 381 | $14333.69 | 1477549145 - CENTRAL MONTGOMERY MEDICAL CENTER L L C | 263359979 - (PA) LANSDALE HOSPITAL CORPORATION | PA | Rehabilitation Hospital Unit (273Y00000X) |
United | 381 | $24245.53 | 1396835138 - CARONDELET HEALTH NETWORK, ST. MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 381 | $14739.87 | 1902840424 - NORTH KANSAS CITY HOSPITAL | 446005747 - (MO) NORTH KANSAS CITY HOSPITAL | MO | General Acute Care Hospital (282N00000X) |
United | 381 | $23246.83 | 1598337339 - STEWARD NSMC, INC., SWING BED | 862695690 | FL | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 381 | $14812.84 | 1386188837 - SAINT FRANCIS HOSPITAL MUSKOGEE INC, SAINT FRANCIS HOSPITAL MUSKOGEE | 814322087 - (OK) SAINT FRANCIS HOSPITAL MUSKOGEE INC | OK | General Acute Care Hospital (282N00000X) |
United | 381 | $6830.83 | 1952419681 - VALLEY MEDICAL FACILITIES, INC., VALLEY MEDICAL FACILITIES D/B/A SEWICKLEY VALLEY HOSPITAL INPT REHAB U | 251801532 - (PA) HERITAGE VALLEY HEALTH SYSTEM | PA | Rehabilitation Hospital Unit (273Y00000X) |
United | 381 | $20486.78 | 1073893020 - PASCO-PINELLAS HILLSBOROUGH COMMUNITY HEALTH SYSTEM INC, ADVENTHEALTH WESLEY CHAPEL | 208488713 - (FL) PASCO-PINELLAS HILLSBOROUGH COMMUNITY HEALTH SYSTEM INC | FL | General Acute Care Hospital (282N00000X) |
United | 381 | $11564.05 | 1215916812 - WILLIAM BEAUMONT HOSPITAL, COREWELL HEALTH WILLIAM BEAUMONT UNIVERSITY HOSPITAL REHABILITATION | 381459362 - WILLIAM BEAUMONT HOSPITAL | MI | Rehabilitation Hospital Unit (273Y00000X) |
United | 381 | $18766.27 | 1447575832 - PRESBYTARIAN HOSPITAL | 850105601 - PRESBYTERIAN HEALTHCARE SERVICES | NM | General Acute Care Hospital (282N00000X) |
United | 381 | $9211.61 | 1134130289 - VALLEY MEDICAL FACILITIES, INC., VALLEY MEDICAL FACILITIES, HERITAGE VALLEY BEAVER | 251801532 - (PA) HERITAGE VALLEY HEALTH SYSTEM | PA | Psychiatric Hospital Unit (273R00000X) |
United | 381 | $10629.94 | 1700901873 - EAST TEXAS MEDICAL CENTER REHABILITATION HOSPITAL | 824037220 | TX | Rehabilitation Hospital (283X00000X) |
United | 381 | $10868.33 | 1205251204 - PROSPECT CHARTERCARE SJHSRI, LLC, SOUTHERN NEW ENGLAND REHABILITATION CENTER | 464661337 | RI | Rehabilitation Hospital Unit (273Y00000X) |
United | 381 | $13016.91 | 1841335783 - ST. JOSEPH HEALTH SERVICES OF RI, EEG GROUP | 464661337 | RI | General Acute Care Hospital (282N00000X) |
United | 381 | $18654.09 | 1902865355 - GOOD SAMARITAN HOSPITAL MEDICAL CENTER | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 381 | $7940.20 | 1124108568 - COMMUNITY MEMORIAL HOSPITAL, INC | 460219795 - COMMUNITY MEMORIAL HOSPITAL INC | SD | Critical Access Hospital (282NC0060X) |
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 381 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 381 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 381 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 |
|---|---|---|
| 380-APR-DRG | High | SKIN ULCERS |
| 380-MS-DRG | High | Complicated Peptic Ulcer with MCC |
| 381-MS-DRG | High | Complicated Peptic Ulcer with CC |
| 382-APR-DRG | High | MALIGNANT BREAST DISORDERS |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 381. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 381 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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