MS-DRG 385 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 385 by major payers:
$18,392.78
$21,500.79
$25,549.87
$25,975.65
| 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 385 | ||||||
United | 385 | $27195.11 | 1134607005 - ADVOCATE NORTH SIDE HEALTH NETWORK, ADVOCATE ILLINOIS MASONIC MEDICAL CENTER REHAB UNIT | 363196629 - (IL) ADVOCATE NORTH SIDE HEALTH NETWORK | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 385 | $14197.84 | 1821042979 - HCA HEALTHONE LLC, NORTH SUBURBAN MEDICAL CENTER | 841321373 | CO | General Acute Care Hospital (282N00000X) |
United | 385 | $11683.94 | 1568463701 - JERSEY COMMUNITY HOSPITAL DISTRICT, JERSEY COMMUNITY HOSPITAL | 376013958 | IL | General Acute Care Hospital (282N00000X) |
United | 385 | $19780.56 | 1992133714 - MERCY HOSPITAL BOONEVILLE | 463851119 - MERCY HOSPITAL BOONEVILLE | AR | Critical Access Hospital (282NC0060X) |
United | 385 | $4590.00 | 1780655332 - THE HEALTH CARE AUTHORITY OF THE CITY OF GREENVILLE, REGIONAL MEDICAL CENTER OF CENTRAL ALABAMA | 822445000 - (AL) THE HEALTH CARE AUTHORITY OF THE CITY OF GREENVILLE | AL | General Acute Care Hospital (282N00000X) |
United | 385 | $46028.69 | 1013080084 - ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC, PROVIDENCE QUEEN OF THE VALLEY MEDICAL CENTER | 814791043 - (CA) ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC | CA | General Acute Care Hospital (282N00000X) |
United | 385 | $8959.00 | 1760580757 - VCU HEALTH TAPPAHANNOCK HOSPITAL | 541489410 - (VA) VCU HEALTH TAPPAHANNOCK HOSPITAL | VA | Rural Acute Care Hospital (282NR1301X) |
United | 385 | $21943.48 | 1225195464 - CANNON COUNTY HOSPITAL LLC, STONES RIVER HOSPITAL | 474063232 | TN | Rehabilitation Hospital Unit (273Y00000X) |
United | 385 | $30013.67 | 1134223878 - PROVIDENCE EVERETT MEDICAL CENTER, INPATIENT REHABILITATION FACILITY | 352346161 | WA | Rehabilitation Hospital Unit (273Y00000X) |
United | 385 | $1655.00 | 1558472803 - TISHOMINGO HEALTH SERVICES, INC., TISHOMINGO HEALTH SWING BED | 640741047 - TISHOMINGO HEALTH SERVICES INC | MS | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 385 | $16778.86 | 1801883996 - GARDEN CITY HOSPITAL | 464719451 - (MI) PRIME HEALTHCARE SERVICES -- GARDEN CITY, LLC | MI | Rehabilitation Hospital Unit (273Y00000X) |
United | 385 | $14197.84 | 1821042979 - HCA HEALTHONE LLC, NORTH SUBURBAN MEDICAL CENTER | 841321373 | CO | General Acute Care Hospital (282N00000X) |
United | 385 | $36171.30 | 1801262423 - SMSJ TUCSON HOLDINGS LLC, ST. JOSEPHS HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 385 | $20993.93 | 1407897309 - HENNEPIN HEALTHCARE SYSTEM, INC, HENNEPIN COUNTY MEDICAL CENTER | 421707837 - (MN) HENNEPIN HEALTHCARE SYSTEM INC | MN | General Acute Care Hospital (282N00000X) |
United | 385 | $27135.57 | 1801262423 - SMSJ TUCSON HOLDINGS LLC, ST. JOSEPHS HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
MS-DRG 385 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 385 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 385 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 |
|---|---|---|
| 384-APR-DRG | High | CONTUSION, OPEN WOUND & OTHER TRAUMA TO SKIN & SUBCUTANEOUS TISSUE |
| 384-MS-DRG | High | Uncomplicated Peptic Ulcer without MCC |
| 385-MS-DRG | High | Inflammatory Bowel Disease with MCC |
| 386-MS-DRG | High | Inflammatory Bowel Disease 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 385. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 385 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like MS-DRG 385) and we'll show you how you compare in 15 minutes or less.