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 | $8106.00 | 1083728026 - FREEMAN-OAK HILL HEALTH SYSTEM, FREEMAN HEALTH SYSTEM | 431704371 - FREEMAN HEALTH SYSTEM | MO | Rehabilitation Hospital Unit (273Y00000X) |
United | 385 | $3630.00 | 1215998323 - UNIVERSITY HOSPITAL, UNIVERSITY OF MEDICINE AND DENTISTRY OF NJ | 221775306 | NJ | General Acute Care Hospital (282N00000X) |
United | 385 | $10997.65 | 1407121189 - PREFERRED HOSPITAL LEASING COLEMAN, INC., COLEMAN COUNTY MEDICAL CENTER | 453780407 | TX | Critical Access Hospital (282NC0060X) |
United | 385 | $42901.58 | 1538522412 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE TRANSMOUNTAIN CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 385 | $42901.58 | 1538522412 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE TRANSMOUNTAIN CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 385 | $43086.44 | 1699884858 - BANNER GATEWAY MEDICAL CENTER | 900220728 | AZ | General Acute Care Hospital (282N00000X) |
United | 385 | $3630.00 | 1205047651 - UMDNJ UNIVERSITY HOSPITAL | 221775306 | NJ | General Acute Care Hospital (282N00000X) |
United | 385 | $30013.67 | 1134223878 - PROVIDENCE EVERETT MEDICAL CENTER, INPATIENT REHABILITATION FACILITY | 352346161 | WA | Rehabilitation Hospital Unit (273Y00000X) |
United | 385 | $11968.29 | 1144274770 - UNIVERSITY HOSPITAL, LTD., HCA FLORIDA WOODMONT HOSPITAL | 650566885 | FL | General Acute Care Hospital (282N00000X) |
United | 385 | $32496.00 | 1760787576 - WELLSPAN SURGERY AND REHABILITATION HOSPITAL, WELLSPAN SURGERY AND REHABILITATION HOSPITAL | 232899911 - (PA) WELLSPAN SURGERY AND REHABILITATION HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 385 | $15378.19 | 1629026364 - ADVOCATE SHERMAN HOSPITAL, SHERMAN FAMILY HEALTHCARE | 362167920 - (IL) ADVOCATE SHERMAN HOSPITAL | IL | General Acute Care Hospital (282N00000X) |
United | 385 | $3630.00 | 1215998323 - UNIVERSITY HOSPITAL, UNIVERSITY OF MEDICINE AND DENTISTRY OF NJ | 221775306 | NJ | General Acute Care Hospital (282N00000X) |
United | 385 | $15565.58 | 1962976472 - BAXTER COUNTY REGIONAL HOSPITAL, INC | 710561765 - BAXTER COUNTY REGIONAL HOSPITAL INC | AR | General Acute Care Hospital (282N00000X) |
United | 385 | $36359.76 | 1649367269 - MEMORIAL HOSPITAL-WEST VOLUSIA INC, ADVENTHEALTH DELAND | 593256803 - MEMORIAL HOSPITAL-WEST VOLUSIA INC | FL | General Acute Care Hospital (282N00000X) |
United | 385 | $15806.00 | 1225062193 - STATEN ISLAND UNIVERSITY HOSPITAL | 112868878 - (NY) STATEN ISLAND UNIVERSITY HOSPITAL | 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 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.
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