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See a sample rate comparisonMS-DRG 385 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.
INFLAMMATORY BOWEL DISEASE 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 385 by major payers:
$18,392.78
$21,500.79
$25,549.87
$25,975.65
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MS-DRG 385
5 of 25 sample ratesHigher to lower in this preview
St. Joseph Health Northern California, LLC, Providence Queen Of The Valley Medical Center
St Joseph Health Northern California LLC
$46,028.69Published rateProvidence Everett Medical Center, Inpatient Rehabilitation Facility
$30,013.67Published rateHennepin Healthcare System, Inc, Hennepin County Medical Center
Hennepin Healthcare System Inc
$20,993.93Published rateHca Healthone LLC, North Suburban Medical Center
$14,197.84Published rateTishomingo Health Services, Inc., Tishomingo Health Swing Bed
Tishomingo Health Services Inc
$1,655.00Published rate
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See a sample payer proposalMS-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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