MS-DRG 386 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 386 by major payers:
$11,964.90
$13,601.37
$15,764.84
$16,130.05
| 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 386 | ||||||
United | 386 | $14292.00 | 1760408801 - AMISUB (SFH), INC., ST. FRANCIS HOSPITAL | 752522262 | TN | Rehabilitation Hospital Unit (273Y00000X) |
United | 386 | $10781.53 | 1154493633 - CARITAS NORWOOD HOSPITAL | 272473602 - (MA) STEWARD NORWOOD HOSPITAL, INC. | MA | General Acute Care Hospital (282N00000X) |
United | 386 | $13340.51 | 1689875320 - THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY | 356005697 | IN | General Acute Care Hospital (282N00000X) |
United | 386 | $23516.30 | 1093713091 - ST FRANCIS COMMUNITY HOSPITAL, FRANCISCAN HEALTH SYSTEM | 911267921 - (WA) ST FRANCIS COMMUNITY HOSPITAL | WA | General Acute Care Hospital (282N00000X) |
United | 386 | $17574.19 | 1821720681 - PARKVIEW MEDICAL CENTER, INC., PARKVIEW PUEBLO WEST | 840935136 - (CO) PARKVIEW MEDICAL CENTER INC | CO | General Acute Care Hospital (282N00000X) |
United | 386 | $12667.28 | 1578372363 - SAINT MARY OF NAZARETH HOSPITAL | 992171028 | IL | Psychiatric Hospital Unit (273R00000X) |
United | 386 | $28854.94 | 1467690891 - SENTARA HOSPITALS, SENTARA WILLIAMSBURG REGIONAL MEDICAL CENTER | 541547408 - SENTARA HOSPITALS | VA | Rehabilitation Hospital Unit (273Y00000X) |
United | 386 | $19850.00 | 1821091059 - WAYNESBORO HOSPITAL, WELLSPAN WAYNESBORO HOSPITAL | 231360854 - (PA) WAYNESBORO HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 386 | $18387.52 | 1902865355 - GOOD SAMARITAN HOSPITAL MEDICAL CENTER | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 386 | $31694.56 | 1568419976 - UNIVERSITY OF VERMONT MEDICAL CENTER INC | 30219309 - UNIVERSITY OF VERMONT MEDICAL CENTER INC | VT | General Acute Care Hospital (282N00000X) |
United | 386 | $8237.30 | 1609826783 - ST. VINCENT RANDOLPH HOSPITAL, INC., ASCENSION ST. VINCENT RANDOLPH | 352103153 - (IN) ST VINCENT RANDOLPH HOSPITAL INC | IN | Critical Access Hospital (282NC0060X) |
United | 386 | $6094.60 | 1396755393 - VALLEY MEDICAL FACILITIES, INC., HERITAGE VALLEY SEWICKLEY | 251801532 - (PA) HERITAGE VALLEY HEALTH SYSTEM | PA | Psychiatric Hospital Unit (273R00000X) |
United | 386 | $15806.00 | 1568772507 - STATEN ISLAND UNIVERSITY HOSPITAL | 112868878 - (NY) STATEN ISLAND UNIVERSITY HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 386 | $18675.55 | 1649355132 - ALEGENT CREIGHTON HEALTH, CHI HEALTH LAKESIDE | 470757164 - ALEGENT CREIGHTON HEALTH | NE | General Acute Care Hospital (282N00000X) |
United | 386 | $4158.00 | 1134448541 - SMYTH COUNTY COMMUNITY HOSPITAL, SOUTHWEST VIRGINIA INPATIENT REHABILITAION UNIT | 540794913 - (VA) SMYTH COUNTY COMMUNITY HOSPITAL | VA | 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 386 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 386 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 386 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 |
|---|---|---|
| 385-APR-DRG | High | OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST DISORDERS |
| 385-MS-DRG | High | Inflammatory Bowel Disease with MCC |
| 386-MS-DRG | High | Inflammatory Bowel Disease with CC |
| 387-MS-DRG | High | Inflammatory Bowel Disease without CC/MCC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 386. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 386 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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