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 | $18150.46 | 1437718491 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 386 | $17913.06 | 1790729101 - NEMAHA COUNTY HOSPITAL | 470471042 - (NE) NEMAHA COUNTY HOSPITAL | NE | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 386 | $13340.51 | 1689875320 - THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY | 356005697 | IN | 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 | $15806.00 | 1568772507 - STATEN ISLAND UNIVERSITY HOSPITAL | 112868878 - (NY) STATEN ISLAND UNIVERSITY HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 386 | $16121.75 | 1619050549 - NORTH VISTA HOSPITAL LLC | 200470861 | NV | Psychiatric Hospital Unit (273R00000X) |
United | 386 | $14292.00 | 1760408801 - AMISUB (SFH), INC., ST. FRANCIS HOSPITAL | 752522262 | TN | Rehabilitation Hospital Unit (273Y00000X) |
United | 386 | $14292.00 | 1760408801 - AMISUB (SFH), INC., ST. FRANCIS HOSPITAL | 752522262 | TN | Rehabilitation Hospital Unit (273Y00000X) |
United | 386 | $15270.62 | 1932125606 - WEST PENN ALLEGHENY HEALTH SYSTEM INC., FORBES REGIONAL HOSPITAL - PSYCH | 250969492 - (PA) HIGHMARK HEALTH | PA | Psychiatric Hospital Unit (273R00000X) |
United | 386 | $10850.19 | 1750346359 - HARDIN MEMORIAL HOSPITAL, LIFESPRING OF HARDIN MEMORIAL HOSPITAL | 610444707 - BAPTIST HEALTHCARE SYSTEM INC | KY | Psychiatric Hospital Unit (273R00000X) |
United | 386 | $14313.61 | 1538199617 - MARIAN HEALTH CENTER-SMHC, MERCYONE SIOUXLAND MEDICAL CENTER | 311407377 | IA | General Acute Care Hospital (282N00000X) |
United | 386 | $27331.47 | 1821647801 - ST MARY'S HOSPITAL AND MEDICAL CENTER, INC, ST MARY'S HOSPITAL & MEDICAL CENTER LIFE CENTER OT/PT/SP | 840425720 - (CO) ST MARYS HOSPITAL AND MEDICAL CENTER INC | CO | General Acute Care Hospital (282N00000X) |
United | 386 | $16199.58 | 1699065136 - DUKE UNIVERSITY HOSPITAL | 562070036 - DUKE UNIVERSITY HEALTH SYSTEM INC | NC | General Acute Care Hospital (282N00000X) |
United | 386 | $19393.14 | 1669424354 - SILVERTON HEALTH, LEGACY SILVERTON MEDICAL CENTER | 930281321 - (OR) SILVERTON HEALTH | OR | General Acute Care Hospital (282N00000X) |
United | 386 | $9424.51 | 1508859661 - MERCY HOSPITAL JEFFERSON, JEFFERSON MEMORIAL HOSPITAL ASSOCIATION | 430687077 - (MO) MERCY HOSPITAL JEFFERSON | MO | General Acute Care Hospital (282N00000X) |
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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