MS-DRG 391 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 391 by major payers:
$14,235.45
$17,199.39
$20,234.84
$20,629.53
| 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 391 | ||||||
United | 391 | $37764.30 | 1982738571 - TEXAS HEALTH HARRIS METHODIST HOSPITAL CLEBURNE | 751977850 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL CLEBURNE | TX | Chronic Disease Hospital (281P00000X) |
United | 391 | $7369.00 | 1205089026 - PRIME HEALTHCARE SERVICES | 263487583 | CA | General Acute Care Hospital (282N00000X) |
United | 391 | $12586.05 | 1124272547 - ADVOCATE CONDELL MEDICAL CENTER | 262525968 - (IL) ADVOCATE HEALTH CARE NETWORK | IL | General Acute Care Hospital (282N00000X) |
United | 391 | $28023.30 | 1417290958 - CARONDELET HEALTH NETWORK, O'RIELLY TRANSITIONS INTENSIVE OUTPATIENT PROGRAM | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 391 | $7369.00 | 1205089026 - PRIME HEALTHCARE SERVICES | 263487583 | CA | General Acute Care Hospital (282N00000X) |
United | 391 | $13466.29 | 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 | 391 | $12154.50 | 1326088139 - THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY, CAROLINAS HEALTHCARE SYSTEM LINCOLN | 560529945 | NC | General Acute Care Hospital (282N00000X) |
United | 391 | $15684.73 | 1023010261 - MERCY TYLER HOSPITAL, TYLER MEMORIAL HOSPITAL | 274566015 | PA | General Acute Care Hospital (282N00000X) |
United | 391 | $15684.73 | 1023010261 - MERCY TYLER HOSPITAL, TYLER MEMORIAL HOSPITAL | 274566015 | PA | General Acute Care Hospital (282N00000X) |
United | 391 | $16050.00 | 1326143058 - ROCHESTER GENERAL HOSPITAL, ROCHESTER GENERAL -REHAB | 160743134 - ROCHESTER GENERAL HOSPITAL | NY | Rehabilitation Hospital Unit (273Y00000X) |
United | 391 | $4975.22 | 1578960647 - MEMORIAL MEDICAL CLINIC | 746003411 | TX | Critical Access Hospital (282NC0060X) |
United | 391 | $15931.65 | 1760453633 - MERCY HOSPITAL PARIS | 710655753 - MERCY HOSPITAL PARIS | AR | Critical Access Hospital (282NC0060X) |
United | 391 | $8622.00 | 1568772507 - STATEN ISLAND UNIVERSITY HOSPITAL | 112868878 - (NY) STATEN ISLAND UNIVERSITY HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 391 | $8867.87 | 1235239211 - MERCY HEALTH, MERCY HOSPITAL ANDERSON | 310537085 | OH | General Acute Care Hospital (282N00000X) |
United | 391 | $8867.87 | 1235239211 - MERCY HEALTH, MERCY HOSPITAL ANDERSON | 310537085 | OH | 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 391 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 391 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 391 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 |
|---|---|---|
| 390-MS-DRG | High | Gastrointestinal Obstruction without CC/MCC |
| 391-MS-DRG | High | Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders with MCC |
| 392-MS-DRG | High | Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders without 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 391. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 391 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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