MS-DRG 392 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 392 by major payers:
$9,003.82
$11,220.96
$12,960.03
$12,778.14
| 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 392 | ||||||
United | 392 | $8093.25 | 1578550174 - GARDEN CITY HOSPITAL | 464719451 - (MI) PRIME HEALTHCARE SERVICES -- GARDEN CITY, LLC | MI | General Acute Care Hospital (282N00000X) |
United | 392 | $10788.59 | 1679684682 - ALVA HOSPITAL AUTHORITY, SHARE MEDICAL CENTER | 730765084 | OK | Critical Access Hospital (282NC0060X) |
United | 392 | $4485.00 | 1033937883 - OHMH, LLC | 994761958 | FL | General Acute Care Hospital (282N00000X) |
United | 392 | $7866.00 | 1720371065 - LONG BEACH MEMORIAL MEDICAL, COMMUNITY HOSPITAL LONG BEACH | 953527031 - (CA) LONG BEACH MEMORIAL MEDICAL CENTER | CA | General Acute Care Hospital (282N00000X) |
United | 392 | $6305.22 | 1578670543 - ADVOCATE HEALTH AND HOSPITALS CORPORATION, ADVOCATE GOOD SAMARITAN HOSPITAL | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | General Acute Care Hospital (282N00000X) |
United | 392 | $8830.44 | 1417991159 - GENERAL JOHN J PERSHING MEMORIAL HOSPITAL ASSOCIATION, PERSHING MEMORIAL HOSPITAL | 430715842 - (MO) GENERAL JOHN J PERSHING MEMORIAL HOSPITAL ASSOCIATION | MO | Critical Access Hospital (282NC0060X) |
United | 392 | $16995.71 | 1801803903 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION, QUEENS HOSPITAL CENTER | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | General Acute Care Hospital (282N00000X) |
United | 392 | $5363.00 | 1215151154 - PORTER HOSPITAL LLC, NORTHWEST HEALTH-PORTER | 351088541 | IN | General Acute Care Hospital (282N00000X) |
United | 392 | $13383.69 | 1144397134 - UCH-MHS, MEMORIAL HOSPITAL | 460796114 - (CO) UCH-MHS | CO | General Acute Care Hospital (282N00000X) |
United | 392 | $6706.00 | 1972679694 - PRIME HEALTHCARE PARADISE VALLEY LLC, PARADISE VALLEY HOSPITAL | 205837239 | CA | Rehabilitation Hospital Unit (273Y00000X) |
United | 392 | $10369.91 | 1740920909 - THEDACARE REGIONAL MEDICAL CENTER, THEDACARE MEDICAL CENTER ORTHOPEDICS, SPINE, AND PAIN | 390824015 - (WI) THEDACARE REGIONAL MEDICAL CENTER- APPLETON INC | WI | General Acute Care Hospital (282N00000X) |
United | 392 | $20221.63 | 1154775401 - VHS HARLINGEN HOSPITAL COMPANY, LLC, VALLEY BAPTIST MEDICAL CENTER - HARLINGEN | 452662980 | TX | Psychiatric Hospital Unit (273R00000X) |
United | 392 | $33442.87 | 1093808800 - STAMFORD HOSPITAL | 60646917 - (CT) STAMFORD HOSPITAL | CT | Psychiatric Hospital Unit (273R00000X) |
United | 392 | $26086.09 | 1164529400 - VALLEY BAPTIST MEDICAL CENTER | 452662980 | TX | General Acute Care Hospital (282N00000X) |
United | 392 | $26086.09 | 1164529400 - VALLEY BAPTIST MEDICAL CENTER | 452662980 | TX | 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 392 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 392 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 392 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 |
|---|---|---|
| 391-MS-DRG | High | Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders with MCC |
| 392-MS-DRG | High | Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders without MCC |
| 393-MS-DRG | High | Other Digestive System Diagnoses with 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 392. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 392 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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