MS-DRG 395 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 395 by major payers:
$8,147.06
$9,154.22
$10,189.36
$10,531.80
| 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 395 | ||||||
United | 395 | $17121.71 | 1609812700 - AHS HOSPITAL CORP., OVERLOOK HOSPITAL | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | General Acute Care Hospital (282N00000X) |
United | 395 | $11595.00 | 1386897148 - JERSEY CITY MEDICAL CENTER, LIBERTY HOSPITALIST SERVICES | 222783298 - (NJ) JERSEY CITY MEDICAL CENTER | NJ | Hospitalist Physician (208M00000X) |
United | 395 | $8061.25 | 1013957836 - SHERMAN GRAYSON HOSPITAL LLC, WILSON N. JONES REGIONAL MEDICAL CENTER | 272025690 | TX | General Acute Care Hospital (282N00000X) |
United | 395 | $5439.31 | 1477859254 - NASHOBA VALLEY MEDICAL CENTER, A STEWARD FAMILY HOSPITAL, INC, NASHOBA VALLEY MEDICAL CENTER | 274157855 | MA | General Acute Care Hospital (282N00000X) |
United | 395 | $7892.62 | 1831663657 - INTEGRIS BAPTIST MEDICAL CENTER, INC | 731034824 - (OK) INTEGRIS BAPTIST MEDICAL CENTER INC | OK | Rehabilitation Hospital Unit (273Y00000X) |
United | 395 | $9533.91 | 1295788735 - MEMORIAL HERMANN HEALTH SYSTEM, MEMORIAL HERMANN SUGAR LAND HOSPITAL | 741152597 - (TX) MEMORIAL HERMANN HEALTH SYSTEM | TX | General Acute Care Hospital (282N00000X) |
United | 395 | $11900.40 | 1376521575 - LOYOLA UNIVERSITY MEDICAL CENTER, FOSTER G. MCGAW HOSPITAL | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | General Acute Care Hospital (282N00000X) |
United | 395 | $12594.51 | 1902832306 - THEDACARE REGIONAL MEDICAL CENTER, APPLETON MEDICAL CENTER,INC. | 350983617 - COMMUNITY HEALTH NETWORK INC | WI | General Acute Care Hospital (282N00000X) |
United | 395 | $8650.33 | 1275593337 - COMMUNITY HOSPITAL LLC, COMMUNITY HOSPITAL | 202501360 | OK | General Acute Care Hospital (282N00000X) |
United | 395 | $10853.66 | 1336475789 - LEE MEMORIAL HEALTH SYSTEM, LEE MEMORIAL SENIOR BEHAVIOR UNIT | 590714812 - LEE MEMORIAL HEALTH SYSTEM | FL | Psychiatric Hospital Unit (273R00000X) |
United | 395 | $12817.09 | 1891895835 - UNIVERSITY OF WASHINGTON, UNIVERSITY OF WASHINGTON MEDICAL CENTER | 916001537 | WA | Psychiatric Hospital Unit (273R00000X) |
United | 395 | $11576.75 | 1821187758 - EAST BATON ROUGE MEDICAL CENTER REHAB, OCHSNER MEDICAL CENTER BATON ROUGE REHAB | 201729674 | LA | Rehabilitation Hospital Unit (273Y00000X) |
United | 395 | $11576.75 | 1821187758 - EAST BATON ROUGE MEDICAL CENTER REHAB, OCHSNER MEDICAL CENTER BATON ROUGE REHAB | 201729674 | LA | Rehabilitation Hospital Unit (273Y00000X) |
United | 395 | $9261.53 | 1801242987 - THEDACARE REGIONAL MEDICAL CENTER, THEDACARE DIAGNOSTIC IMAGING CENTER | 390830664 - (WI) THEDACARE REGIONAL MEDICAL CENTER - NEENAH INC | WI | General Acute Care Hospital (282N00000X) |
United | 395 | $14340.00 | 1326078288 - DELRAY MEDICAL CENTER, INC., DELRAY MEDICAL CENTER | 752922687 | FL | 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 395 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 395 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 395 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 |
|---|---|---|
| 394-MS-DRG | High | Other Digestive System Diagnoses with CC |
| 395-MS-DRG | High | Other Digestive System Diagnoses without CC/MCC |
| 397-MS-DRG | High | Appendix Procedures 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 395. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 395 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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