MS-DRG 398 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 398 by major payers:
$16,848.30
$22,676.48
$24,251.34
$24,940.34
| 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 398 | ||||||
United | 398 | $26582.38 | 1407637531 - TAMPA GENERAL HOSPITAL CITRUS LLC, TAMPA GENERAL HOSPITAL CRYSTAL RIVER | 933040761 | FL | General Acute Care Hospital (282N00000X) |
United | 398 | $61602.37 | 1487904546 - PEACEHEALTH, ST. JOSEPH MEDICAL CENTER | 910565889 - PEACEHEALTH ST JOSEPH MEDICAL CENTER | WA | Rural Acute Care Hospital (282NR1301X) |
United | 398 | $32210.58 | 1770048217 - UCHEALTH BROOMFIELD HOSPITAL | 473393862 - (CO) UCHEALTH BROOMFIELD HOSPITAL | CO | Rehabilitation Hospital Unit (273Y00000X) |
United | 398 | $2122.00 | 1922096585 - AMERIS OF ARKANSAS LLC, GREAT RIVER MEDICAL CENTER | 716042625 - (AR) MISSISSIPPI COUNTY HOSPITAL SYSTEM | AR | General Acute Care Hospital (282N00000X) |
United | 398 | $8443.00 | 1043204316 - THE MERCY HOSPITAL INC, MERCY MEDICAL CENTER | 43398280 - (MA) THE MERCY HOSPITAL INC | MA | General Acute Care Hospital (282N00000X) |
United | 398 | $23740.58 | 1720003312 - NASSAU HEALTHCARE CORPORATION, NUMC DEPARTMENT OF PATHOLOGY, FPP | 113465690 | NY | General Acute Care Hospital (282N00000X) |
United | 398 | $33686.85 | 1518042605 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 398 | $13320.07 | 1497708473 - NASON MEDICAL CENTER LLC, NASON HOSPITAL | 472546387 | PA | General Acute Care Hospital (282N00000X) |
United | 398 | $5185.00 | 1922002674 - FRISCO MEDICAL CENTER LLP, BAYLOR SCOTT & WHITE MED CNTR - FRISCO | 752865177 - (TX) FRISCO MEDICAL CENTER LLP | TX | General Acute Care Hospital (282N00000X) |
United | 398 | $42667.69 | 1396129201 - UNION MEDICAL CENTER, UNION MEDICAL CENTER | 474491361 | SC | General Acute Care Hospital (282N00000X) |
United | 398 | $31072.58 | 1902893415 - ASCENSION VIA CHRISTI HOSPITALS WICHITA INC. | 481172106 - ASCENSION VIA CHRISTI HOSPITALS WICHITA INC | KS | Psychiatric Hospital Unit (273R00000X) |
United | 398 | $23920.66 | 1336119478 - COMMUNITY HEALTH NETWORK, INC, COMMUNITY HOSPITAL EAST | 350983617 - COMMUNITY HEALTH NETWORK INC | IN | General Acute Care Hospital (282N00000X) |
United | 398 | $5526.00 | 1265468946 - ALVARADO HOSPITAL, LLC, ALVARADO HOSPITAL | 205683387 - (CA) ALVARADO HOSPITAL LLC | CA | General Acute Care Hospital (282N00000X) |
United | 398 | $33686.85 | 1518042605 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 398 | $16762.82 | 1609984889 - UPMC WASHINGTON | 250965600 - (PA) WASHINGTON HOSPITAL | PA | 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 398 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 398 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 398 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 |
|---|---|---|
| 397-MS-DRG | High | Appendix Procedures with MCC |
| 398-MS-DRG | High | Appendix Procedures with CC |
| 399-MS-DRG | High | Appendix Procedures 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 398. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 398 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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