MS-DRG 399 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 399 by major payers:
$12,513.39
$17,142.51
$18,176.97
$18,591.17
| 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 399 | ||||||
United | 399 | $12168.50 | 1487624136 - ST JOHN DETROIT RIVERVIEW HOSPITAL | 383322109 - ASCENSION MACOMB OAKLAND HOSPITAL | MI | General Acute Care Hospital (282N00000X) |
United | 399 | $10355.82 | 1023061496 - CRESTWOOD HEALTHCARE LP, CRESTWOOD MEDICAL CENTER | 621647983 | AL | General Acute Care Hospital (282N00000X) |
United | 399 | $24307.78 | 1255317590 - MEMORIAL MEDICAL CENTER | 370661220 - (IL) MEMORIAL HEALTH SYSTEM | IL | General Acute Care Hospital (282N00000X) |
United | 399 | $13877.80 | 1477602860 - MORRISTOWN HAMBLEN HOSPITAL ASSOCIATION, MORRISTOWN HAMBLEN HEALTHCARE SYSTEM | 620545814 - (TN) MORRISTOWN HAMBLEN HOSP | TN | Psychiatric Hospital Unit (273R00000X) |
United | 399 | $18662.23 | 1164445250 - AVERA MCKENNAN, AVERA MCKENNAN BEHAVIORAL HEALTH SERVICES | 460224743 - AVERA MCKENNAN | SD | Psychiatric Hospital Unit (273R00000X) |
United | 399 | $36242.55 | 1457382798 - TEXAS HEALTH PRESBYTERIAN HOSPITAL KAUFMAN | 752771437 - (TX) TEXAS HEALTH PRESBYTERIAN HOSPITAL KAUFMAN | TX | General Acute Care Hospital (282N00000X) |
United | 399 | $23694.19 | 1356307581 - NEBRASKA MEDICAL CENTER, THE NEBRASKA MEDICAL CENTER - NEBRASKA MEDICINE | 911858433 - (NE) THE NEBRASKA MEDICAL CENTER | NE | General Acute Care Hospital (282N00000X) |
United | 399 | $17631.30 | 1598781486 - NUMC DEPARTMENT OF NEPHROLOGY, FPP | 113465690 | NY | General Acute Care Hospital (282N00000X) |
United | 399 | $23791.40 | 1083615587 - EPHRATA COMMUNITY HOSPITAL, WELLSPAN EPHRATA COMMUNITY HOSPITAL | 231370484 - EPHRATA COMMUNITY HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 399 | $10469.32 | 1881602357 - MERCY HOSPITAL JEFFERSON | 430687077 - (MO) MERCY HOSPITAL JEFFERSON | MO | Psychiatric Hospital Unit (273R00000X) |
United | 399 | $14358.79 | 1073568754 - MOORESVILLE HOSPITAL MANAGEMENT ASSOCIATES LLC, LAKE NORMAN REGIONAL MEDICAL CENTER | 332476324 | NC | General Acute Care Hospital (282N00000X) |
United | 399 | $16216.75 | 1679545966 - COMMUNITY HEALTH NETWORK, INC., COMMUNITY HOSPITAL NORTH | 743230935 | IN | Psychiatric Hospital Unit (273R00000X) |
United | 399 | $26835.22 | 1336696335 - ORLANDO HEALTH CENTRAL | 800764192 - (FL) ORLANDO HEALTH CENTRAL INC | FL | Chronic Disease Hospital (281P00000X) |
United | 399 | $19120.33 | 1023114634 - HENRY FORD MACOMB HOSPITAL CORPORATION, HENRY FORD MACOMB HOSPITAL | 381357020 - HENRY FORD HEALTH SYSTEM | MI | General Acute Care Hospital (282N00000X) |
United | 399 | $15682.32 | 1003260480 - BBH BMC, LLC, BROOKWOOD MEDICAL CENTER | 474757851 | AL | 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 399 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 399 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 399 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 |
|---|---|---|
| 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 399. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 399 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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