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See a sample rate comparisonMS-DRG 399 Fee Schedule
Last Verified: October 2026
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.
APPENDIX PROCEDURES WITHOUT CC/MCC
| 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
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MS-DRG 399
5 of 25 sample ratesHigher to lower in this preview
New York Presbyterian Medical Center
The New York And Presbyterian Hospital
$38,796.94Published rateMemorial Medical Center
Memorial Health System
$24,307.78Published rateHenry Ford Macomb Hospital Corporation, Henry Ford Macomb Hospital
Henry Ford Health System
$19,120.33Published rateMooresville Hospital Management Associates LLC, Lake Norman Regional Medical Center
$14,358.79Published rateCrestwood Healthcare Lp, Crestwood Medical Center
$10,355.82Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-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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