MS-DRG 034 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 Nervous System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 034 by major payers:
$43,295.91
$48,780.94
$59,722.49
$61,819.51
| 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 034 | ||||||
United | 034 | $48807.07 | 1871512855 - DUBOIS REGIONAL MEDICAL CENTER, PENN HIGHLANDS DUBOIS | 251490707 - DUBOIS REGIONAL MEDICAL CENTER | PA | General Acute Care Hospital (282N00000X) |
United | 034 | $117870.39 | 1396117362 - MAIMONIDES MEDICAL CENTER | 111635081 - (NY) MAIMONIDES MEDICAL CENTER- | NY | General Acute Care Hospital (282N00000X) |
United | 034 | $11547.04 | 1376175687 - LAUDERDALE COMMUNITY HOSPITAL LLC, LAUDERDALE COMMUNITY HOSPITAL | 844580729 | TN | Critical Access Hospital (282NC0060X) |
United | 034 | $95199.25 | 1679525919 - THE CLEVELAND CLINIC FOUNDATION | 340714585 - THE CLEVELAND CLINIC FOUNDATION | OH | General Acute Care Hospital (282N00000X) |
United | 034 | $86570.24 | 1801971965 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 034 | $118290.36 | 1053347955 - DELRAY MEDICAL CENTER, INC., DELRAY MEDICAL CENTER | 752922687 | FL | Psychiatric Hospital Unit (273R00000X) |
United | 034 | $85430.85 | 1376637496 - ASPIRUS WAUSAU HOSPITAL, INC, ASPIRUS WAUSAU HOSPITAL BEHAVIORAL HEALTH SERVICES | 391138241 - ASPIRUS WAUSAU HOSPITAL INC | WI | Psychiatric Hospital Unit (273R00000X) |
United | 034 | $95358.70 | 1407116759 - FAUQUIER HEALTH | 463107896 | VA | General Acute Care Hospital (282N00000X) |
United | 034 | $88546.71 | 1265818488 - SMSJ TUCSON HOLDINGS LLC, ST. MARYS HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 034 | $43293.83 | 1275703910 - UCHEALTH PIKES PEAK REGIONAL HOSPITAL | 824191576 - (CO) UCHEALTH PIKES PEAK REGIONAL HOSPITAL | CO | Critical Access Hospital (282NC0060X) |
United | 034 | $77342.35 | 1457500191 - FLORIDA HOSPITAL | 590724459 - (FL) ADVENTIST HEALTH SYSTEM-SUNBELT INC | FL | General Acute Care Hospital (282N00000X) |
United | 034 | $34454.82 | 1487743340 - DLP RUTHERFORD REGIONAL HEALTH SYSTEM, LLC, RUTHERFORD REGIONAL MEDICAL CENTER - PSYCHIATRIC UNIT | 300811171 | NC | Psychiatric Hospital Unit (273R00000X) |
United | 034 | $92078.18 | 1730540238 - CHILDREN'S HOSPITAL COLORADO, CHILDREN'S HOSPITAL COLORADO SOUTH CAMPUS | 840166760 - CHILDRENS HOSPITAL COLORADO | CO | Children's Hospital (282NC2000X) |
United | 034 | $89304.00 | 1366859597 - TEXAS HEALTH ARLINGTON MEMORIAL HOSPITAL, TEXAS HEALTH BEHAVIORAL HEALTH FACILITY ARLINGTON | 750972805 - (TX) TEXAS HEALTH ARLINGTON MEMORIAL HOSPITAL | TX | Psychiatric Hospital Unit (273R00000X) |
United | 034 | $7268.00 | 1972689172 - LAKE HOSPITAL SYSTEM INC, LAKE HEALTH | 341425870 - (OH) UNIVERSITY HOSPITALS HEALTH SYSTEM INC | OH | 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 034 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 034 code is part of the Diseases & Disorders of the Nervous 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 034 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 |
|---|---|---|
| 033-APR-DRG | Moderate | Bone Marrow Transplant |
| 033-MS-DRG | High | Ventricular Shunt Procedures without CC/MCC |
| 034-MS-DRG | High | Carotid Artery Stent Procedures with MCC |
| 035-MS-DRG | High | Carotid Artery Stent Procedures with CC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 034. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 034 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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