MS-DRG 035 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 035 by major payers:
$26,743.63
$29,199.24
$35,855.31
$37,243.23
| 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 035 | ||||||
United | 035 | $12368.00 | 1285671313 - HCA-HEALTHONE LLC, THE MEDICAL CENTER OF AURORA | 841321373 | CO | General Acute Care Hospital (282N00000X) |
United | 035 | $23287.91 | 1053414037 - MARSHALL COUNTY HMA, LLC, ALLIANCEHEALTH MADILL | 383862800 | OK | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 035 | $26976.25 | 1407364847 - TYLER REGIONAL HOSPITAL LLC | 823878395 | TX | General Acute Care Hospital (282N00000X) |
United | 035 | $1800.00 | 1669403192 - NACOGDOCHES COUNTY HOSPITAL DISTRICT, NACOGDOCHES MEMORIAL HOSPITAL | 871142127 - (TX) LION STAR NACOGDOCHES HOSPITAL, LLC DBA NACOGDOCHES MEMORIAL HOSPITAL | TX | Rural Acute Care Hospital (282NR1301X) |
United | 035 | $12469.00 | 1629069638 - ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT HAMILTON | 210634572 - (NJ) RWJ BARNABAS HEALTH INC | NJ | General Acute Care Hospital (282N00000X) |
United | 035 | $42490.16 | 1871594127 - UNIONTOWN HOSPITAL | 250965588 - (PA) UNIONTOWN HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 035 | $47445.50 | 1497765630 - ST. CHARLES HOSPITAL CORP. | 111871039 - (NY) ST CHARLES HOSPITAL CORP | NY | General Acute Care Hospital (282N00000X) |
United | 035 | $76419.28 | 1548399736 - DOCTORS MEDICAL CENTER OF MODESTO, INC., DOCTORS BEHAVIORAL HEALTH CENTER | 752918774 | CA | Psychiatric Hospital Unit (273R00000X) |
United | 035 | $18676.10 | 1144205360 - MEMORIAL HOSPITAL OF TEXAS COUNTY AUTHORITY | 730725208 | OK | Critical Access Hospital (282NC0060X) |
United | 035 | $4158.00 | 1114033628 - MOUNTAIN STATES HEALTH ALLIANCE, FRANKLIN WOODS COMMUNITY HOSPITAL | 620476282 - MOUNTAIN STATES HEALTH ALLIANCE | TN | General Acute Care Hospital (282N00000X) |
United | 035 | $38257.58 | 1245615772 - PARK NICOLLET METHODIST HOSPITAL, PN METHODIST HOSPITAL EPISODIC BUNDLE | 410132080 - (MN) PARK NICOLLET HEALTH SERVICES | MN | General Acute Care Hospital (282N00000X) |
United | 035 | $29033.26 | 1679627376 - SAINTS MARY AND ELIZABETH MEDICAL CENTER, SAINT ELIZABETH HOSPITAL | 992171028 | IL | General Acute Care Hospital (282N00000X) |
United | 035 | $38034.41 | 1811341167 - BBH SBMC, LLC, SHELBY BAPTIST MEDICAL CENTER | 474780023 | AL | General Acute Care Hospital (282N00000X) |
United | 035 | $54190.01 | 1659360709 - BON SECOURS COMMUNITY HOSPITAL | 141347717 - BON SECOURS CHARITY HEALTH SYSTEM INC | NY | General Acute Care Hospital (282N00000X) |
United | 035 | $4796.00 | 1669569984 - IRVING-COPPELL SURGICAL HOSPITAL LLP, BAYLOR SCOTT & WHITE SURGICAL HOSPITAL - LAS COLINAS | 542086863 | TX | 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 035 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 035 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 035 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 |
|---|---|---|
| 034-APR-DRG | Moderate | Bone Marrow Transplant |
| 034-MS-DRG | High | Carotid Artery Stent Procedures with MCC |
| 035-MS-DRG | High | Carotid Artery Stent Procedures with CC |
| 036-MS-DRG | High | Carotid Artery Stent 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 035. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 035 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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