MS-DRG 234 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 Circulatory System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 234 by major payers:
$59,454.25
$66,418.04
$84,401.19
$84,895.24
| 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 234 | ||||||
United | 234 | $2772.00 | 1518580893 - CLEVELAND TENNESSEE HOSPITAL COMPANY LLC, TENNOVA HEALTHCARE-CLEVELAND | 992892769 | TN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 234 | $99348.75 | 1063541266 - GEORGETOWN UNIVERSITY HOSPITAL | 522218584 - (DC) MEDSTAR-GEORGETOWN MEDICAL CENTER INC | DC | General Acute Care Hospital (282N00000X) |
United | 234 | $178976.84 | 1144521949 - EMANUEL MEDICAL CENTER, INC., EMANUEL SPECIALTY CARE - CARDIOVASCULAR MEDICINE | 752918774 | CA | General Acute Care Hospital (282N00000X) |
United | 234 | $51645.00 | 1912152851 - MOTHER FRANCES HOSPITAL-WINNSBORO | 752771569 - (TX) MOTHER FRANCES HOSPITAL-WINNSBORO | TX | Psychiatric Hospital Unit (273R00000X) |
United | 234 | $61458.94 | 1386786119 - SSM REGIONAL HEALTH SERVICES, ST, MARY'S HEALTH CENTER BHM | 440546097 | MO | Psychiatric Hospital Unit (273R00000X) |
United | 234 | $162933.00 | 1265710412 - STATEN ISLAND UNIVERSITY HOSPITAL | 112868878 - (NY) STATEN ISLAND UNIVERSITY HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 234 | $198433.01 | 1548301112 - DESERT REGIONAL MEDICAL CENTER, INC., DESERT REGIONAL MEDICAL CENTER | 752694137 | CA | Psychiatric Hospital Unit (273R00000X) |
United | 234 | $87119.00 | 1548278476 - ALTON MEMORIAL HOSPITAL | 370661172 - (IL) ALTON MEMORIAL HOSPITAL | IL | General Acute Care Hospital (282N00000X) |
United | 234 | $96292.00 | 1780762120 - UH REGIONAL HOSPITALS, UNIVERSITY HOSPITALS GEAUGA MEDICAL CENTER | 341924226 - (OH) UNIVERSITY HOSPITALS HEALTH SYSTEM INC | OH | Psychiatric Hospital Unit (273R00000X) |
United | 234 | $67901.71 | 1386453165 - SAINT JOSEPH MEDICAL CENTER | 992141118 | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 234 | $43111.37 | 1235111071 - SALINE HOSPITAL LLC, SALINE MEMORIAL HOSPITAL | 812816675 | AR | General Acute Care Hospital (282N00000X) |
United | 234 | $30325.14 | 1881956720 - DOCTORS MEMORIAL HOSPITAL, INC, DMH SWING BED | 593122517 - (FL) DOCTORS MEMORIAL HOSPITAL INC | FL | Rural Acute Care Hospital (282NR1301X) |
United | 234 | $80122.21 | 1881758126 - KISHWAUKEE COMMUNITY HOSPITAL, NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL | 237087041 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | General Acute Care Hospital (282N00000X) |
United | 234 | $3665.00 | 1558404632 - SHRINERS HOSPITALS FOR CHILDREN | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | PA | Children's Hospital (282NC2000X) |
United | 234 | $58985.00 | 1518057769 - MOUNT SINAI HOSPITAL MEDICAL CENTER, MOUNT SINAI HOSPITAL - PSYCH | 361509000 - (IL) MOUNT SINAI HOSPITAL MEDICAL CENTER | IL | Psychiatric Hospital Unit (273R00000X) |
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 234 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 234 code is part of the Diseases & Disorders of the Circulatory 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 234 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 |
|---|---|---|
| 233-APR-DRG | High | APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS |
| 233-MS-DRG | High | Coronary Bypass with Cardiac Catheterization or Open Ablation with MCC |
| 234-MS-DRG | High | Coronary Bypass with Cardiac Catheterization or Open Ablation without MCC |
| 235-APR-DRG | Moderate | Spinal Procedures |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 234. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 234 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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