MS-DRG 294 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 294 by major payers:
$13,958.75
$16,078.22
$19,214.42
$19,694.77
| 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 294 | ||||||
United | 294 | $20387.25 | 1477579464 - NASSAU HEALTH CARE CORPORATION, NUMC DEPARTMENT OF RADIOLOGY, FFP | 113465690 | NY | General Acute Care Hospital (282N00000X) |
United | 294 | $12058.95 | 1730264128 - BAPTIST HEALTHCARE SYSTEM, INC | 610444707 - BAPTIST HEALTHCARE SYSTEM INC | KY | General Acute Care Hospital (282N00000X) |
United | 294 | $19473.61 | 1114995156 - THE PENNSYLVANIA HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA HEALTH SYS | 311538725 - (PA) PENNSYLVANIA HOSPITAL OF THE UNIV OF PENNSYLVANIA HEALTH SYSTEM | PA | Rehabilitation Hospital Unit (273Y00000X) |
United | 294 | $25817.47 | 1932131141 - UNITED HEALTH SERVICES HOSPITALS, INC | 161165049 - (NY) UNITED HEALTH SERVICES HOSPITALS INC | NY | General Acute Care Hospital (282N00000X) |
United | 294 | $6520.00 | 1144231432 - OWASSO MEDICAL FACILITY, INC, ST. JOHN OWASSO | 203700131 - (OK) OWASSO MEDICAL FACILITY INC | OK | General Acute Care Hospital (282N00000X) |
United | 294 | $9737.40 | 1649259656 - UNIVERSITY OF KANSAS HOSPITAL AUTHORITY, THE UNIVERSITY OF KANSAS HOSPITAL | 481202402 - UNIVERSITY OF KANSAS HOSPITAL AUTHORITY | KS | General Acute Care Hospital (282N00000X) |
United | 294 | $29600.93 | 1275566200 - BANNER ESTRELLA MEDICAL CENTER | 900065118 - (AZ) BANNER ESTRELLA MEDICAL CENTER | AZ | General Acute Care Hospital (282N00000X) |
United | 294 | $20440.06 | 1528169125 - HONORHEALTH, HONORHEALTH DEER VALLEY MEDICAL CENTER | 860181654 - HONORHEALTH | AZ | General Acute Care Hospital (282N00000X) |
United | 294 | $14063.05 | 1093876997 - PHC-MORGAN CITY LP, TECHE REGIONAL MEDICAL CENTER | 842237042 | LA | Rural Acute Care Hospital (282NR1301X) |
United | 294 | $10295.73 | 1699810523 - ST. JOSEPH HEALTH SERVICES OF RI, VASCULAR GROUP | 464661337 | RI | General Acute Care Hospital (282N00000X) |
United | 294 | $13499.40 | 1700961869 - CARONDELET HEALTH NETWORK, ST. MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 294 | $15739.28 | 1912423260 - TOPEKA HOSPITAL, LLC, THE UNIVERSITY OF KANSAS HEALTH SYSTEM, ST. FRANCIS CAMPUS | 822034009 | KS | General Acute Care Hospital (282N00000X) |
United | 294 | $1688.00 | 1639284409 - CLAY COUNTY MEDICAL CORPORATION, CLAY COUNTY MEDICAL CENTER | 640668465 - (MS) CLAY COUNTY MEDICAL CORPORATION | MS | General Acute Care Hospital (282N00000X) |
United | 294 | $14573.90 | 1598905762 - CENTRAL IOWA HOSPITAL CORPORATION, UNITYPOINT HEALTH - DES MOINES IOWA METHODIST MEDICAL CENTER | 420680452 - CENTRAL IOWA HOSPITAL CORPORATION | IA | General Acute Care Hospital (282N00000X) |
United | 294 | $19546.83 | 1033224704 - UNIVERSITY HOSPITAL AT STONY BROOK, STONY BROOK SOUTHAMPTON HOSPITAL | 113243405 | NY | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
MS-DRG 294 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 294 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 294 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 |
|---|---|---|
| 293-APR-DRG | Moderate | Other Percutaneous Intracranial Procedures |
| 293-MS-DRG | High | Heart Failure and Shock without CC/MCC |
| 294-MS-DRG | High | Deep Ven Thrombophlebitis with CC/MCC |
| 295-MS-DRG | High | Deep Ven Thrombophlebitis 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 294. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 294 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like MS-DRG 294) and we'll show you how you compare in 15 minutes or less.