MS-DRG 304 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 304 by major payers:
$12,917.43
$15,537.95
$18,881.87
$19,044.79
| 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 304 | ||||||
United | 304 | $31318.99 | 1285798918 - UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS, UT SOUTHWESTERN UNIVERSITY HOSPITAL | 753175630 | TX | General Acute Care Hospital (282N00000X) |
United | 304 | $13447.61 | 1942478011 - CLIFTON SPRINGS SANITARIUM COMPANY, CLIFTON SPRINGS HOSPITAL AND CLINIC | 160743966 - (NY) CLIFTON SPRINGS SANITARIUM CO | NY | General Acute Care Hospital (282N00000X) |
United | 304 | $23492.48 | 1275886434 - PHOENIX CHILDREN'S HOSPITAL, INC., PHOENIX CHILDREN'S SURGERY CENTER - EAST VALLEY | 860422559 - (AZ) PHOENIX CHILDRENS HOSPITAL | AZ | Children's Hospital (282NC2000X) |
United | 304 | $9203.12 | 1194758284 - BANNER BAYWOOD MEDICAL CENTER | 363386394 - (AZ) BANNER BAYWOOD MEDICAL CENTER | AZ | General Acute Care Hospital (282N00000X) |
United | 304 | $12276.66 | 1336841568 - ERLANGER HEALTH | 883616696 - ERLANGER HEALTH | TN | Critical Access Hospital (282NC0060X) |
United | 304 | $53404.05 | 1548399736 - DOCTORS MEDICAL CENTER OF MODESTO, INC., DOCTORS BEHAVIORAL HEALTH CENTER | 952588614 | CA | Psychiatric Hospital Unit (273R00000X) |
United | 304 | $20479.10 | 1902822992 - NASSAU HEALTHCARE CORPORATION, NASSAU DEPARTMENT OF PSYCHIATRY AND PSYCHOLOGY, FPP | 113465690 | NY | General Acute Care Hospital (282N00000X) |
United | 304 | $5268.00 | 1770681421 - JAY HOSPITAL, INC., JAY HOSPITAL - SNF | 592425149 - JAY HOSPITAL INC | FL | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 304 | $10553.15 | 1487629978 - PERSON MEMORIAL HOSPITAL | 452909143 | NC | General Acute Care Hospital (282N00000X) |
United | 304 | $6256.79 | 1598873796 - FREEMAN NEOSHO HOSPITAL | 431240629 - (MO) FREEMAN NEOSHO HOSPITAL | MO | Critical Access Hospital (282NC0060X) |
United | 304 | $16151.15 | 1659523132 - THE METHODIST HOSPITAL, THE METHODIST HOSPITAL | 350868133 - METHODIST HOSPITALS INC | IN | General Acute Care Hospital (282N00000X) |
United | 304 | $10339.53 | 1538449830 - SUMMA REHAB HOSPITAL LLC, SUMMA REHAB HOSPITAL | 271952573 - (OH) SUMMA REHAB HOSPITAL, LLC. | OH | Rehabilitation Hospital (283X00000X) |
United | 304 | $1200.00 | 1619057155 - SABINE MEDICAL CENTER | 262074318 | LA | General Acute Care Hospital (282N00000X) |
United | 304 | $16662.47 | 1013998426 - WSNCHS NORTH, INC., ST. JOSEPH HOSPITAL | 113438973 - ST JOSEPH HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 304 | $27782.84 | 1467764555 - VANDERBILT MEDICAL CENTER | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Critical Access Hospital (282NC0060X) |
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 304 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 304 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 304 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 |
|---|---|---|
| 303-APR-DRG | High | DORSAL & LUMBAR FUSION PROC FOR CURVATURE OF BACK |
| 303-MS-DRG | High | Atherosclerosis without MCC |
| 304-MS-DRG | High | Hypertension with MCC |
| 305-APR-DRG | High | AMPUTATION OF LOWER LIMB EXCEPT TOES |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 304. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 304 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 304) and we'll show you how you compare in 15 minutes or less.