MS-DRG 354 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 Digestive System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 354 by major payers:
$19,922.85
$22,505.54
$26,986.31
$27,706.62
| 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 354 | ||||||
United | 354 | $39065.76 | 1174533343 - TEXAS HEALTH ARLINGTON MEMORIAL HOSPITAL | 750972805 - (TX) TEXAS HEALTH ARLINGTON MEMORIAL HOSPITAL | TX | General Acute Care Hospital (282N00000X) |
United | 354 | $29684.19 | 1700553856 - SOUTHERN BAPTIST HOSPITAL OF FLORIDA, INC | 590747311 - SOUTHERN BAPTIST HOSPITAL OF FLORIDA INC | FL | Children's Hospital (282NC2000X) |
United | 354 | $18358.26 | 1093712655 - CHATHAM HOSPITAL INC | 560611546 - (NC) CHATHAM HOSPITAL INC | NC | Critical Access Hospital (282NC0060X) |
United | 354 | $21333.50 | 1851496152 - SSM HEALTH CARE ST. LOUIS, SSM HEALTH ST. CLARE HOSPITAL - FENTON | 431343281 - SSM HEALTH CARE ST LOUIS | MO | General Acute Care Hospital (282N00000X) |
United | 354 | $19993.47 | 1043659816 - ORO VALLEY HOSPITAL LLC, ORO VALLEY HOSPITAL | 621762430 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 354 | $23046.50 | 1700821808 - PHC-LAS CRUCES INC, MEMORIAL MEDICAL CENTER OF LAS CRUCES | 270085482 | NM | General Acute Care Hospital (282N00000X) |
United | 354 | $15138.12 | 1790715381 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL DULUTH | 581954432 - (GA) NORTHSIDE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | 354 | $30973.63 | 1891354726 - UCH-MHS, MEMORIAL HEALTH SYSTEM | 460796114 - (CO) UCH-MHS | CO | General Acute Care Hospital (282N00000X) |
United | 354 | $29715.66 | 1679121024 - FAIRVIEW HEALTH SERVICES, UMMC, FAIRVIEW (PSYCH UNIT) | 410991680 - FAIRVIEW HEALTH SERVICES | MN | Psychiatric Hospital Unit (273R00000X) |
United | 354 | $7895.00 | 1538141627 - HANFORD COMMUNITY HOSPITAL, ADVENTIST HEALTH HANFORD | 940535360 - (CA) HANFORD COMMUNITY HOSPITAL | CA | General Acute Care Hospital (282N00000X) |
United | 354 | $17737.36 | 1518129881 - LESTER E COX MEDICAL CENTERS, COX WALNUT LAWN PHARMACY | 440577118 - LESTER E COX MEDICAL CENTER | MO | General Acute Care Hospital (282N00000X) |
United | 354 | $21011.74 | 1548376700 - TISHOMINGO HEALTH SERVICES, INC., TISHOMINGO CO HOSPITAL | 640741047 - TISHOMINGO HEALTH SERVICES INC | MS | General Acute Care Hospital (282N00000X) |
United | 354 | $37487.53 | 1700961869 - CARONDELET HEALTH NETWORK, ST. MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 354 | $4958.00 | 1780680215 - RUSSELL COUNTY MEDICAL CENTER, INC, RUSSELL COUNTY MEDICAL CENTER | 620476282 - MOUNTAIN STATES HEALTH ALLIANCE | VA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 354 | $26108.48 | 1639783509 - PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA, JACKSON WEST | 591713947 - (FL) PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY FLORIDA | FL | 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 354 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 354 code is part of the Diseases & Disorders of the Digestive 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 354 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 |
|---|---|---|
| 353-MS-DRG | High | Hernia Procedures except Inguinal and Femoral with MCC |
| 354-MS-DRG | High | Hernia Procedures except Inguinal and Femoral with CC |
| 355-MS-DRG | High | Hernia Procedures except Inguinal and Femoral 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 354. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 354 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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