MS-DRG 374 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 374 by major payers:
$23,955.53
$27,154.51
$33,101.58
$33,761.08
| 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 374 | ||||||
United | 374 | $24852.46 | 1770662348 - CHEROKEE INDIAN HOSPITAL AUTHORITY | 50524222 | NC | General Acute Care Hospital (282N00000X) |
United | 374 | $6520.00 | 1497988596 - ST. JOHN BROKEN ARROW, INC, ST. JOHN BROKEN ARROW | 383833117 - ST JOHN BROKEN ARROW INC | OK | General Acute Care Hospital (282N00000X) |
United | 374 | $29395.19 | 1730710898 - FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC, FROEDTERT COMMUNITY HOSPITAL | 843381796 | WI | General Acute Care Hospital (282N00000X) |
United | 374 | $29395.19 | 1730710898 - FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC, FROEDTERT COMMUNITY HOSPITAL | 843381796 | WI | General Acute Care Hospital (282N00000X) |
United | 374 | $57966.37 | 1790718500 - USC UNIVERSITY HOSPITAL, INC., USC HOSPITAL | 851644866 - (CA) KECK MEDICAL CENTER OF USC | CA | Psychiatric Hospital Unit (273R00000X) |
United | 374 | $28370.64 | 1780600577 - MARY IMOGENE BASSETT HOSPITAL, BASSETT HEALTHCARE | 135596796 - MARY IMOGENE BASSETT HOSPITAL | NY | Rural Acute Care Hospital (282NR1301X) |
United | 374 | $20119.52 | 1376584110 - CLARKSDALE HMA LLC, NORTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER | 853959101 | MS | General Acute Care Hospital (282N00000X) |
United | 374 | $12255.00 | 1225133473 - MONMOUTH MEDICAL CENTER INC, MONMOUTH MEDICAL CENTER SOUTHERN CAMPUS | 223452412 | NJ | General Acute Care Hospital (282N00000X) |
United | 374 | $18262.96 | 1841224870 - BANNER | 270036499 | AZ | General Acute Care Hospital (282N00000X) |
United | 374 | $23939.05 | 1528398534 - ADVANCED SURGICAL HOSPITAL LLC | 264093335 - (PA) ADVANCED SURGICAL HOSPITAL LLC | PA | General Acute Care Hospital (282N00000X) |
United | 374 | $36632.78 | 1164419198 - OUR LADY OF THE LAKE HOSPITAL, INC., OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER | 720423651 - (LA) OUR LADY OF THE LAKE HOSPITAL INC | LA | Psychiatric Hospital Unit (273R00000X) |
United | 374 | $16787.00 | 1346243375 - ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL, INC | 221487243 - (NJ) ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL | NJ | General Acute Care Hospital (282N00000X) |
United | 374 | $19205.84 | 1932260676 - RUSH OAK PARK HOSPITAL, RUSH OAK PARK HOSPITAL REHABILITATION UNIT | 362183812 - (IL) RUSH OAK PARK HOSPITAL INC | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 374 | $20119.52 | 1376584110 - CLARKSDALE HMA LLC, NORTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER | 853959101 | MS | General Acute Care Hospital (282N00000X) |
United | 374 | $35883.39 | 1427607464 - SAINT JOSEPH HOSPITAL, INC | 840417134 - (CO) SAINT JOSEPH HOSPITAL | CO | 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 374 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 374 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 374 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 |
|---|---|---|
| 373-MS-DRG | High | Major Gastrointestinal Disorders and Peritoneal Infections without CC/MCC |
| 374-MS-DRG | High | Digestive Malignancy with MCC |
| 375-MS-DRG | High | Digestive Malignancy with CC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 374. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 374 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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