MS-DRG 394 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 394 by major payers:
$11,291.51
$12,997.04
$14,973.27
$15,301.51
| 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 394 | ||||||
United | 394 | $4027.00 | 1780375592 - SOUTH ARKANSAS REGIONAL HOSPITAL LLC | 923616260 | AR | General Acute Care Hospital (282N00000X) |
United | 394 | $4512.58 | 1447465075 - WARDS 3 4 & 10 HOSPITAL SERVICE DISTRICT PARISH OF UNION, REEVES MEMORIAL MEDICAL CENTER | 720685207 | LA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 394 | $16421.91 | 1487633509 - VHS SAN ANTONIO PARTNERS LLC, BAPTIST HEALTH SYSTEM | 760714523 | TX | Psychiatric Hospital Unit (273R00000X) |
United | 394 | $4512.58 | 1447465075 - WARDS 3 4 & 10 HOSPITAL SERVICE DISTRICT PARISH OF UNION, REEVES MEMORIAL MEDICAL CENTER | 720685207 | LA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 394 | $9855.41 | 1942205166 - CLAIBORNE MEDICAL CENTER | 464420358 - (TN) CLAIBORNE MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | 394 | $4027.00 | 1780375592 - SOUTH ARKANSAS REGIONAL HOSPITAL LLC | 923616260 | AR | General Acute Care Hospital (282N00000X) |
United | 394 | $16567.82 | 1992815195 - OCHSNER BAPTIST MEDICAL CENTER | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | General Acute Care Hospital (282N00000X) |
United | 394 | $15383.66 | 1841844735 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL KELLY | 452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 394 | $7019.00 | 1467491027 - ROSE CITY HMA LLC, LANCASTER REGIONAL MEDICAL CENTER | 474849671 | PA | General Acute Care Hospital (282N00000X) |
United | 394 | $9534.42 | 1942317656 - MEMORIAL HOSPITAL | 356001853 - (IN) MEMORIAL HOSPITAL | IN | General Acute Care Hospital (282N00000X) |
United | 394 | $14101.62 | 1043457583 - MEMORIAL HERMANN REHABILITATION HOSPITAL KATY, LLC, MEMORIAL HERMANN REHABILITATION HOSPITAL KATY | 263896170 | TX | Rehabilitation Hospital (283X00000X) |
United | 394 | $23632.65 | 1790702371 - COUNTY OF YOAKUM, YOAKUM COUNTY HOSPITAL | 756001212 | TX | Critical Access Hospital (282NC0060X) |
United | 394 | $17792.51 | 1427283795 - ALEGENT HEALTH IMMANUEL MEDICAL CENTER, ALEGENT HEALTH IMMANUEL MEDICAL CENTER - PSYCHIATRIC UNIT | 470376615 - ALEGENT HEALTH-IMMANUEL MEDICAL CENTER | NE | Psychiatric Hospital Unit (273R00000X) |
United | 394 | $1829.00 | 1073647384 - NATCHITOCHES PARISH HOSPITAL SERVICE DISTRICT, NATCHITOCHES REGIONAL MEDICAL CENTER | 726013916 - (LA) NATCHITOCHES REGIONAL MEDICAL CENTER | LA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 394 | $12777.20 | 1114903523 - BRIM HEALTHCARE OF TEXAS LLC | 264178850 | TX | 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 394 vs. Other Diseases & Disorders of the Digestive System Codes
The MS-DRG 394 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 394 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 |
|---|---|---|
| 393-MS-DRG | High | Other Digestive System Diagnoses with MCC |
| 394-MS-DRG | High | Other Digestive System Diagnoses with CC |
| 395-MS-DRG | High | Other Digestive System Diagnoses 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 394. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 394 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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