MS-DRG 434 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 Hepatobiliary System & Pancreas |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 434 by major payers:
$8,656.57
$10,213.84
$11,082.52
$11,472.88
| 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 434 | ||||||
United | 434 | $17546.23 | 1154355188 - BANNER THUNDERBIRD MEDICAL CENTER | 270036484 - (AZ) BANNER THUNDERBIRD MEDICAL CENTER | AZ | General Acute Care Hospital (282N00000X) |
United | 434 | $19639.21 | 1205307378 - CHEROKEE MEDICAL CENTER, CMC WOUND SERVICES | 832531807 | SC | General Acute Care Hospital (282N00000X) |
United | 434 | $1864.00 | 1821103516 - PONTOTOC HEALTH SERVICES, INC., PONTOTOC HEALTH SERVICES CAH | 640751410 - (MS) PONTOTOC HEALTH SERVICES INC | MS | Critical Access Hospital (282NC0060X) |
United | 434 | $19974.23 | 1528101284 - DIGNITY HEALTH, ST. ROSE DOMINICAN HOSPITAL, SAN MARTIN CAMPUS | 880059427 - (NV) DIGNITY HEALTH | NV | General Acute Care Hospital (282N00000X) |
United | 434 | $15994.42 | 1043270564 - THE MEDICAL CENTER OF CENTRAL GEORGIA INC, ATRIUM HEALTH NAVICENT THE MEDICAL CENTER | 582149128 - MEDICAL CENTER OF CENTRAL GEORGIA INC | GA | General Acute Care Hospital (282N00000X) |
United | 434 | $12506.34 | 1972582724 - UNIVERSITY OF KANSAS HOSPITAL AUTHORITY, THE UNIVERSITY OF KANSAS HOSPITAL | 481202402 - UNIVERSITY OF KANSAS HOSPITAL AUTHORITY | KS | Rehabilitation Hospital Unit (273Y00000X) |
United | 434 | $4833.00 | 1437483864 - ALLIANCE HEALTH PARTNERS LLC, MERIT HEALTH BATESVILLE | 832451967 | MS | Psychiatric Hospital Unit (273R00000X) |
United | 434 | $4833.00 | 1437483864 - ALLIANCE HEALTH PARTNERS LLC, MERIT HEALTH BATESVILLE | 832451967 | MS | Psychiatric Hospital Unit (273R00000X) |
United | 434 | $7661.50 | 1164689394 - REEDSBURG AREA MEDICAL CENTER | 391091432 - (WI) REEDSBURG AREA MEDICAL CENTER INC | WI | Critical Access Hospital (282NC0060X) |
United | 434 | $12024.88 | 1144471715 - PROVIDENCE HEALTH & SERVICES, PROV SCRED HRT MED CTR & CHLDS HOS | 364640211 | WA | General Acute Care Hospital (282N00000X) |
United | 434 | $9923.73 | 1710039508 - THE METHODIST HOSPITALS, INC. | 350868133 - METHODIST HOSPITALS INC | IN | Rehabilitation Hospital Unit (273Y00000X) |
United | 434 | $5973.18 | 1306914882 - MARSHALL MEDICAL CENTER SOUTH | 831651180 | AL | General Acute Care Hospital (282N00000X) |
United | 434 | $14480.92 | 1124032982 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION, CONEY ISLAND HOSPITAL | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | General Acute Care Hospital (282N00000X) |
United | 434 | $5973.18 | 1306914882 - MARSHALL MEDICAL CENTER SOUTH | 831651180 | AL | General Acute Care Hospital (282N00000X) |
United | 434 | $11045.63 | 1467406132 - EASTSIDE MEDICAL CENTER, LLC, PIEDMONT EASTSIDE MEDICAL CENTER | 582433432 | GA | 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 434 vs. Other Diseases & Disorders of the Hepatobiliary System & Pancreas Codes
The MS-DRG 434 code is part of the Diseases & Disorders of the Hepatobiliary System & Pancreas 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 434 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 |
|---|---|---|
| 433-APR-DRG | Moderate | Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies |
| 433-MS-DRG | High | Cirrhosis and Alcoholic Hepatitis with CC |
| 434-MS-DRG | High | Cirrhosis and Alcoholic Hepatitis without CC/MCC |
| 435-APR-DRG | Moderate | Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 434. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 434 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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