MS-DRG 002 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 | • Pre-MDC |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 002 by major payers:
$136,250.11
$136,251.63
$175,652.60
$181,179.13
| 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 002 | ||||||
United | 002 | $189704.14 | 1497843940 - BAPTIST HEALTH SYSTEM INC, WALKER BAPTIST MEDICAL CENTER | 474790386 | AL | General Acute Care Hospital (282N00000X) |
United | 002 | $136705.37 | 1801852736 - ODESSA REGIONAL HOSPITAL LP | 621795574 | TX | General Acute Care Hospital (282N00000X) |
United | 002 | $99166.28 | 1215918560 - ENDLESS MOUNTAINS HEALTH SYSTEMS, INC. | 232720289 - (PA) ENDLESS MOUNTAINS HEALTH SYSTEMS INC | PA | Critical Access Hospital (282NC0060X) |
United | 002 | $320170.96 | 1740772268 - FLORIDA HOSPITAL OCALA INC, ADVENT HEALTH OCALA | 824372339 - (FL) FLORIDA HOSPITAL OCALA INC | FL | General Acute Care Hospital (282N00000X) |
United | 002 | $179929.65 | 1275527889 - CANDLER HOSPITAL INCORPORATED | 580593388 - CANDLER HOSPITAL INCORPORATED | GA | General Acute Care Hospital (282N00000X) |
United | 002 | $137018.95 | 1962504175 - ST MARY MEDICAL CENTER INC, ST MARY WOUND CLINIC | 352007327 - (IN) ST MARY MEDICAL CENTER INC | IN | General Acute Care Hospital (282N00000X) |
United | 002 | $126197.60 | 1912553744 - OCHSNER MORGAN CITY LLC, OCHSNER ST. MARY | 842237042 | LA | Psychiatric Hospital Unit (273R00000X) |
United | 002 | $213616.87 | 1669559811 - UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER, UHCMC - PSYCH | 341567805 - UNIVERSITY HOSPITALS HEALTH SYSTEM INC | OH | Psychiatric Hospital Unit (273R00000X) |
United | 002 | $126197.60 | 1912553744 - OCHSNER MORGAN CITY LLC, OCHSNER ST. MARY | 842237042 | LA | Psychiatric Hospital Unit (273R00000X) |
United | 002 | $193142.28 | 1841701562 - NAVICENT HEALTH BALDWIN, INC, NAVICENT HEALTH BALDWIN | 823914925 - (GA) NAVICENT HEALTH BALDWIN | GA | General Acute Care Hospital (282N00000X) |
United | 002 | $108433.85 | 1376591941 - HOSPITAL SERVICE DISTRICT 1 OF EAST BATON ROUGE PARISH, LANE REGIONAL MEDICAL CENTER | 726015227 | LA | General Acute Care Hospital (282N00000X) |
United | 002 | $174034.12 | 1316324403 - INDIANA SPINE HOSPITAL, LLC, INDIANA SPINE HOSPITAL | 473759447 - (IN) INDIANA SPINE HOSPITAL | IN | Special Hospital (284300000X) |
United | 002 | $318524.43 | 1598181091 - WESTCHESTER COUNTY HEALTH CARE CORPORATION, MID-HUDSON VALLEY DIVISION OF WESTCHESTER MEDICAL CENTER | 133964321 - (NY) PEO MID-HUDSON VALLEY STAFFCO | NY | General Acute Care Hospital (282N00000X) |
United | 002 | $165086.12 | 1932152337 - MEMORIAL HERMANN HEALTH SYSTEM, MEMORIAL HERMANN KATY HOSPITAL | 741152597 - (TX) MEMORIAL HERMANN HEALTH SYSTEM | TX | General Acute Care Hospital (282N00000X) |
United | 002 | $179389.70 | 1932260833 - FAIRVIEW HEALTH SERVICES, FAIRVIEW DIAGNOSTIC LABORATORY | 410991680 - FAIRVIEW HEALTH SERVICES | MN | 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 002 vs. Other Pre-MDC Codes
The MS-DRG 002 code is part of the Pre-MDC 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 002 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 |
|---|---|---|
| 001-APR-DRG | High | LIVER TRANSPLANT &/OR INTESTINAL TRANSPLANT |
| 001-MS-DRG | High | Heart Transplant or Implant of Heart Assist System with MCC |
| 002-MS-DRG | High | Heart Transplant or Implant of Heart Assist System without MCC |
| 003-APR-DRG | High | Bone Marrow Transplant |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 002. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 002 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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