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See a sample rate comparisonMS-DRG 005 Fee Schedule
Last Verified: October 2026
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.
LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT
| 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 005 by major payers:
$115,538.75
$133,848.56
$167,171.90
$175,083.14
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MS-DRG 005
5 of 25 sample ratesHigher to lower in this preview
NYU Langone Hospitals
$341,673.87Published rateGreenville Health System, Ghs Ob/Gyn Clinic
Prisma Health - Upstate
$199,816.42Published rateRehabilitation Hospital, LLC
$138,652.09Published rateMemorial Hospital Of Texas County Authority, Memorial Hospital Of Texas County Authority - Swing Bed
$87,431.57Published rateThe Brooklyn Hospital Center
$9,314.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 005 vs. Other Pre-MDC Codes
The MS-DRG 005 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 005 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 |
|---|---|---|
| 004-APR-DRG | High | TRACHEOSTOMY W MV 96+ HOURS W EXTENSIVE PROCEDURE |
| 004-MS-DRG | High | TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES |
| 005-MS-DRG | High | LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT |
| 006-APR-DRG | High | PANCREAS 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 005. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 005 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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