MS-DRG 006 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 006 by major payers:
$63,395.59
$62,294.77
$76,349.00
$79,812.55
| 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 006 | ||||||
United | 006 | $9401.00 | 1487649430 - THE MIRIAM HOSPITAL | 50258905 - THE MIRIAM HOSPITAL | RI | General Acute Care Hospital (282N00000X) |
United | 006 | $90869.15 | 1255640819 - VHS OF ARROWHEAD, INC., ABRAZO ARIZONA HEART HOSPITAL | 621811285 | AZ | General Acute Care Hospital (282N00000X) |
United | 006 | $50366.32 | 1083619712 - GENERAL HOSPITAL, IRAAN GENERAL HOSPITAL DISTRICT | 746003374 - (TX) GENERAL HOSPITAL | TX | Critical Access Hospital (282NC0060X) |
United | 006 | $123460.63 | 1144914607 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH ADULT CONGENITAL HEART PROGRAM | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 006 | $504.00 | 1548488224 - NORTH SUNFLOWER MEDICAL CENTER | 646001408 | MS | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 006 | $504.00 | 1548488224 - NORTH SUNFLOWER MEDICAL CENTER | 646001408 | MS | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 006 | $5270.00 | 1568899391 - HILLCREST BAPTIST MEDICAL CENTER, BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | 741161944 - (TX) HILLCREST BAPTIST MEDICAL CENTER | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 006 | $48395.01 | 1801895644 - CHRISTUS HEALTH SOUTHWESTERN LOUISIANA, CHRISTUS ST. PATRICK HOSPITAL | 720411322 - (LA) CHRISTUS HEALTH SOUTHWESTERN LOUISIANA | LA | Rehabilitation Hospital Unit (273Y00000X) |
United | 006 | $67738.46 | 1821186313 - SHANDS JACKSONVILLE MEDICAL CENTER INC, SHANDS JACKSONVILLE | 592142859 - SHANDS JACKSONVILLE MEDICAL CENTER INC | FL | General Acute Care Hospital (282N00000X) |
United | 006 | $50173.16 | 1730697350 - JACKSONVILLE HOSPITAL LLC, UTHEALTH EAST TEXAS JACKSONVILLE HOSPITAL | 824037220 | TX | General Acute Care Hospital (282N00000X) |
United | 006 | $105775.74 | 1255804753 - MEDICAL UNIVERSITY HOSPITAL AUTHORITY, MUSC HEALTH LANCASTER MEDICAL CENTER | 571098556 - (SC) MEDICAL UNIVERSITY HOSPITAL AUTHORITY | SC | Psychiatric Hospital (283Q00000X) |
United | 006 | $40098.89 | 1356528269 - MULTICARE HEALTH SYSTEM, MULTICARE DEACONESS HOSPITAL | 911352172 - MULTICARE HEALTH SYSTEM | WA | General Acute Care Hospital (282N00000X) |
United | 006 | $6034.00 | 1669453932 - PARADISE VALLEY HOSPITAL | 205837239 | CA | Rehabilitation Hospital Unit (273Y00000X) |
United | 006 | $8249.00 | 1861486870 - ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT RAHWAY, RAHWAY HOSPITAL | 221487305 - (NJ) ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL RAHWAY | NJ | General Acute Care Hospital (282N00000X) |
United | 006 | $90313.84 | 1790734127 - SAINT FRANCIS MEDICAL CENTER, CHILDREN'S HOSPITAL OF ILLINOIS | 370662569 - (IL) SAINT FRANCIS MEDICAL CENTER | IL | Children's Hospital (282NC2000X) |
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 006 vs. Other Pre-MDC Codes
The MS-DRG 006 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 006 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 |
|---|---|---|
| 005-APR-DRG | High | TRACHEOSTOMY W MV 96+ HOURS W/O EXTENSIVE PROCEDURE |
| 005-MS-DRG | High | Liver Transplant with MCC or Intestinal Transplant |
| 006-MS-DRG | High | Liver Transplant without MCC |
| 007-APR-DRG | High | ALLOGENEIC 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 006. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 006 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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