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 | $65444.80 | 1972560654 - BAPTIST MEMORIAL HOSPITAL-DESOTO, INC. | 640682111 - (MS) BAPTIST MEMORIAL HOSPITAL-DESOTO INC | MS | Rehabilitation Hospital Unit (273Y00000X) |
United | 006 | $75068.68 | 1144521949 - EMANUEL MEDICAL CENTER, INC., EMANUEL SPECIALTY CARE - CARDIOVASCULAR MEDICINE | 752918774 | CA | General Acute Care Hospital (282N00000X) |
United | 006 | $33057.05 | 1245274950 - MERCY HEALTH-REGIONAL MEDICAL CENTER LLC, MERCY HEALTH LORAIN HOSPITAL | 340714704 | OH | General Acute Care Hospital (282N00000X) |
United | 006 | $69358.10 | 1366440620 - JORDAN VALLEY MEDICAL CENTER LP | 820588653 | UT | General Acute Care Hospital (282N00000X) |
United | 006 | $152812.84 | 1720004450 - NORTH COLORADO MEDICAL CENTER | 841287638 | CO | General Acute Care Hospital (282N00000X) |
United | 006 | $5264.00 | 1174521991 - PAWHUSKA HOSPITAL, INC. | 237169376 - (OK) PAWHUSKA HOSPITAL INC | OK | Critical Access Hospital (282NC0060X) |
United | 006 | $62865.03 | 1043659816 - ORO VALLEY HOSPITAL LLC, ORO VALLEY HOSPITAL | 621762430 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 006 | $26672.00 | 1174599468 - WAYNE COUNTY HOSPITAL | 426038180 | IA | Critical Access Hospital (282NC0060X) |
United | 006 | $85796.89 | 1972523348 - UNIVERSITY HOSPITAL AT STONY BROOK, STONY BROOK UNIVERSITY HOSPITAL | 113243405 | NY | General Acute Care Hospital (282N00000X) |
United | 006 | $83988.14 | 1073967329 - BBH SBMC, LLC, SHELBY BAPTIST MEDICAL CENTER | 474780023 | AL | Psychiatric Hospital Unit (273R00000X) |
United | 006 | $44690.23 | 1073598439 - VALLEY MEDICAL FACILITIES, INC., HERITAGE VALLEY KENNEDY | 251801532 - (PA) HERITAGE VALLEY HEALTH SYSTEM | PA | General Acute Care Hospital (282N00000X) |
United | 006 | $64214.67 | 1548260839 - THEDACARE MEDICAL CENTER, SHAWANO MEDICAL CENTER, INC. | 390807068 - THEDACARE MEDICAL CENTER-SHAWANO INC | WI | Critical Access Hospital (282NC0060X) |
United | 006 | $50366.32 | 1083619712 - GENERAL HOSPITAL, IRAAN GENERAL HOSPITAL DISTRICT | 746003374 - (TX) GENERAL HOSPITAL | TX | Critical Access Hospital (282NC0060X) |
United | 006 | $85796.89 | 1972523348 - UNIVERSITY HOSPITAL AT STONY BROOK, STONY BROOK UNIVERSITY HOSPITAL | 113243405 | NY | General Acute Care Hospital (282N00000X) |
United | 006 | $56388.57 | 1528387842 - DESOTO COUNTY HOSPITAL DISTRICT, DESOTO MEMORIAL HOSPITAL | 591205441 - (FL) DESOTO MEMORIAL HOSPITAL | FL | Rural Acute Care Hospital (282NR1301X) |
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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