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See a sample rate comparisonMS-DRG 007 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.
LUNG 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 007 by major payers:
$118,130.84
$163,568.37
$204,326.74
$214,824.54
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MS-DRG 007
5 of 25 sample ratesHigher to lower in this preview
York Hospital, Wellspan York Hospital Inpatient Psych Unit
York Hospital
$483,545.59Published rateCarondelet Health Network, St Mary'S Hospital
$230,847.28Published rateHigh Point Regional Health, High Point Regional Rehab
High Point Regional Health
$171,815.51Published rateKing'S Daughters Medical Center
Kings Daughters Medical Center
$129,943.07Published rateDoctors' Hospital Of Slidell, LLC, Sterling Surgical Hospital
Doctors Hospital Of Slidell, LLC
$1,800.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 007 vs. Other Pre-MDC Codes
The MS-DRG 007 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 007 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 |
|---|---|---|
| 006-APR-DRG | High | PANCREAS TRANSPLANT |
| 006-MS-DRG | High | LIVER TRANSPLANT WITHOUT MCC |
| 007-MS-DRG | High | LUNG TRANSPLANT |
| 008-APR-DRG | High | AUTOLOGOUS BONE MARROW TRANSPLANT OR T-CELL IMMUNOTHERAPY |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 007. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 007 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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