MS-DRG 010 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 010 by major payers:
$57,891.45
$95,015.02
$122,456.64
$131,124.99
| 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 010 | ||||||
United | 010 | $3744.00 | 1669740056 - HIGHLANDS HOSPITAL AND HEALTH CENTER | 251494705 - HIGHLANDS HOSPITAL AND HEALTH CENTER | PA | General Acute Care Hospital (282N00000X) |
United | 010 | $4008.00 | 1801826912 - WELLMONT HEALTH SYSTEM, LONESOME PINE HOSPITAL | 621636465 - WELLMONT HEALTH SYSTEM | VA | General Acute Care Hospital (282N00000X) |
United | 010 | $117888.78 | 1710499462 - HMH HOSPITALS CORPORATION, RIVERVIEW MEDICAL CENTER | 340714755 - SUMMA HEALTH SYSTEM | NJ | General Acute Care Hospital (282N00000X) |
United | 010 | $114037.82 | 1437894011 - JORDAN VALLEY & MOUNTAIN POINT MEDICAL CENTER, LLC | 820588653 | UT | General Acute Care Hospital (282N00000X) |
United | 010 | $114037.82 | 1437894011 - JORDAN VALLEY & MOUNTAIN POINT MEDICAL CENTER, LLC | 820588653 | UT | General Acute Care Hospital (282N00000X) |
United | 010 | $123198.79 | 1659393932 - DLP FRYE REGIONAL MEDICAL CENTER LLC, FRYE REGIONAL MEDICAL CENTER | 352547114 | NC | Psychiatric Hospital Unit (273R00000X) |
United | 010 | $123198.79 | 1659393932 - DLP FRYE REGIONAL MEDICAL CENTER LLC, FRYE REGIONAL MEDICAL CENTER | 352547114 | NC | Psychiatric Hospital Unit (273R00000X) |
United | 010 | $214816.54 | 1255804753 - MEDICAL UNIVERSITY HOSPITAL AUTHORITY, MUSC HEALTH LANCASTER MEDICAL CENTER | 571098556 - (SC) MEDICAL UNIVERSITY HOSPITAL AUTHORITY | SC | Psychiatric Hospital (283Q00000X) |
United | 010 | $256028.98 | 1609858950 - ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC, PROVIDENCE ST. JOSEPH HOSPITAL | 814791043 - (CA) ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC | CA | General Acute Care Hospital (282N00000X) |
United | 010 | $75069.52 | 1932125606 - WEST PENN ALLEGHENY HEALTH SYSTEM INC., FORBES REGIONAL HOSPITAL - PSYCH | 250969492 - (PA) HIGHMARK HEALTH | PA | Psychiatric Hospital Unit (273R00000X) |
United | 010 | $114819.17 | 1518178268 - J C BLAIR MEMORIAL HOSPITAL, PENN HIGHLANDS HUNTINGDON | 231352159 - (PA) J C BLAIR MEMORIAL HOSPITAL | PA | Psychiatric Hospital Unit (273R00000X) |
United | 010 | $170526.51 | 1912108002 - MISSION HOSPITAL REGIONAL MEDICAL CENTER, PROVIDENCE MISSION HOSPITAL | 951643360 - (CA) MISSION HOSPITAL REGIONAL MEDICAL CENTER | CA | General Acute Care Hospital (282N00000X) |
United | 010 | $82361.09 | 1083615587 - EPHRATA COMMUNITY HOSPITAL, WELLSPAN EPHRATA COMMUNITY HOSPITAL | 883577015 | PA | General Acute Care Hospital (282N00000X) |
United | 010 | $82361.09 | 1083615587 - EPHRATA COMMUNITY HOSPITAL, WELLSPAN EPHRATA COMMUNITY HOSPITAL | 883577015 | PA | General Acute Care Hospital (282N00000X) |
United | 010 | $67882.11 | 1063113983 - GRAHAM HOSPITAL DISTRICT | 463113489 | TX | Critical Access Hospital (282NC0060X) |
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 010 vs. Other Pre-MDC Codes
The MS-DRG 010 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 010 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 |
|---|---|---|
| 008-APR-DRG | High | AUTOLOGOUS BONE MARROW TRANSPLANT OR T-CELL IMMUNOTHERAPY |
| 008-MS-DRG | High | Simultaneous Pancreas and Kidney Transplant |
| 010-MS-DRG | High | Pancreas Transplant |
| 011-APR-DRG | High | Chimeric Antigen Receptor (Car) T-Cell And Other Immunotherapies |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 010. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 010 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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