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See a sample rate comparisonMS-DRG 016 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.
AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC
| 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 016 by major payers:
$72,208.22
$76,417.60
$95,281.12
$98,982.65
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MS-DRG 016
5 of 25 sample ratesHigher to lower in this preview
John Muir Medical Center
$226,080.67Published rateCarondelet Health Network, O'Rielly Transitions Intensive Outpatient Program
$134,371.20Published rateDlp Haywood Regional Medical Center LLC., Haywood Regional Medical Center
$86,415.97Published rateAnson Hospital District
$54,323.10Published rateArnot Ogden Medical Center, St. Joseph'S Psychiatric Unit
Arnot Ogden Medical Center
$4,346.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 016 vs. Other Pre-MDC Codes
The MS-DRG 016 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 016 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 |
|---|---|---|
| 014-APR-DRG | Moderate | Liver Transplant And/Or Intestinal Transplant |
| 014-MS-DRG | High | ALLOGENEIC BONE MARROW TRANSPLANT |
| 016-MS-DRG | High | AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC |
| 017-APR-DRG | Moderate | Liver Transplant And/Or Intestinal 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 016. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 016 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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