MS-DRG 139 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 | • Diseases & Disorders of the Ear, Nose, Mouth & Throat |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 139 by major payers:
$14,441.25
$17,399.05
$21,393.06
$22,305.16
| 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 139 | ||||||
United | 139 | $18891.10 | 1609804822 - BAPTIST HEALTH, BAPTIST HEALTH MEDICAL CENTER - HEBER SPRINGS | 710236856 - (AR) BAPTIST HEALTH | AR | Critical Access Hospital (282NC0060X) |
United | 139 | $22518.05 | 1952326977 - AMISUB (SFH), INC., ST. FRANCIS HOSPITAL | 752522262 | TN | General Acute Care Hospital (282N00000X) |
United | 139 | $30568.57 | 1003344334 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE HORIZON CITY CAMPUS | 813935393 - (TX) HCN EP HORIZON CITY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 139 | $21810.08 | 1790727543 - SISTERS OF CHARITY HOSPITAL OF BUFFALO NEW YORK | 160743187 - (NY) SISTERS OF CHARITY HOSPITAL OF BUFFALO NEW YORK | NY | General Acute Care Hospital (282N00000X) |
United | 139 | $5910.25 | 1215005129 - PHC-LOS ALAMOS INC, LOS ALAMOS MEDICAL CENTER - SWING BED UNIT | 30390794 | NM | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 139 | $11735.66 | 1093959413 - OAKWOOD HEALTHCARE INC, COREWELL HEALTH DEARBORN HOSPITAL | 381405141 - (MI) OAKWOOD HEALTHCARE INC | MI | General Acute Care Hospital (282N00000X) |
United | 139 | $25290.83 | 1003991845 - PROVIDENCE HEALTH & SERVICES OREGON, PROVIDENCE PORTLAND MEDICAL CENTER | 930386906 | OR | General Acute Care Hospital (282N00000X) |
United | 139 | $17667.75 | 1912423260 - TOPEKA HOSPITAL, LLC, THE UNIVERSITY OF KANSAS HEALTH SYSTEM, ST. FRANCIS CAMPUS | 822034009 | KS | General Acute Care Hospital (282N00000X) |
United | 139 | $9782.83 | 1306845557 - CLALLAM COUNTY PUBLIC HOSPITAL DISTRICT 2, OLYMPIC MEDICAL CENTER | 916001709 - (WA) CLALLAM COUNTY PUBLIC HOSPITAL DISTRICT 2 | WA | General Acute Care Hospital (282N00000X) |
United | 139 | $4736.52 | 1033118716 - CASTRO COUNTY HOSPITAL DISTRICT, PLAINS MEMORIAL HOSPITAL | 756003939 | TX | Critical Access Hospital (282NC0060X) |
United | 139 | $3083.56 | 1710907175 - ADVENTIST HINSDALE HOSPITAL | 362276984 - ADVENTIST MIDWEST HEALTH | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 139 | $27988.60 | 1366536963 - PROVIDENCE HEALTH & SERVICES OREGON, PROVIDENCE MILWAUKIE HOSPITAL | 930924302 - (OR) PROVIDENCE HEALTH & SERVICES OREGON | OR | General Acute Care Hospital (282N00000X) |
United | 139 | $4736.52 | 1033118716 - CASTRO COUNTY HOSPITAL DISTRICT, PLAINS MEMORIAL HOSPITAL | 756003939 | TX | Critical Access Hospital (282NC0060X) |
United | 139 | $21039.84 | 1811023823 - BATON ROUGE GENERAL MEDICAL CENTER | 721025017 - (LA) BATON ROUGE GENERAL MEDICAL CENTER | LA | Rehabilitation Hospital Unit (273Y00000X) |
United | 139 | $4391.00 | 1508856535 - LANCASTER HOSPITAL CORPORATION, PALMDALE REGIONAL MEDICAL CENTER | 953565954 - (CA) LANCASTER HOSPITAL CORPORATION | CA | General Acute Care Hospital (282N00000X) |
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 139 vs. Other Diseases & Disorders of the Ear, Nose, Mouth & Throat Codes
The MS-DRG 139 code is part of the Diseases & Disorders of the Ear, Nose, Mouth & Throat 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 139 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 |
|---|---|---|
| 138-APR-DRG | High | BRONCHIOLITIS & RSV PNEUMONIA |
| 138-MS-DRG | High | Mouth Procedures without CC/MCC |
| 139-MS-DRG | High | Salivary Gland Procedures |
| 140-APR-DRG | High | CHRONIC OBSTRUCTIVE PULMONARY DISEASE |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 139. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 139 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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