MS-DRG 142 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 142 by major payers:
$20,826.59
$20,862.28
$24,675.05
$25,667.09
| 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 142 | ||||||
United | 142 | $30477.44 | 1942247291 - PROVIDENCE HEALTH SYSTEM, PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER SAN PEDRO | 421672806 | CA | General Acute Care Hospital (282N00000X) |
United | 142 | $30280.05 | 1952309098 - FRANCISCAN HEALTH SYSTEM, ST JOSEPH MEDICAL CENTER | 910564491 - (WA) FRANCISCAN HEALTH SYSTEM | WA | General Acute Care Hospital (282N00000X) |
United | 142 | $49071.92 | 1316361025 - TEXAS HEALTH PRESBYTERIAN HOSPITAL KAUFMAN, TEXAS HEALTH KAUFMAN MIDWIFE CARE CENTER | 752771437 - (TX) TEXAS HEALTH PRESBYTERIAN HOSPITAL KAUFMAN | TX | General Acute Care Hospital (282N00000X) |
United | 142 | $24939.83 | 1962726067 - NORTHWESSTERN LAKE FOREST HOSPITA | 362179779 - (IL) NORTHWESTERN MEMORIAL HEALTHCARE | IL | General Acute Care Hospital (282N00000X) |
United | 142 | $8888.00 | 1215165832 - COOPER UNIVERSITY HOSPITAL | 210634462 - (NJ) COOPER HEALTH SYSTEM A NEW JERSEY NON-PROFIT CORPORATION | NJ | General Acute Care Hospital (282N00000X) |
United | 142 | $18518.15 | 1619066594 - HENRY FORD MACOMB HOSPITAL CORPORATION, HENRY FORD MACOMB HOSPITAL | 382947657 - (MI) HENRY FORD MACOMB HOSPITAL CORPORATION | MI | Psychiatric Hospital Unit (273R00000X) |
United | 142 | $3947.84 | 1205868627 - TYLER HOLMES MEMORIAL HOSPITAL | 646010221 | MS | Critical Access Hospital (282NC0060X) |
United | 142 | $18468.55 | 1467537506 - CARONDELET HEALTH NETWORK, ST. MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 142 | $42338.30 | 1841948254 - CHILDREN'S HOSPITAL COLORADO | 840166760 - CHILDRENS HOSPITAL COLORADO | CO | Children's Hospital (282NC2000X) |
United | 142 | $54684.92 | 1891117966 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE MEMORIAL CAMPUS | 954537720 | TX | Psychiatric Hospital Unit (273R00000X) |
United | 142 | $67659.59 | 1467411991 - UNIVERSITY HOSPITAL AT STONY BROOK, STONY BROOK EASTERN LONG ISLAND HOSPITAL PSYCH UNIT | 113243405 | NY | Psychiatric Hospital Unit (273R00000X) |
United | 142 | $48027.87 | 1649290982 - ANMED HEALTH, ANMED | 570359174 - ANMED HEALTH | SC | General Acute Care Hospital (282N00000X) |
United | 142 | $23485.55 | 1508941097 - ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM, CHI HEALTH CREIGHTON UNIVERSITY MEDICAL CENTER-BERGAN MERCY | 470484764 - ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM | NE | General Acute Care Hospital (282N00000X) |
United | 142 | $28891.46 | 1801971965 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 142 | $28872.41 | 1003039488 - SAINT FRANCIS HOSPITAL, INC. | 730700090 - (OK) SAINT FRANCIS HOSPITAL INC | OK | Rehabilitation Hospital Unit (273Y00000X) |
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 142 vs. Other Diseases & Disorders of the Ear, Nose, Mouth & Throat Codes
The MS-DRG 142 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 142 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 |
|---|---|---|
| 141-APR-DRG | High | ASTHMA |
| 141-MS-DRG | High | Major Head and Neck Procedures with CC |
| 142-MS-DRG | High | Major Head and Neck Procedures without CC/MCC |
| 143-APR-DRG | High | OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS & MINOR DIAGNOSES |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 142. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 142 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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