MS-DRG 145 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 145 by major payers:
$14,626.38
$15,559.78
$18,782.40
$19,444.02
| 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 145 | ||||||
United | 145 | $23941.25 | 1588665566 - UNIVERSITY HEALTH SERVICES,INC, UNIVERSITY HOSPITAL | 581581103 - UNIVERSITY HEALTH SERVICES INC | GA | General Acute Care Hospital (282N00000X) |
United | 145 | $26062.05 | 1144471715 - PROVIDENCE HEALTH & SERVICES, PROV SCRED HRT MED CTR & CHLDS HOS | 364640211 | WA | General Acute Care Hospital (282N00000X) |
United | 145 | $18926.00 | 1922487966 - SAINT THOMAS HIGHLANDS HOSPITAL, LLC, ASCENSION SAINT THOMAS HIGHLANDS | 474063406 | TN | General Acute Care Hospital (282N00000X) |
United | 145 | $44908.42 | 1851787295 - HDMC HOLDINGS, LLC, HI-DESERT MEDICAL CENTER | 473550779 | CA | General Acute Care Hospital (282N00000X) |
United | 145 | $7624.16 | 1427320993 - FORREST COUNTY GENERAL HOSPITAL, MARION GENERAL HOSPITAL | 646001587 - FORREST COUNTY GENERAL HOSPITAL | MS | General Acute Care Hospital (282N00000X) |
United | 145 | $18487.78 | 1568461440 - APPALACHIAN REGIONAL HEALTHCARE, INC, BECKLEY ARH HOSPITAL | 520795508 - APPALACHIAN REGIONAL HEALTHCARE INC | WV | General Acute Care Hospital (282N00000X) |
United | 145 | $19836.91 | 1407854771 - THE TOLEDO HOSPITAL | 344428256 - (OH) TOLEDO HOSPITAL | OH | General Acute Care Hospital (282N00000X) |
United | 145 | $18327.66 | 1023398807 - AHS CLAREMORE REGIONAL HOSPITAL, LLC., HILLCREST HOSPITAL CLAREMORE | 452652006 | OK | General Acute Care Hospital (282N00000X) |
United | 145 | $15121.59 | 1548079320 - SAINT JOSEPH MEDICAL CENTER | 992141118 | IL | Psychiatric Hospital Unit (273R00000X) |
United | 145 | $3446.51 | 1376548370 - COFFEY COUNTY HOSPITAL, COFFEY COUNTY HOSPITAL | 480860883 | KS | Critical Access Hospital (282NC0060X) |
United | 145 | $38877.87 | 1073916896 - , VALLEYWISE HEALTH | 860830701 | AZ | General Acute Care Hospital (282N00000X) |
United | 145 | $20468.59 | 1427671098 - OHI WEST, INC, BAYFRONT HEALTH ST. PETERSBURG | 845074208 - (FL) OHI WEST INC | FL | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 145 | $18307.52 | 1801823349 - DLP FRYE REGIONAL MEDICAL CENTER LLC, FRYE REGIONAL MEDICAL CENTER | 352547114 | NC | General Acute Care Hospital (282N00000X) |
United | 145 | $15810.09 | 1154411338 - KING COUNTY PUBLIC HOSPITAL DISTRICT NO. 2, EVERGREENHEALTH MEDICAL CENTER | 910844563 | WA | Rehabilitation Hospital Unit (273Y00000X) |
United | 145 | $26098.76 | 1578640728 - UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER, UNIVERSITY HOSPITALS CASE MEDICAL CENTER - REHAB | 341567805 - UNIVERSITY HOSPITALS HEALTH SYSTEM INC | OH | 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 145 vs. Other Diseases & Disorders of the Ear, Nose, Mouth & Throat Codes
The MS-DRG 145 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 145 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 |
|---|---|---|
| 144-APR-DRG | High | RESPIRATORY SIGNS, SYMPTOMS & MINOR DIAGNOSES |
| 144-MS-DRG | High | Other Ear, Nose, Mouth and Throat O.R. Procedures with CC |
| 145-MS-DRG | High | Other Ear, Nose, Mouth and Throat O.R. Procedures without CC/MCC |
| 146-MS-DRG | High | Ear, Nose, Mouth and Throat Malignancy with MCC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 145. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 145 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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