MS-DRG 149 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 149 by major payers:
$8,512.95
$10,361.13
$11,854.80
$12,215.46
| 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 149 | ||||||
United | 149 | $17548.10 | 1053475004 - SENTARA HOSPITALS, SENTARA OBICI HOSPITAL PSYCHIATRIC UNIT | 541547408 - SENTARA HOSPITALS | VA | Psychiatric Hospital Unit (273R00000X) |
United | 149 | $19821.46 | 1740059948 - EAST COOPER MEDICAL CENTER LLC | 934555562 | SC | Rehabilitation Hospital Unit (273Y00000X) |
United | 149 | $6034.00 | 1972679694 - PRIME HEALTHCARE PARADISE VALLEY LLC, PARADISE VALLEY HOSPITAL | 205837239 | CA | Rehabilitation Hospital Unit (273Y00000X) |
United | 149 | $13667.76 | 1679592380 - WEST PENN ALLEGHENY HEALTH SYSTEM INC., FORBES REGIONAL HOSPITAL | 250969492 - (PA) HIGHMARK HEALTH | PA | General Acute Care Hospital (282N00000X) |
United | 149 | $6643.00 | 1225033020 - PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA, JACKSON HEALTH SYSTEMS JACKSON MEMORIAL HOSPITA | 591713947 - (FL) PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY FLORIDA | FL | General Acute Care Hospital (282N00000X) |
United | 149 | $8619.90 | 1902865355 - GOOD SAMARITAN HOSPITAL MEDICAL CENTER | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 149 | $6154.95 | 1922182831 - SALINE HOSPITAL LLC, SALINE MEMORIAL HOSPITAL | 812816675 | AR | Psychiatric Hospital Unit (273R00000X) |
United | 149 | $17266.84 | 1801803903 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION, QUEENS HOSPITAL CENTER | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | General Acute Care Hospital (282N00000X) |
United | 149 | $8694.91 | 1073047981 - ST. LUKE'S HOSPITAL- EASTON CAMPUS | 815457243 | PA | General Acute Care Hospital (282N00000X) |
United | 149 | $10682.51 | 1215979190 - VANDERBILT UNIVERSITY MEDICAL CENTER, VANDERBILT WILSON COUNTY HOSPITAL | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Rehabilitation Hospital Unit (273Y00000X) |
United | 149 | $6882.22 | 1447297304 - CLARKSDALE HMA LLC, NORTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER | 853959101 | MS | Rehabilitation Hospital Unit (273Y00000X) |
United | 149 | $6638.04 | 1588795942 - IVY CREEK OF ELMORE, LLC, ELMORE COMMUNITY HOSPITAL | 631253446 | AL | General Acute Care Hospital (282N00000X) |
United | 149 | $23292.84 | 1104847888 - SOUND SHORE MEDICAL CENTER OF WESTCHESTER | 462931956 - (NY) MONTEFIORE NEW ROCHELLE HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 149 | $26354.92 | 1881690691 - UNIVERSITY HOSPITAL AT STONY BROOK, STONY BROOK EASTERN LONG ISLAND HOSPITAL | 113243405 | NY | General Acute Care Hospital (282N00000X) |
United | 149 | $14421.12 | 1316096266 - WINTER HAVEN HOSPITAL INC, MID FLORIDA MEDICAL SERVIES | 590724462 - (FL) WINTER HAVEN HOSPITAL INC | FL | 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 149 vs. Other Diseases & Disorders of the Ear, Nose, Mouth & Throat Codes
The MS-DRG 149 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 149 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 |
|---|---|---|
| 148-MS-DRG | High | Ear, Nose, Mouth and Throat Malignancy without CC/MCC |
| 149-MS-DRG | High | Dysequilibrium |
| 150-MS-DRG | High | Epistaxis 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 149. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 149 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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