MS-DRG 173 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 Respiratory System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 173 by major payers:
$33,742.66
$45,339.12
$48,436.65
$49,824.07
| 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 173 | ||||||
United | 173 | $48661.85 | 1063489342 - THE PENNSYLVANIA HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA HEALTH SYS | 311538725 - (PA) PENNSYLVANIA HOSPITAL OF THE UNIV OF PENNSYLVANIA HEALTH SYSTEM | PA | General Acute Care Hospital (282N00000X) |
United | 173 | $69267.50 | 1538471800 - VHS CHILDRENS HOSPITAL OF MICHIGAN INC, CHILDRENS HOSPITAL OF MICHIGAN | 272845064 | MI | Children's Hospital (282NC2000X) |
United | 173 | $54495.14 | 1174650824 - INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL, INC. | 350867958 - (IN) INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL INC | IN | Rehabilitation Hospital Unit (273Y00000X) |
United | 173 | $38274.64 | 1578630182 - AUBURN MEMORIAL HOSPITAL | 150532054 - AUBURN COMMUNITY HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 173 | $69648.75 | 1003819475 - FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC., FROEDTERT BLUEMOUND REHABILITATION HOSPITAL | 396105970 - (WI) FROEDTERT MEMORIAL LUTHERAN HOSPITAL INC | WI | Rehabilitation Hospital Unit (273Y00000X) |
United | 173 | $48508.42 | 1497119218 - THEDACARE REGIONAL MEDICAL CENTER, APPLETON MEDICAL CENTER, INC. | 350983617 - COMMUNITY HEALTH NETWORK INC | WI | General Acute Care Hospital (282N00000X) |
United | 173 | $16425.00 | 1356853907 - HMH HOSPITALS CORPORATION, RIVERVIEW MEDICAL CENTER-REHAB | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | Rehabilitation Hospital Unit (273Y00000X) |
United | 173 | $64811.78 | 1285601237 - HEALTHALLIANCE HOSPITAL MARYS AVENUE CAMPUS, BENEDICTINE HOSPITAL | 141338470 - (NY) HEALTHALLIANCE HOSPITAL MARYS AVENUE CAMPUS | NY | Psychiatric Hospital Unit (273R00000X) |
United | 173 | $81364.50 | 1043462013 - GADSDEN REGIONAL MEDICAL CENTER LLC, GADSDEN REGIONAL MEDICAL CENTER | 631102774 | AL | General Acute Care Hospital (282N00000X) |
United | 173 | $77307.24 | 1225507114 - UNIVERSITY HOSPITAL AT STONY BROOK | 113243405 | NY | General Acute Care Hospital (282N00000X) |
United | 173 | $32656.40 | 1326155706 - NORTH MISSISSIPPI MEDICAL CENTER, INC., NORTH MS REHAB UNIT | 640662976 - NORTH MISSISSIPPI MEDICAL CENTER INC | MS | Rehabilitation Hospital Unit (273Y00000X) |
United | 173 | $42220.87 | 1497790042 - BAPTIST HEALTH, BAPTIST HEALTH MEDICAL CENTER-NORTH LITTLE ROCK | 710236856 - (AR) BAPTIST HEALTH | AR | General Acute Care Hospital (282N00000X) |
United | 173 | $30320.83 | 1508096876 - OAKWOOD ANNAPOLIS | 381405141 - (MI) OAKWOOD HEALTHCARE INC | MI | General Acute Care Hospital (282N00000X) |
United | 173 | $44660.39 | 1538260229 - J. ARTHUR DOSHER MEMORIAL HOSPITAL | 560845824 - (NC) J ARTHUR DOSHER MEMORIAL HOSPITAL | NC | Critical Access Hospital (282NC0060X) |
United | 173 | $21069.00 | 1477886141 - ST MARTIN HOSPITAL, INC., ST MARTIN HOSPITAL | 264626264 - (LA) ST MARTIN HOSPITAL INC | LA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
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 173 vs. Other Diseases & Disorders of the Respiratory System Codes
The MS-DRG 173 code is part of the Diseases & Disorders of the Respiratory System 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 173 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 |
|---|---|---|
| 168-MS-DRG | High | Other Respiratory System O.R. Procedures without CC/MCC |
| 173-MS-DRG | High | Ultrasound Accelerated and Other Thrombolysis with Principal Diagnosis Pulmonary Embolism |
| 175-APR-DRG | High | PERCUTANEOUS CARDIAC INTERVENTION W/O AMI |
| 175-MS-DRG | High | Pulmonary Embolism with MCC or Acute Cor Pulmonale |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 173. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 173 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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