MS-DRG 175 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 175 by major payers:
$17,365.22
$18,669.04
$22,269.04
$22,649.81
| 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 175 | ||||||
United | 175 | $3630.00 | 1215998323 - UNIVERSITY HOSPITAL, UNIVERSITY OF MEDICINE AND DENTISTRY OF NJ | 221775306 | NJ | General Acute Care Hospital (282N00000X) |
United | 175 | $20366.00 | 1356359244 - CHRISTIAN HOSPITAL NORTHEAST- NORTHWEST | 436057893 - CHRISTIAN HOSPITAL NORTHEAST NORTHWEST | MO | Psychiatric Hospital Unit (273R00000X) |
United | 175 | $17173.66 | 1386667533 - MERCY TYLER HOSPITAL, TYLER MEMORIAL HOSPITAL | 274566015 | PA | General Acute Care Hospital (282N00000X) |
United | 175 | $12181.66 | 1376854208 - RCHP, SHOALS HOSPITAL | 272451336 | AL | Psychiatric Hospital Unit (273R00000X) |
United | 175 | $12181.66 | 1376854208 - RCHP, SHOALS HOSPITAL | 272451336 | AL | Psychiatric Hospital Unit (273R00000X) |
United | 175 | $40007.14 | 1417980566 - MCKEE MEDICAL CENTER | 840826332 - (CO) MCKEE MEDICAL CENTER | CO | General Acute Care Hospital (282N00000X) |
United | 175 | $12084.44 | 1407313760 - HH HEALTH SYSTEM, MARSHALL MEDICAL CENTER | 831651180 | AL | General Acute Care Hospital (282N00000X) |
United | 175 | $12084.44 | 1407313760 - HH HEALTH SYSTEM, MARSHALL MEDICAL CENTER | 831651180 | AL | General Acute Care Hospital (282N00000X) |
United | 175 | $37366.51 | 1215961248 - BANNER HEART HOSPITAL | 861035549 - (AZ) BANNER HEART HOSPITAL | AZ | Special Hospital (284300000X) |
United | 175 | $3564.00 | 1821477456 - JOHNSTON MEMORIAL HOSPITAL, INC, CENTER FOR SLEEP DISORDERS AT JMH | 540544705 - JOHNSTON MEMORIAL HOSPITAL INC | VA | General Acute Care Hospital (282N00000X) |
United | 175 | $2723.00 | 1073598439 - VALLEY MEDICAL FACILITIES, INC., HERITAGE VALLEY KENNEDY | 251801532 - (PA) HERITAGE VALLEY HEALTH SYSTEM | PA | General Acute Care Hospital (282N00000X) |
United | 175 | $3630.00 | 1215998323 - UNIVERSITY HOSPITAL, UNIVERSITY OF MEDICINE AND DENTISTRY OF NJ | 221775306 | NJ | General Acute Care Hospital (282N00000X) |
United | 175 | $15490.24 | 1285719385 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 175 | $15490.24 | 1285719385 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 175 | $43083.23 | 1437718491 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | 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 175 vs. Other Diseases & Disorders of the Respiratory System Codes
The MS-DRG 175 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 175 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 |
|---|---|---|
| 173-APR-DRG | Moderate | Ap-Drg: Digestive Malignancy W/O Cc |
| 173-MS-DRG | High | Ultrasound Accelerated and Other Thrombolysis with Principal Diagnosis Pulmonary Embolism |
| 175-MS-DRG | High | Pulmonary Embolism with MCC or Acute Cor Pulmonale |
| 176-APR-DRG | High | INSERTION, REVISION & REPLACEMENTS OF PACEMAKER & OTHER CARDIAC DEVICES |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 175. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 175 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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