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See a sample rate comparisonMS-DRG 175 Fee Schedule
Last Verified: October 2026
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.
PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE
| 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
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MS-DRG 175
5 of 25 sample ratesHigher to lower in this preview
Westchester County Healthcare Corp, Act Program
Peo Mid-Hudson Valley Staffco
$50,032.91Published rateLegacy Emanuel Hospital & Health Center
$28,768.18Published rateSsm Select Rehab St. Louis, LLC, Ssm Health Physical Therapy
$17,671.51Published rateT J Samson Community Hospital
$11,898.44Published ratePrime Healthcare Paradise Valley LLC, Paradise Valley Hospital
$6,034.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-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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