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 | $10403.00 | 1396714663 - BETHESDA HOSPITAL INC, BETHESDA NORTH HOSPITAL | 310537122 - (OH) BETHESDA HOSPITAL INC | OH | General Acute Care Hospital (282N00000X) |
United | 175 | $11070.04 | 1376537555 - COLUMBUS REGIONAL HEALTHCARE SYSTEM, SOUTH COLUMBUS MEDICAL CLINIC | 560538020 - (NC) COLUMBUS REGIONAL HEALTHCARE SYSTEM | NC | General Acute Care Hospital (282N00000X) |
United | 175 | $11622.25 | 1801943725 - PORTER | 351088541 | IN | General Acute Care Hospital (282N00000X) |
United | 175 | $10682.04 | 1053363853 - RESTON HOSPITAL CENTER LLC, RESTON HOSPITAL CENTER | 621777534 | VA | General Acute Care Hospital (282N00000X) |
United | 175 | $7828.00 | 1326131301 - STAMFORD HOSPITAL | 60646917 - (CT) STAMFORD HOSPITAL | CT | Rehabilitation Hospital Unit (273Y00000X) |
United | 175 | $29495.27 | 1760413777 - THEDACARE MEDICAL CENTER, COMMUNITY HEALTH NETWORK, INC AND BERLIN MEMORIAL HOSPITAL | 350983617 - COMMUNITY HEALTH NETWORK INC | WI | Critical Access Hospital (282NC0060X) |
United | 175 | $15230.95 | 1356334510 - INDIANA REGIONAL MEDICAL CENTER | 250965404 - (PA) INDIANA REGIONAL MEDICAL CENTER | PA | Rural Acute Care Hospital (282NR1301X) |
United | 175 | $50032.91 | 1528292596 - WESTCHESTER COUNTY HEALTHCARE CORP, ACT PROGRAM | 133964321 - (NY) PEO MID-HUDSON VALLEY STAFFCO | NY | General Acute Care Hospital (282N00000X) |
United | 175 | $11898.44 | 1770581894 - T J SAMSON COMMUNITY HOSPITAL | 610461767 - T J SAMSON COMMUNITY HOSPITAL | KY | General Acute Care Hospital (282N00000X) |
United | 175 | $22791.00 | 1497701106 - ST. PETER'S HOSPITAL OF THE CITY OF ALBANY, ST. PETER'S ADDICTION RECOVERY CENTER | 141348692 - (NY) ST PETERS HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 175 | $17671.51 | 1477101376 - SSM SELECT REHAB ST. LOUIS, LLC, SSM HEALTH PHYSICAL THERAPY | 263694972 | MO | Rehabilitation Hospital (283X00000X) |
United | 175 | $20292.44 | 1790996445 - J C BLAIR MEMORIAL HOSPITAL | 231352159 - (PA) J C BLAIR MEMORIAL HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 175 | $32318.24 | 1376544320 - STATE UNIVERSITY OF IOWA, UNIVERSITY OF IOWA HOSPITALS & CLINICS | 426004813 | IA | General Acute Care Hospital (282N00000X) |
United | 175 | $30194.18 | 1689233645 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 175 | $17671.51 | 1477101376 - SSM SELECT REHAB ST. LOUIS, LLC, SSM HEALTH PHYSICAL THERAPY | 263694972 | MO | Rehabilitation Hospital (283X00000X) |
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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