MS-DRG 176 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 176 by major payers:
$10,947.06
$11,168.88
$13,425.48
$13,491.63
| 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 176 | ||||||
United | 176 | $3564.00 | 1376933580 - DICKENSON COMMUNITY HOSPITAL, INC, DICKENSON COMMUNITY HOSPITAL PSYCHIATRIC UNIT | 770599553 - DICKENSON COMMUNITY HOSPITAL INC | VA | Psychiatric Hospital Unit (273R00000X) |
United | 176 | $15859.33 | 1598868655 - GENESIS HEALTHCARE SYSTEM | 311480941 - (OH) GENESIS HEALTHCARE SYSTEM | OH | General Acute Care Hospital (282N00000X) |
United | 176 | $14124.55 | 1801971965 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 176 | $14124.55 | 1801971965 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 176 | $6439.97 | 1164741617 - VALLEY MEDICAL FACILITIES, INC., BEAVER INPATIENT REHAB UNIT | 251801532 - (PA) HERITAGE VALLEY HEALTH SYSTEM | PA | Rehabilitation Hospital Unit (273Y00000X) |
United | 176 | $14353.92 | 1497764526 - NORTHERN ILLINOIS MEDICAL CENTER, NORTHWESTERN MEDICINE MCHENRY HOSPITAL | 362338884 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 176 | $8814.00 | 1902901333 - CLARA MAASS MEDICAL CENTER | 221500556 | NJ | General Acute Care Hospital (282N00000X) |
United | 176 | $8814.00 | 1902901333 - CLARA MAASS MEDICAL CENTER | 221500556 | NJ | General Acute Care Hospital (282N00000X) |
United | 176 | $27570.83 | 1154618742 - VHS HARLINGEN HOSPITAL COMPANY LLC, VALLEY BAPTIST MEDICAL CENTER | 452662980 | TX | General Acute Care Hospital (282N00000X) |
United | 176 | $27570.83 | 1154618742 - VHS HARLINGEN HOSPITAL COMPANY LLC, VALLEY BAPTIST MEDICAL CENTER | 452662980 | TX | General Acute Care Hospital (282N00000X) |
United | 176 | $15898.23 | 1851927586 - NOVANT HEALTH MINT HILL MEDICAL CENTER, LLC | 260599536 - (NC) NOVANT HEALTH MINT HILL MEDICAL CENTER LLC | NC | General Acute Care Hospital (282N00000X) |
United | 176 | $19203.00 | 1770569832 - RARITAN BAY MEDICAL CENTER | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | General Acute Care Hospital (282N00000X) |
United | 176 | $22726.68 | 1851568687 - DIGNITY HEALTH, ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER | 721561134 - (AZ) ST JOSEPHS HOSPITAL AND MEDICAL CENTER | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 176 | $15013.67 | 1821002007 - UNIVERSITY OF CALIFORNIA IRVINE, UCI HEALTH - FOUNTAIN VALLEY | 952226406 - REGENTS OF THE UNIVERSITY OF CALIFORNIA AT IRVINE | CA | General Acute Care Hospital (282N00000X) |
United | 176 | $11299.23 | 1023398807 - AHS CLAREMORE REGIONAL HOSPITAL, LLC., HILLCREST HOSPITAL CLAREMORE | 452652006 | OK | 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 176 vs. Other Diseases & Disorders of the Respiratory System Codes
The MS-DRG 176 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 176 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 |
|---|---|---|
| 175-APR-DRG | High | PERCUTANEOUS CARDIAC INTERVENTION W/O AMI |
| 175-MS-DRG | High | Pulmonary Embolism with MCC or Acute Cor Pulmonale |
| 176-MS-DRG | High | Pulmonary Embolism without MCC |
| 177-APR-DRG | High | CARDIAC PACEMAKER & DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 176. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 176 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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