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See a sample rate comparisonMS-DRG 176 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 WITHOUT MCC
| 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
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MS-DRG 176
5 of 25 sample ratesHigher to lower in this preview
Vhs Harlingen Hospital Company LLC, Valley Baptist Medical Center
$27,570.83Published rateProvidence Health & Services Oregon, Providence Portland Medical Center
$15,064.17Published rateRex Hospital Inc., Rex Hospital
Rex Hospital Inc
$12,105.95Published rateOdessa Regional Hospital Lp
$8,811.28Published rateDmc-Memphis, LLC, Delta Specialty Hospital
Dmc - Memphis, Inc.
$1,236.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-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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