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 | $9343.25 | 1356492953 - JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2, JEFFERSON HEALTHCARE | 910928081 | WA | Critical Access Hospital (282NC0060X) |
United | 176 | $20436.61 | 1932131489 - SAN RAMON REGIONAL MEDICAL CENTER, LLC | 752918809 | CA | General Acute Care Hospital (282N00000X) |
United | 176 | $8811.28 | 1801852736 - ODESSA REGIONAL HOSPITAL LP | 621795574 | TX | 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 | $27570.83 | 1154618742 - VHS HARLINGEN HOSPITAL COMPANY LLC, VALLEY BAPTIST MEDICAL CENTER | 452662980 | TX | General Acute Care Hospital (282N00000X) |
United | 176 | $8858.50 | 1609603877 - LIFESPAN OF MASSACHUSETTS | 994836263 | MA | General Acute Care Hospital (282N00000X) |
United | 176 | $12927.07 | 1477579464 - NASSAU HEALTH CARE CORPORATION, NUMC DEPARTMENT OF RADIOLOGY, FFP | 113465690 | NY | General Acute Care Hospital (282N00000X) |
United | 176 | $3722.26 | 1316537228 - DUBOIS REGIONAL MEDICAL CENTER, PENN HIGHLANDS CLEARFIELD-A CAMPUS OF PENN HIGHLANDS DUBOIS | 251490707 - DUBOIS REGIONAL MEDICAL CENTER | PA | General Acute Care Hospital (282N00000X) |
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 | $5952.12 | 1508895079 - MISSION HOSPITAL, INC, MISSION REGIONAL MEDICAL CENTER | 742206635 - (TX) MISSION HOSPITAL INC | TX | Rehabilitation Hospital (283X00000X) |
United | 176 | $9260.95 | 1366532228 - MEMORIAL HERMANN SPECIALTY HOSPITAL KINGWOOD L L C, MEMORIAL HERMANN SURGICAL HOSPITAL KINGWOOD | 208385914 - (TX) MEMORIAL HERMANN SPECIALTY HOSPITAL KINGWOOD L L C | TX | General Acute Care Hospital (282N00000X) |
United | 176 | $1236.00 | 1437188216 - DMC-MEMPHIS, LLC, DELTA SPECIALTY HOSPITAL | 621650705 - (TN) DMC - MEMPHIS, INC. | TN | General Acute Care Hospital (282N00000X) |
United | 176 | $9343.25 | 1356492953 - JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2, JEFFERSON HEALTHCARE | 910928081 | WA | Critical Access Hospital (282NC0060X) |
United | 176 | $15754.05 | 1265787923 - OSF SAINT FRANCIS | 370662569 - (IL) SAINT FRANCIS MEDICAL CENTER | IL | General Acute Care Hospital (282N00000X) |
United | 176 | $14902.08 | 1457413551 - AMISUB (SFH), INC., ST. FRANCIS HOSPITAL | 752522262 | TN | Psychiatric Hospital Unit (273R00000X) |
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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