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See a sample rate comparisonMS-DRG 180 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.
RESPIRATORY NEOPLASMS WITH 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 180 by major payers:
$20,331.62
$22,823.37
$27,496.42
$28,075.91
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MS-DRG 180
5 of 25 sample ratesHigher to lower in this preview
Mercy Health, Mercy Health St Vincent Medical Center
Mercy Health - St Vincent Medical Center LLC
$47,907.19Published rateSmsj Tucson Holdings, LLC, Carondelet Marana Hospital
$38,315.14Published rateBoa Vida Hospital Of Aberdeen, Ms, LLC
$28,986.34Published rateWomens Center Of Northwest Arkansas LLC, Willow Creek Women'S Hospital
$20,849.50Published rateHmh Hospitals Corporation, Palisades Medical Center
Hackensack Meridian Health Inc
$4,193.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 180 vs. Other Diseases & Disorders of the Respiratory System Codes
The MS-DRG 180 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 180 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 |
|---|---|---|
| 179-APR-DRG | High | DEFIBRILLATOR IMPLANTS |
| 179-MS-DRG | High | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC |
| 180-MS-DRG | High | RESPIRATORY NEOPLASMS WITH MCC |
| 181-APR-DRG | High | LOWER EXTREMITY ARTERIAL PROCEDURES |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 180. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 180 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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