MS-DRG 180 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 180 by major payers:
$20,331.62
$22,823.37
$27,496.42
$28,075.91
| 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 180 | ||||||
United | 180 | $4193.00 | 1730692344 - HMH HOSPITALS CORPORATION, PALISADES MEDICAL CENTER | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | General Acute Care Hospital (282N00000X) |
United | 180 | $32989.30 | 1598724924 - MERCY MEDICAL CENTER | 111635088 - (NY) MERCY MEDICAL CENTER | NY | Rehabilitation Hospital Unit (273Y00000X) |
United | 180 | $9326.00 | 1194900654 - HUNTINGTON HOSPITAL ASSOCIATION | 111630914 - (NY) HUNTINGTON HOSPITAL ASSOCIATION | NY | Psychiatric Hospital Unit (273R00000X) |
United | 180 | $30873.14 | 1578648614 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 180 | $29471.40 | 1669466561 - STATE OF CONNECTICUT, JOHN DEMPSEY HOSPITAL | 66000798 | CT | General Acute Care Hospital (282N00000X) |
United | 180 | $25319.09 | 1013233741 - RCHP OTTUMWA LLC, OTTUMWA REGIONAL HEALTH CENTER | 272200283 | IA | General Acute Care Hospital (282N00000X) |
United | 180 | $8106.00 | 1891809679 - FREEMAN-OAK HILL HEALTH SYSTEM, FREEMAN HEALTH SYSTEM | 431704371 - FREEMAN HEALTH SYSTEM | MO | General Acute Care Hospital (282N00000X) |
United | 180 | $25319.09 | 1528175981 - OTTUMWA REGIONAL HEALTH CENTER INC | 272200283 | IA | General Acute Care Hospital (282N00000X) |
United | 180 | $29399.33 | 1386779031 - ADVOCATE LUTHERAN GENERAL | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | General Acute Care Hospital (282N00000X) |
United | 180 | $44846.80 | 1154453579 - ALAMEDA HEALTH SYSTEM, FAIRMONT HOSPITAL | 943302014 | CA | Rehabilitation Hospital (283X00000X) |
United | 180 | $41220.12 | 1891904942 - ST JUDE HOSPITAL INC, PROVIDENCE ST. JUDE MEDICAL CENTER | 951643325 - (CA) ST JUDE HOSPITAL | CA | General Acute Care Hospital (282N00000X) |
United | 180 | $7117.00 | 1578656161 - ST JOHN MEDICAL CENTER INC, BERNSEN REHAB | 730579286 - (OK) ST JOHN MEDICAL CENTER INC | OK | Rehabilitation Hospital Unit (273Y00000X) |
United | 180 | $33117.44 | 1194733121 - UPPER VALLEY MEDICAL CENTER, SUB PROVIDER PSYCH | 310537095 - (OH) UPPER VALLEY MEDICAL CENTER | OH | Psychiatric Hospital Unit (273R00000X) |
United | 180 | $41852.87 | 1780630608 - RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA, UVA HEALTH SCIENCES CENTER | 546001796 - RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA | VA | General Acute Care Hospital (282N00000X) |
United | 180 | $47907.19 | 1467493551 - MERCY HEALTH, MERCY HEALTH ST VINCENT MEDICAL CENTER | 344428250 - MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC | OH | 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 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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