MS-DRG 185 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 185 by major payers:
$8,720.67
$10,678.40
$12,316.40
$12,695.49
| 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 185 | ||||||
United | 185 | $7171.16 | 1356860621 - CHI MEMORIAL HOSPITAL | 822748395 - CHI MEMORIAL HOSPITAL - GEORGIA | GA | General Acute Care Hospital (282N00000X) |
United | 185 | $6859.18 | 1215233986 - ANDERSON REGIONAL MEDICAL CENTER, ANDERSON REGIONAL MEDICAL CENTER SOUTH CAMPUS | 640362400 - (MS) ANDERSON REGIONAL MEDICAL CENTER | MS | General Acute Care Hospital (282N00000X) |
United | 185 | $15011.66 | 1538239397 - NEW HANOVER REGIONAL MEDICAL CENTER | 853777599 | NC | Psychiatric Hospital (283Q00000X) |
United | 185 | $7834.54 | 1326048810 - UNC ROCKINGHAM HEALTH CARE, INC., UNC ROCKINGHAM HOSPITAL | 823745228 - (NC) UNC ROCKINGHAM HEALTH CARE INC | NC | General Acute Care Hospital (282N00000X) |
United | 185 | $17485.81 | 1710353339 - SMSJ TUCSON HOLDINGS LLC, ST. MARYS HOSPITAL | 474131755 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 185 | $16658.33 | 1730123175 - ST FRANCIS HOSPITAL INC, ST. FRANCIS-DOWNTOWN | 582504530 - (SC) ST FRANCIS HOSPITAL INC | SC | General Acute Care Hospital (282N00000X) |
United | 185 | $9883.79 | 1417957473 - ELADH, LP, EAST LOS ANGELES DOCTORS HOSPITAL | 760594559 - (CA) EAST L A DOCTORS HOSPITAL | CA | General Acute Care Hospital (282N00000X) |
United | 185 | $16657.90 | 1750788667 - CARONDELET HEALTH NETWORK, BRIDGES GEROPSYCHIATRIC PROGRAM AT ST. MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 185 | $8000.20 | 1508859661 - MERCY HOSPITAL JEFFERSON, JEFFERSON MEMORIAL HOSPITAL ASSOCIATION | 430687077 - (MO) MERCY HOSPITAL JEFFERSON | MO | General Acute Care Hospital (282N00000X) |
United | 185 | $13008.62 | 1578693321 - INOVA FAIRFAX HOSPITAL | 540620889 - INOVA HEALTH CARE SERVICES | VA | General Acute Care Hospital (282N00000X) |
United | 185 | $2765.00 | 1558391045 - WELLMONT HEALTH SYSTEM, BRISTOL REGIONAL MEDICAL CENTER PSYCHIATRIC UNIT | 621636465 - WELLMONT HEALTH SYSTEM | TN | Psychiatric Hospital Unit (273R00000X) |
United | 185 | $9711.63 | 1083650188 - AHS HOSPITAL CORP., OVERLOOK HOSPITAL | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | Psychiatric Hospital Unit (273R00000X) |
United | 185 | $3744.00 | 1851491187 - HIGHLANDS HOSPITAL AND HEALTH CENTER, HIGHLANDS HOSPITAL EMERGENCY DEPT PHYSICIANS | 251494705 - HIGHLANDS HOSPITAL AND HEALTH CENTER | PA | General Acute Care Hospital (282N00000X) |
United | 185 | $7964.00 | 1497702575 - ORANGE COAST MEMORIAL MEDICAL CENTER | 330687414 - (CA) MEMORIAL HEALTH SERVICES | CA | General Acute Care Hospital (282N00000X) |
United | 185 | $6893.02 | 1851921571 - BHSM REHABILITATION, LLC | 823481322 | AZ | Rehabilitation Hospital (283X00000X) |
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 185 vs. Other Diseases & Disorders of the Respiratory System Codes
The MS-DRG 185 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 185 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 |
|---|---|---|
| 184-MS-DRG | High | Major Chest Trauma with CC |
| 185-MS-DRG | High | Major Chest Trauma without CC/MCC |
| 186-MS-DRG | High | Pleural Effusion with MCC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 185. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 185 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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