MS-DRG 187 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 187 by major payers:
$12,697.49
$13,711.27
$15,914.16
$16,287.85
| 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 187 | ||||||
United | 187 | $13968.00 | 1760769624 - PECONIC BAY MEDICAL CENTER | 111661359 - (NY) CENTRAL SUFFOLK HOSPITAL | NY | Rural Acute Care Hospital (282NR1301X) |
United | 187 | $6292.00 | 1619401528 - STEWARD SEBASTIAN RIVER MEDICAL CENTER, INC. | 994762475 | FL | General Acute Care Hospital (282N00000X) |
United | 187 | $13649.00 | 1679885347 - VHS SINAI-GRACE HOSPITAL INC, SINAI GRACE HOSPITAL | 272844632 | MI | Rehabilitation Hospital Unit (273Y00000X) |
United | 187 | $17797.91 | 1912902206 - JEANES HOSPITAL | 232825878 - (PA) TEMPLE UNIVERSITY HOSPITAL INC | PA | General Acute Care Hospital (282N00000X) |
United | 187 | $16474.64 | 1972517365 - COVENANT MEDICAL CENTER | 822913146 - (TX) COVENANT MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 187 | $12814.04 | 1942354642 - PRESENCE CHICAGO HOSPITALS NETWORK, PRESENCE SAINTS MARY AND ELIZABETH MEDICAL CENTER-REHABILITATION UNIT | 362235165 - (IL) PRESENCE CHICAGO HOSPITALS NETWORK | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 187 | $15738.70 | 1619289998 - VHS DETROIT RECEIVING HOSPITAL INC, DETROIT RECEIVING HOSPITAL | 272844942 | MI | General Acute Care Hospital (282N00000X) |
United | 187 | $15001.76 | 1639194228 - NASSAU HEALTH CARE CORPORATION, NUMC-DEPARTMENT OF MEDICINE, FPP | 113465690 | NY | General Acute Care Hospital (282N00000X) |
United | 187 | $8558.59 | 1386793115 - GRAHAM REGIONAL MEDICAL CENTER | 463113489 | TX | General Acute Care Hospital (282N00000X) |
United | 187 | $7992.54 | 1104909654 - DLP CONEMAUGH MEMORIAL MEDICAL CENTER LLC, MEMORIAL MEDICAL CENTER - CRICHTON REHABILITATION CENTER | 250965307 - (PA) CONEMAUGH VALLEY MEMORIAL HOSPITAL MEMORIAL MEDICAL CENTER | PA | Rehabilitation Hospital Unit (273Y00000X) |
United | 187 | $16240.70 | 1861609208 - NORTHWESTERN MEMORIAL HOSPITAL | 370960170 - (IL) NORTHWESTERN MEMORIAL HOSPITAL | IL | General Acute Care Hospital (282N00000X) |
United | 187 | $19970.56 | 1447359997 - OHIO STATE UNIVERSITY HOSPITALS | 311340739 | OH | General Acute Care Hospital (282N00000X) |
United | 187 | $5268.00 | 1700979465 - BAPTIST HEALTH CARE, INC | 590657322 - BAPTIST HEALTH CARE INC | FL | General Acute Care Hospital (282N00000X) |
United | 187 | $2412.00 | 1881899284 - CITY OF PHILA TRUSTEE ACTING BY THE BRD OF DIR OF CITY TRUSTS | 236000204 - (PA) CITY OF PHILADELPHIA TTEE ADMINISTERING WILLS EYE INSTITUTE | PA | Special Hospital (284300000X) |
United | 187 | $22311.14 | 1306992151 - SWEDISH HEALTH SERVICES, SWEDISH MEDICAL CENTER | 910433740 - (WA) SWEDISH HEALTH SERVICES | WA | 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 187 vs. Other Diseases & Disorders of the Respiratory System Codes
The MS-DRG 187 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 187 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 |
|---|---|---|
| 186-MS-DRG | High | Pleural Effusion with MCC |
| 187-MS-DRG | High | Pleural Effusion with CC |
| 188-MS-DRG | High | Pleural Effusion without CC/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 187. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 187 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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