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 | $17068.00 | 1912908567 - DEKALB MEDICAL CENTER, INC., EMORY DECATUR HOSPITAL | 581966795 - (GA) EMORY UNIVERSITY | GA | Rehabilitation Hospital Unit (273Y00000X) |
United | 187 | $11621.29 | 1902865355 - GOOD SAMARITAN HOSPITAL MEDICAL CENTER | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 187 | $4498.00 | 1013365824 - ST VINCENTS CHILTON LLC, ST VINCENTS CHILTON SWING BEDS | 810935368 | AL | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 187 | $4498.00 | 1013365824 - ST VINCENTS CHILTON LLC, ST VINCENTS CHILTON SWING BEDS | 810935368 | AL | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 187 | $7991.93 | 1700855533 - NORTH PLATTE NEBRASKA HOSPITAL CORPORATION, GREAT PLAINS HEALTH | 470662290 - (NE) NORTH PLATTE NEBRASKA HOSPITAL CORPORATION | NE | General Acute Care Hospital (282N00000X) |
United | 187 | $18967.57 | 1982600540 - UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC., PIEDMONT MCDUFFIE HOSPITAL | 454166209 - (GA) UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | 187 | $18088.06 | 1922032424 - SACRED HEART HEALTH SYSTEM, INC., SACRED HEART HOSPITAL | 590634434 - SACRED HEART HEALTH SYSTEM INC | FL | General Acute Care Hospital (282N00000X) |
United | 187 | $5385.33 | 1548452261 - CHAMBERS COUNTY PUBLIC HOSPITAL DISTRICT NO 1, OMNI POINT HEALTH HOSPITAL | 760153629 | TX | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 187 | $8607.80 | 1851340608 - NEW YORK WESTCHESTER SQ MED CTR, WESTCHESTER SQUARE MEDICAL CENTER | 311730177 - (NY) NY WESTCHESTER SQUARE MEDICAL CTR. | NY | General Acute Care Hospital (282N00000X) |
United | 187 | $15738.70 | 1619289998 - VHS DETROIT RECEIVING HOSPITAL INC, DETROIT RECEIVING HOSPITAL | 272844942 | MI | General Acute Care Hospital (282N00000X) |
United | 187 | $15738.70 | 1619289998 - VHS DETROIT RECEIVING HOSPITAL INC, DETROIT RECEIVING HOSPITAL | 272844942 | MI | General Acute Care Hospital (282N00000X) |
United | 187 | $7385.00 | 1548296106 - MERCY HEALTH YOUNGSTOWN LLC, MERCY HEALTH ST ELIZABETH YOUNGSTOWN HOSPITAL | 340505560 - HUMILITY OF MARY HEALTH PARTNERS | OH | General Acute Care Hospital (282N00000X) |
United | 187 | $12349.20 | 1285705988 - MIDLAND MEMORIAL HOSPITAL | 751584559 - (TX) MIDLAND COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 187 | $10240.79 | 1174687040 - AITKIN COMMUNITY HOSPITAL, INC., RIVERWOOD HEALTHCARE CENTER | 410745522 - (MN) AITKIN COMMUNITY HOSPITAL INC | MN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 187 | $11052.00 | 1508227109 - CHILDREN'S HOSPITAL COLORADO, CHILDREN'S HOSPITAL COLORADO OUTPATIENT SPECIALTY AND THERAPY | 840166760 - CHILDRENS HOSPITAL COLORADO | CO | Children's Hospital (282NC2000X) |
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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