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See a sample rate comparisonMS-DRG 187 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.
PLEURAL EFFUSION WITH CC
| 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
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MS-DRG 187
5 of 25 sample ratesHigher to lower in this preview
Westchester County Health Care Corporation, Mid-Hudson Valley Division Of Westchester Medical Center
Peo Mid-Hudson Valley Staffco
$34,142.01Published rateJeanes Hospital
Temple University Hospital Inc
$17,797.91Published ratePeconic Bay Medical Center
Central Suffolk Hospital
$13,968.00Published rateHca Healthone LLC, Rose Medical Center
$8,045.37Published rateCity Of Phila Trustee Acting By The Brd Of Dir Of City Trusts
City Of Philadelphia Ttee Administering Wills Eye Institute
$2,412.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-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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