MS-DRG 188 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 188 by major payers:
$9,298.07
$10,700.95
$11,714.51
$12,052.58
| 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 188 | ||||||
United | 188 | $13667.00 | 1689744856 - JERSEY CITY MEDICAL CENTER | 222783298 - (NJ) JERSEY CITY MEDICAL CENTER | NJ | General Acute Care Hospital (282N00000X) |
United | 188 | $10101.86 | 1477039782 - BAPTIST HEALTH REGIONAL HOSPITALS, BAPTIST HEALTH - FORT SMITH | 825426152 - (AR) BAPTIST HEALTH REGIONAL HOSPITALS | AR | Psychiatric Hospital Unit (273R00000X) |
United | 188 | $10599.36 | 1386188068 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatric Hospital Unit (273R00000X) |
United | 188 | $12518.11 | 1225029390 - JACKSON MADISON COUNTY GENERAL HOSPITAL, WEST TENNESSEE REHABILITATION CENTER | 626010402 - (TN) JACKSON MADISON COUNTY GENERAL HOSPITAL | TN | Rehabilitation Hospital Unit (273Y00000X) |
United | 188 | $8299.00 | 1477596583 - LONG BEACH MEMORIAL MEDICAL, MILLER CHILDREN'S HOSPITAL | 953527031 - (CA) LONG BEACH MEMORIAL MEDICAL CENTER | CA | Children's Hospital (282NC2000X) |
United | 188 | $11997.40 | 1477805406 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL WESTOVER HILLS | 452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 188 | $16773.52 | 1457500191 - FLORIDA HOSPITAL | 590724459 - (FL) ADVENTIST HEALTH SYSTEM-SUNBELT INC | FL | General Acute Care Hospital (282N00000X) |
United | 188 | $5761.00 | 1992772008 - IRVING COPPELL SURGICAL HOSPITAL | 542086863 | TX | Special Hospital (284300000X) |
United | 188 | $7645.22 | 1942396163 - INDIANA REGIONAL MEDICAL CENTER | 250965404 - (PA) INDIANA REGIONAL MEDICAL CENTER | PA | Rural Acute Care Hospital (282NR1301X) |
United | 188 | $7033.64 | 1881788933 - BAXTER COUNTY REGIONAL HOSPITAL, INC, BAXTER HEALTH | 710561765 - BAXTER COUNTY REGIONAL HOSPITAL INC | AR | General Acute Care Hospital (282N00000X) |
United | 188 | $18792.58 | 1528133147 - LONG ISLAND COMMUNITY HOSPITAL AT NYU LANGONE HEALTH, BROOKHAVEN MEMORIAL HOSPITAL PSYCHIATRIC UNIT | 133971298 - NYU LANGONE HOSPITALS | NY | Psychiatric Hospital Unit (273R00000X) |
United | 188 | $10339.53 | 1902870132 - ENCOMPASS HEALTH REHABILITATION HOSPITAL OF SCOTTSDALE, LLC, ENCOMPASS HEALTH REHABILITATION HOSPITAL OF SCOTTSDALE | 631184846 | AZ | Rehabilitation Hospital (283X00000X) |
United | 188 | $11494.00 | 1124305065 - BAYLOR SCOTT & WHITE MEDICAL CENTERS, BAYLOR SCOTT & WHITE MEDICAL CENTER - MCKINNEY | 751037591 - (TX) BAYLOR MEDICAL CENTERS AT GARLAND AND MCKINNEY | TX | General Acute Care Hospital (282N00000X) |
United | 188 | $8049.02 | 1043450828 - SSM SELECT REHAB ST LOUIS LLC, SSM PHYSICAL THERAPY | 263694972 | MO | Rehabilitation Hospital (283X00000X) |
United | 188 | $13685.49 | 1225097652 - ST. CHARLES HOSPITAL | 111871039 - (NY) ST CHARLES HOSPITAL CORP | NY | Rehabilitation Hospital Unit (273Y00000X) |
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 188 vs. Other Diseases & Disorders of the Respiratory System Codes
The MS-DRG 188 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 188 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 |
|---|---|---|
| 187-MS-DRG | High | Pleural Effusion with CC |
| 188-MS-DRG | High | Pleural Effusion without CC/MCC |
| 189-MS-DRG | High | Pulmonary Edema and Respiratory Failure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 188. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 188 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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