MS-DRG 189 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 189 by major payers:
$15,900.01
$16,771.10
$19,538.66
$19,958.13
| 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 189 | ||||||
United | 189 | $13376.29 | 1992775449 - CHRISTUS HEALTH CENTRAL LOUISIANA, CHRISTUS ST. FRANCES CABRINI HOSPITAL | 720408984 - (LA) CHRISTUS HEALTH CENTRAL LOUISIANA | LA | Rehabilitation Hospital Unit (273Y00000X) |
United | 189 | $16608.38 | 1033284666 - FRANCISCAN HEALTH MICHIGAN CITY, FRANCISCAN ST. ANTHONY HEALTH - MICHIGAN CITY | 350876394 - (IN) FRANCISCAN HEALTH MICHIGAN CITY | IN | Psychiatric Hospital Unit (273R00000X) |
United | 189 | $40039.78 | 1033325378 - ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC, QUEEN OF THE VALLEY HOSPITAL | 814791043 - (CA) ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC | CA | General Acute Care Hospital (282N00000X) |
United | 189 | $18952.31 | 1205382413 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL ZARZAMORA | 452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 189 | $6706.00 | 1245227180 - ST FRANCIS MEDICAL CENTER | 850737566 | CA | General Acute Care Hospital (282N00000X) |
United | 189 | $15346.23 | 1447962287 - INTEGRIS SOUTH OKLAHOMA CITY HOSPITAL CORPORATION | 731089149 - (OK) INTEGRIS SOUTH OKLAHOMA CITY HOSPITAL CORPORATION | OK | General Acute Care Hospital (282N00000X) |
United | 189 | $1632.00 | 1588868889 - THE BROOKDALE HOSPITAL MEDICAL CENTER | 111631746 - BROOKDALE HOSPITAL MEDICAL CENTER | NY | Psychiatric Hospital Unit (273R00000X) |
United | 189 | $22719.35 | 1134151343 - UNITED HEALTH SERVICES HOSPITALS, INC. | 161165049 - (NY) UNITED HEALTH SERVICES HOSPITALS INC | NY | General Acute Care Hospital (282N00000X) |
United | 189 | $2703.00 | 1225116486 - SINGING RIVER HEALTH SYSTEM, SINGING RIVER HOSPITAL COMPREHENSIVE REHABILITATION CENTER | 851538878 | MS | Rehabilitation Hospital Unit (273Y00000X) |
United | 189 | $2703.00 | 1225116486 - SINGING RIVER HEALTH SYSTEM, SINGING RIVER HOSPITAL COMPREHENSIVE REHABILITATION CENTER | 851538878 | MS | Rehabilitation Hospital Unit (273Y00000X) |
United | 189 | $33460.53 | 1205284411 - MCLEOD HEALTH CLARENDON | 812772554 - MCLEOD HEALTH CLARENDON | SC | Rural Acute Care Hospital (282NR1301X) |
United | 189 | $22017.07 | 1457319485 - ALLINA HEALTH SYSTEM, UNITED HOSPITAL | 363261413 - ALLINA HEALTH SYSTEM | MN | General Acute Care Hospital (282N00000X) |
United | 189 | $15346.23 | 1457372625 - INTEGRIS SOUTH OKLAHOMA CITY HOSPITAL CORPORATION, INTEGRIS SOUTHWEST MEDICAL CENTER | 731089149 - (OK) INTEGRIS SOUTH OKLAHOMA CITY HOSPITAL CORPORATION | OK | General Acute Care Hospital (282N00000X) |
United | 189 | $2765.00 | 1245260660 - WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL INC., HAWKINS COUNTY MEMORIAL HOSPITAL SWING BED | 621816368 - (TN) WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL INC | TN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 189 | $14760.94 | 1699726695 - NORTHWEST ARKANSAS HOSPITALS, LLC, NORTHWEST MEDICAL CENTER | 205896848 | AR | 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 189 vs. Other Diseases & Disorders of the Respiratory System Codes
The MS-DRG 189 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 189 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 |
|---|---|---|
| 188-MS-DRG | High | Pleural Effusion without CC/MCC |
| 189-MS-DRG | High | Pulmonary Edema and Respiratory Failure |
| 190-APR-DRG | High | ACUTE MYOCARDIAL INFARCTION |
| 190-MS-DRG | High | Chronic Obstructive Pulmonary Disease 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 189. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 189 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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