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 | $14570.86 | 1306897335 - IOM HEALTH SYSTEM LP, LUTHERAN HOSPITAL OF INDIANA | 351963748 | IN | General Acute Care Hospital (282N00000X) |
United | 189 | $21923.43 | 1417377565 - GREENVILLE HEALTH SYSTEM, GHS INT MED/SUBSPEC CLINIC | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 189 | $16317.83 | 1629085659 - ST JAMES HOSPITAL AND HEALTH CENTER | 362167869 - FRANCISCAN HEALTH OLYMPIA FIELDS | IL | Psychiatric Hospital (283Q00000X) |
United | 189 | $17187.63 | 1962504175 - ST MARY MEDICAL CENTER INC, ST MARY WOUND CLINIC | 352007327 - (IN) ST MARY MEDICAL CENTER INC | IN | General Acute Care Hospital (282N00000X) |
United | 189 | $5526.00 | 1851396576 - DESERT VALLEY HOSPITAL, LLC, DESERT VALLEY HOSPITAL | 330502805 - (CA) DESERT VALLEY HOSPITAL LLC | CA | General Acute Care Hospital (282N00000X) |
United | 189 | $24737.33 | 1437186111 - PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC. | 582179986 - (GA) PIEDMONT ATHENS REGIONAL MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | 189 | $22343.73 | 1528388634 - ADVOCATE LUTHERAN GENERAL HOSPITAL | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | General Acute Care Hospital (282N00000X) |
United | 189 | $11272.16 | 1043339559 - MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC., MCCURTAIN MEMORIAL HOSPITAL SWING BED | 736617937 - (OK) MCCURTAIN MEMORIAL MEDICAL MANAGEMENT INC | OK | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 189 | $11733.87 | 1710075361 - GOLDEN VALLEY MEMORIAL HOSPITAL DISTRICT | 430975390 - GOLDEN VALLEY MEMORIAL HOSPITAL DISTRICT | MO | General Acute Care Hospital (282N00000X) |
United | 189 | $19460.00 | 1780682161 - MERIDIAN HOSPITALS CORPORATION, RIVERVIEW MEDICAL CENTER- REHAB | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | Rehabilitation Hospital Unit (273Y00000X) |
United | 189 | $24136.72 | 1376597328 - EASTSIDE MEDICAL CENTER, LLC, PIEDMONT EASTSIDE MEDICAL CENTER | 582433432 | GA | Rehabilitation Hospital Unit (273Y00000X) |
United | 189 | $13052.09 | 1770675431 - NORTHWEST IOWA HOSPITAL CORPORATION, ST LUKES REGIONAL MEDICAL CENTER | 421019872 - (IA) NORTHWEST IOWA HOSPITAL CORPORATION | IA | Rehabilitation Hospital Unit (273Y00000X) |
United | 189 | $16983.44 | 1770673535 - PRINCETON BAPTIST MEDICAL CENTER, PRINCETON BAPTIST MEDICAL CENTER | 474775351 | AL | Psychiatric Hospital Unit (273R00000X) |
United | 189 | $24610.65 | 1457500191 - FLORIDA HOSPITAL | 590724459 - (FL) ADVENTIST HEALTH SYSTEM-SUNBELT INC | FL | General Acute Care Hospital (282N00000X) |
United | 189 | $28100.16 | 1053384776 - AHS HOSPITAL CORP., MORRISTOWN MEDICAL CENTER | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | 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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