MS-DRG 190 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 190 by major payers:
$13,444.03
$14,984.52
$18,170.94
$18,326.28
| 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 190 | ||||||
United | 190 | $9988.71 | 1649209230 - PUBLIC HOSPITAL DISTRICT 1 OF KING COUNTY, VALLEY MEDICAL CENTER | 916000986 - (WA) PUBLIC HOSPITAL DISTRICT 1 OF KING COUNTY | WA | General Acute Care Hospital (282N00000X) |
United | 190 | $35668.73 | 1972709970 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE EAST CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 190 | $22255.60 | 1629637608 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 190 | $22460.00 | 1972056364 - EMORY UNIVERSITY HOSPITAL MIDTOWN, CRAWFORD LONG HOSPITAL | 580566200 | GA | General Acute Care Hospital (282N00000X) |
United | 190 | $15681.45 | 1730530940 - NASSAU HEALTH CARE CORPORATION, NUMC DEPARTMENT OF FAMILY MEDICINE, FPP | 113465690 | NY | General Acute Care Hospital (282N00000X) |
United | 190 | $18169.19 | 1518978667 - CATHOLIC HEALTH INITIATIVES COLORADO, CENTURA HEALTH - ST. MARY CORWIN HOSPITAL | 840405257 - CATHOLIC HEALTH INITIATIVES COLORADO | CO | Rehabilitation Hospital Unit (273Y00000X) |
United | 190 | $16625.86 | 1912908567 - DEKALB MEDICAL CENTER, INC., EMORY DECATUR HOSPITAL | 581966795 - (GA) EMORY UNIVERSITY | GA | Rehabilitation Hospital Unit (273Y00000X) |
United | 190 | $14394.32 | 1427269174 - J C BLAIR MEMORIAL HOSPITAL, PENN HIGHLANDS HUNTINGDON | 231352159 - (PA) J C BLAIR MEMORIAL HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 190 | $35668.73 | 1972709970 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE EAST CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 190 | $18529.49 | 1124007240 - VHS SAN ANTONIO PARTNERS LLC, BAPTIST HEALTH SYSTEM | 760714523 | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 190 | $18529.49 | 1124007240 - VHS SAN ANTONIO PARTNERS LLC, BAPTIST HEALTH SYSTEM | 760714523 | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 190 | $1655.00 | 1659798619 - CLAY COUNTY MEDICAL CORPORATION, CLAY COUNTY MEDICAL CENTER-HOSPITALIST | 640668465 - (MS) CLAY COUNTY MEDICAL CORPORATION | MS | Hospitalist Physician (208M00000X) |
United | 190 | $11195.21 | 1720419583 - STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER, UMMC GRENADA EKG/EEG SERVICES | 646008520 | MS | General Acute Care Hospital (282N00000X) |
United | 190 | $11195.21 | 1720419583 - STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER, UMMC GRENADA EKG/EEG SERVICES | 646008520 | MS | General Acute Care Hospital (282N00000X) |
United | 190 | $11619.36 | 1285779116 - ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND, SOUTHERN NEW ENGLAND REHABILITION | 464661337 | RI | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
MS-DRG 190 vs. Other Diseases & Disorders of the Respiratory System Codes
The MS-DRG 190 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 190 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 |
|---|---|---|
| 189-MS-DRG | High | Pulmonary Edema and Respiratory Failure |
| 190-MS-DRG | High | Chronic Obstructive Pulmonary Disease with MCC |
| 191-APR-DRG | High | CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE |
| 191-MS-DRG | High | Chronic Obstructive Pulmonary Disease with CC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 190. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 190 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like MS-DRG 190) and we'll show you how you compare in 15 minutes or less.