MS-DRG 191 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 191 by major payers:
$10,636.62
$12,139.66
$14,013.28
$14,185.92
| 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 191 | ||||||
United | 191 | $14229.04 | 1558333864 - DYERSBURG HEALTH, WEST TENNESSEE HEALTHCARE DYERSBURG HOSPITAL | 825179383 - (TN) DYERSBURG HEALTH | TN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 191 | $3105.00 | 1538107776 - OUACHITA COUNTY MEDICAL CENTER | 710766341 - (AR) OUACHITA COUNTY MEDICAL CENTER | AR | Psychiatric Hospital Unit (273R00000X) |
United | 191 | $16545.41 | 1265532915 - FRANCISCAN HEALTH INDIANAPOLIS & MOORESVILLE, FRANCISCAN HEALTH - INPATIENT REHAB UNIT | 350913537 | IN | Rehabilitation Hospital Unit (273Y00000X) |
United | 191 | $23612.53 | 1538657267 - PALMETTO HEALTH | 582296052 - (SC) PRISMA HEALTH-MIDLANDS | SC | Hospitalist Physician (208M00000X) |
United | 191 | $19125.27 | 1801971965 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 191 | $8953.11 | 1871572545 - VHS ACQUISITION SUBSIDIARY NUMBER 3 INC, LOUIS A. WEISS MEMORIAL HOSPITAL | 352637418 | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 191 | $8123.22 | 1124090659 - TOOELE HOSPITAL CORPORATION, MOUNTAIN WEST MEDICAL CENTER | 870619248 - (UT) TOOELE HOSPITAL CORPORATION | UT | General Acute Care Hospital (282N00000X) |
United | 191 | $7573.83 | 1669539623 - ANDERSON HOSPITAL, ANDERSON HOSPITAL | 370662561 - ANDERSON HOSPITAL | IL | General Acute Care Hospital (282N00000X) |
United | 191 | $3800.00 | 1740840909 - THIBODAUX REGIONAL HEALTH SYSTEM INC | 842046902 - (LA) THIBODAUX REGIONAL HEALTH SYSTEM INC | LA | Psychiatric Hospital (283Q00000X) |
United | 191 | $14200.91 | 1184655581 - UNIVERSITY OF CALIFORNIA IRVINE, UCI HEALTH LAKEWOOD | 952226406 - REGENTS OF THE UNIVERSITY OF CALIFORNIA AT IRVINE | CA | General Acute Care Hospital (282N00000X) |
United | 191 | $15806.00 | 1366450298 - SOUTH SHORE UNIVERSITY HOSPITAL, PSYCHIATRIC UNIT | 111667761 - (NY) SOUTH SHORE UNIVERSITY HOSPITAL | NY | Psychiatric Hospital Unit (273R00000X) |
United | 191 | $7956.68 | 1740876382 - DELTA HEALTH SYSTEM, DELTA HEALTH-NORTHWEST REGIONAL | 853959101 | MS | General Acute Care Hospital (282N00000X) |
United | 191 | $13121.88 | 1255367611 - KENNEWICK PUBLIC HOSPITAL DISTRICT, KENNEWICK GENERAL HOSPITAL | 823962056 | WA | General Acute Care Hospital (282N00000X) |
United | 191 | $19570.66 | 1649263880 - NORWALK HOSPITAL ASSOCIATION | 66068853 - (CT) NORWALK HOSPITAL ASSOCIATION | CT | General Acute Care Hospital (282N00000X) |
United | 191 | $11010.76 | 1033107214 - SWEDISH EDMONDS, PUBLIC HOSPITAL DISTRICT 2 OF SNOHOMISH COUNTY | 272305304 - (WA) SWEDISH EDMONDS | WA | 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 191 vs. Other Diseases & Disorders of the Respiratory System Codes
The MS-DRG 191 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 191 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 |
|---|---|---|
| 190-APR-DRG | High | ACUTE MYOCARDIAL INFARCTION |
| 190-MS-DRG | High | Chronic Obstructive Pulmonary Disease with MCC |
| 191-MS-DRG | High | Chronic Obstructive Pulmonary Disease with CC |
| 192-APR-DRG | High | CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 191. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 191 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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