MS-DRG 192 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 192 by major payers:
$8,511.91
$9,766.00
$10,630.09
$10,843.02
| 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 192 | ||||||
United | 192 | $6842.20 | 1447747316 - ST JOSEPHS HOSPITAL BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDE | 371208459 - (IL) ST JOSEPHS HOSP OF THE HOSP SISTERS OF THE 3RD ORDER OF ST FRANCIS | IL | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 192 | $3000.00 | 1104857119 - PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA, JACKSON NORTH MEDICAL CENTER | 591713947 - (FL) PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY FLORIDA | FL | General Acute Care Hospital (282N00000X) |
United | 192 | $15456.07 | 1154516755 - SWEDISH HEALTH SERVICES, SWEDISH MEDICAL CENTER, BALLARD | 910433740 - (WA) SWEDISH HEALTH SERVICES | WA | Substance Use Disorder Rehabilitation Hospital Unit (276400000X) |
United | 192 | $9629.55 | 1720371487 - SIBLEY MEMORIAL HOSPITAL | 530196602 - (DC) LUCY WEBB HAYNES NATIONAL TRAINING SCHOOL FOR DEACONESSES AND MISSION | DC | General Acute Care Hospital (282N00000X) |
United | 192 | $13171.12 | 1063071033 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 192 | $4023.12 | 1568695781 - HEARTLAND LONG TERM ACUTE CARE HOSPITAL, LONG TERM ACUTE CARE HOSPITAL, MOSAIC LIFE CARE AT ST. JOSEPH | 261972987 - (MO) HEARTLAND LONG TERM ACUTE CARE HOSPITAL | MO | Long Term Care Hospital (282E00000X) |
United | 192 | $8364.78 | 1588673297 - GRAHAM COUNTY HOSPITAL | 486083417 - (KS) GRAHAM COUNTY HOSPITAL | KS | Critical Access Hospital (282NC0060X) |
United | 192 | $8291.28 | 1427098169 - MERCY HOSPITALS EAST COMMUNITIES, MERCY HOSPITAL ST LOUIS | 430653493 - MERCY HOSPITALS EAST COMMUNITIES | MO | General Acute Care Hospital (282N00000X) |
United | 192 | $6492.72 | 1831280957 - UPLAND HILLS HEALTH, INC., UPLAND HILLS HEALTH | 421017512 - (WI) UPLAND HILLS HEALTH INC | WI | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 192 | $7708.66 | 1669690764 - CLEARFIELD HOSPITAL | 251490707 - DUBOIS REGIONAL MEDICAL CENTER | PA | Psychiatric Hospital Unit (273R00000X) |
United | 192 | $3665.00 | 1114053782 - THE SHRINERS' HOSPITAL FOR CHILDREN | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | MA | Children's Hospital (282NC2000X) |
United | 192 | $15267.15 | 1720373103 - INTEGRIS HEALTH EDMOND, INC, INTEGRIS HEALTH EDMOND HOSPITAL | 451027361 - (OK) INTEGRIS HEALTH EDMOND INC | OK | General Acute Care Hospital (282N00000X) |
United | 192 | $11320.17 | 1558759498 - BANNER | 901074558 | AZ | General Acute Care Hospital (282N00000X) |
United | 192 | $5524.50 | 1548241953 - CAMPBELL COUNTY HMA, LLC, TENNOVA HEALTHCARE-LAFOLLETTE MEDICAL CENTER | 452528273 - CAMPBELL COUNTY HMA LLC | TN | Psychiatric Hospital Unit (273R00000X) |
United | 192 | $14455.86 | 1952359986 - SOUTHWESTERN MEDICAL CENTER, LLC, SOUTHWESTERN MEDICAL CENTER | 621757662 | OK | 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 192 vs. Other Diseases & Disorders of the Respiratory System Codes
The MS-DRG 192 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 192 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 |
|---|---|---|
| 191-APR-DRG | High | CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE |
| 191-MS-DRG | High | Chronic Obstructive Pulmonary Disease with CC |
| 192-MS-DRG | High | Chronic Obstructive Pulmonary Disease without CC/MCC |
| 193-APR-DRG | High | ACUTE & SUBACUTE ENDOCARDITIS |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 192. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 192 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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