MS-DRG 193 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 193 by major payers:
$16,039.77
$17,674.16
$21,119.31
$21,195.40
| 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 193 | ||||||
United | 193 | $13527.54 | 1427097716 - GENESIS HEALTH SYSTEM, GENESIS MEDICAL CENTER DAVENPORT | 421418847 - GENESIS HEALTH SYSTEM | IA | Rehabilitation Hospital Unit (273Y00000X) |
United | 193 | $5706.00 | 1326075193 - MADISON HMA LLC, MERIT HEALTH MADISON | 30400182 - (MS) MADISON HMA LLC | MS | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 193 | $19005.17 | 1023069028 - SOUTHCREST LLC, SOUTHCREST HOSPITAL | 452711804 | OK | General Acute Care Hospital (282N00000X) |
United | 193 | $3558.00 | 1659590644 - SHRINERS HOSPITALS FOR CHILDREN, SHRINERS CHILDREN'S OHIO | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | OH | Children's Hospital (282NC2000X) |
United | 193 | $23660.61 | 1578906673 - KANSAS UNIVERSITY PHYSICIANS, INC. | 481202402 - UNIVERSITY OF KANSAS HOSPITAL AUTHORITY | KS | General Acute Care Hospital (282N00000X) |
United | 193 | $26231.14 | 1629637608 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 193 | $10353.91 | 1336109768 - HOSPITAL SERVICE DISTRICT NO 1-A OF THE PARISH OF RICHLAND STATE OF LA, RICHLAND PARISH HOSPITAL | 721179027 - (LA) RICHLAND PARISH HOSPITAL | LA | Critical Access Hospital (282NC0060X) |
United | 193 | $7245.00 | 1366547747 - RIVERSIDE HOSPITAL INC, RIVERSIDE REGIONAL MEDICAL CENTER | 521245746 - (VA) RIVERSIDE HEALTHCARE ASSOCIATION INC | VA | General Acute Care Hospital (282N00000X) |
United | 193 | $19005.17 | 1023069028 - SOUTHCREST LLC, SOUTHCREST HOSPITAL | 452711804 | OK | General Acute Care Hospital (282N00000X) |
United | 193 | $11753.66 | 1912014564 - ADVOCATE NORTH SIDE HEALTH NETWORK, ADVOCATE ILLINOIS MASONIC MEDICAL CENTER | 363196629 - (IL) ADVOCATE NORTH SIDE HEALTH NETWORK | IL | General Acute Care Hospital (282N00000X) |
United | 193 | $10345.00 | 1669472387 - BAYLOR ALL SAINTS MEDICAL CENTER, BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | 751008430 - (TX) BAYLOR ALL SAINTS MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 193 | $29848.53 | 1083888515 - PEACEHEALTH, SACRED HEART-RIVERBEND | 261871008 | OR | General Acute Care Hospital (282N00000X) |
United | 193 | $24370.85 | 1023194271 - PROVIDENCE HEALTH & SERVICES OREGON, PROVIDENCE PORTLAND MEDICAL CENTER | 930386906 | OR | Psychiatric Hospital Unit (273R00000X) |
United | 193 | $16398.77 | 1467836379 - ST. CLAIR HOSPITAL | 251010303 - (PA) ST CLAIR HEALTH CORPORATION | PA | General Acute Care Hospital (282N00000X) |
United | 193 | $27720.75 | 1720019995 - NORTH SHORE MEDICAL CENTER, INC., NORTH SHORE MEDICAL CENTER | 862695690 | FL | 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 193 vs. Other Diseases & Disorders of the Respiratory System Codes
The MS-DRG 193 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 193 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 |
|---|---|---|
| 192-APR-DRG | High | CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS |
| 192-MS-DRG | High | Chronic Obstructive Pulmonary Disease without CC/MCC |
| 193-MS-DRG | High | Simple Pneumonia and Pleurisy with MCC |
| 194-APR-DRG | High | HEART FAILURE |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 193. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 193 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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