MS-DRG 198 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 198 by major payers:
$9,514.88
$10,358.34
$11,263.03
$11,548.64
| 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 198 | ||||||
United | 198 | $6158.12 | 1659323772 - COLUMBIA PLAZA MEDICAL CENTER OF FORT WORTH SUBSIDIARY LP, MEDICAL CITY FORT WORTH | 621682202 - (TX) COLUMBIA PLAZA MEDICAL CENTER OF FORT WORTH SUBSIDIARY LP | TX | General Acute Care Hospital (282N00000X) |
United | 198 | $7159.47 | 1720037559 - EAST TEXAS MEDICAL CENTER PITTSBURG, ETMC PITTSBURG | 823953636 | TX | Critical Access Hospital (282NC0060X) |
United | 198 | $7330.16 | 1841394418 - THE DCH HEALTHCARE AUTHORITY, NORTHPORT MEDICAL CENTER | 636000271 - (AL) THE DCH HEALTH CARE AUTHORITY | AL | General Acute Care Hospital (282N00000X) |
United | 198 | $10027.62 | 1811158215 - DLP HAYWOOD REGIONAL MEDICAL CENTER LLC., HAYWOOD REGIONAL MEDICAL CENTER | 300830918 | NC | General Acute Care Hospital (282N00000X) |
United | 198 | $1286.00 | 1437222312 - ARKANSAS METHODIST HOSPITAL CORPORATION, ARKANSAS METHODIST MEDICAL CENTER | 710230218 - ARKANSAS METHODIST HOSPITAL CORPORATION | AR | General Acute Care Hospital (282N00000X) |
United | 198 | $13672.20 | 1588697296 - WEST BOCA MEDICAL CENTER, INC., WEST BOCA MEDICAL CENTER | 752922710 | FL | General Acute Care Hospital (282N00000X) |
United | 198 | $10027.62 | 1568618379 - DLP HAYWOOD REGIONAL MEDICAL CENTER LLC, HAYWOOD REGIONAL MEDICAL CENTER BEHAVIORAL HEALTH UNIT | 300830918 | NC | Psychiatric Hospital Unit (273R00000X) |
United | 198 | $13030.95 | 1780608216 - LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER | 930386793 - LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER PAYROLL DEPT | OR | General Acute Care Hospital (282N00000X) |
United | 198 | $12884.55 | 1790881118 - UNIVERSITY OF NORTH CAROLINA | 561118388 | NC | General Acute Care Hospital (282N00000X) |
United | 198 | $12450.30 | 1861635971 - MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL, LLC | 800337676 | WI | Special Hospital (284300000X) |
United | 198 | $10951.45 | 1417961137 - BRONSON METHODIST HOSPITAL, BRONSON MEDICAL GROUP | 381359087 - (MI) BRONSON METHODIST HOSPITAL | MI | Hospitalist Physician (208M00000X) |
United | 198 | $14100.98 | 1326002049 - UNIVERSITY OF WASHINGTON, UNIVERSITY OF WASHINGTON MEDICAL CENTER | 916001537 | WA | General Acute Care Hospital (282N00000X) |
United | 198 | $12591.08 | 1306857974 - CATHOLIC HEALTH INITIATIVES COLORADO, ST. MARY-CORWIN HOSPITAL | 840405257 - CATHOLIC HEALTH INITIATIVES COLORADO | CO | General Acute Care Hospital (282N00000X) |
United | 198 | $9447.00 | 1962504175 - ST MARY MEDICAL CENTER INC, ST MARY WOUND CLINIC | 352007327 - (IN) ST MARY MEDICAL CENTER INC | IN | General Acute Care Hospital (282N00000X) |
United | 198 | $12948.29 | 1255377149 - OHIOHEALTH CORPORATION, GRANT MEDICAL CENTER | 314394942 - OHIOHEALTH CORPORATION GRANT RIVERSIDE DOCTORS DUBLIN MET | OH | 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 198 vs. Other Diseases & Disorders of the Respiratory System Codes
The MS-DRG 198 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 198 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 |
|---|---|---|
| 197-APR-DRG | High | PERIPHERAL & OTHER VASCULAR DISORDERS |
| 197-MS-DRG | High | Interstitial Lung Disease with CC |
| 198-MS-DRG | High | Interstitial Lung Disease without CC/MCC |
| 199-APR-DRG | High | HYPERTENSION |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 198. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 198 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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