MS-DRG 202 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 202 by major payers:
$11,248.41
$13,237.52
$15,237.75
$15,689.55
| 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 202 | ||||||
United | 202 | $21735.27 | 1710353339 - SMSJ TUCSON HOLDINGS LLC, ST. MARYS HOSPITAL | 474131755 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 202 | $7128.00 | 1053447086 - JANE PHILLIPS NOWATA HEALTH CENTER | 731440267 - (OK) JANE PHILLIPS NOWATA HOSPITAL INC | OK | Critical Access Hospital (282NC0060X) |
United | 202 | $10575.58 | 1174512792 - TUCSON MEDICAL CENTER | 860137567 - (AZ) TUCSON MEDICAL CENTER | AZ | General Acute Care Hospital (282N00000X) |
United | 202 | $10328.21 | 1720037559 - EAST TEXAS MEDICAL CENTER PITTSBURG, ETMC PITTSBURG | 823953636 | TX | Critical Access Hospital (282NC0060X) |
United | 202 | $16560.80 | 1124503636 - GENERAL CONFERENCE OF SEVENTH DAY ADVENTIST HACKETTSTOWN COMMUNITY HOS | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | General Acute Care Hospital (282N00000X) |
United | 202 | $10278.00 | 1487015988 - CHILDREN'S HOSPITAL COLORADO, CHILDREN'S HOSPITAL COLORADO URGENT/OUTPATIENT SPECIALTY CARE WHEATRID | 840166760 - CHILDRENS HOSPITAL COLORADO | CO | Children's Hospital (282NC2000X) |
United | 202 | $14308.12 | 1689737223 - SWAIN COUNTY HOSPITAL, INC. | 320441929 | NC | Critical Access Hospital (282NC0060X) |
United | 202 | $14715.82 | 1619289998 - VHS DETROIT RECEIVING HOSPITAL INC, DETROIT RECEIVING HOSPITAL | 272844942 | MI | General Acute Care Hospital (282N00000X) |
United | 202 | $26539.77 | 1497106843 - KECK MEDICAL CENTER | 851644866 - (CA) KECK MEDICAL CENTER OF USC | CA | General Acute Care Hospital (282N00000X) |
United | 202 | $22237.00 | 1700087590 - ALAMEDA HEALTH SYSTEM, HIGHLAND GENERAL HOSPITAL | 943302014 | CA | General Acute Care Hospital (282N00000X) |
United | 202 | $13006.95 | 1841690740 - CHI ST LUKE'S HEALTH BAYLOR ST. LUKE'S MEDICAL CENTER | 741161938 - CHI ST LUKES HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 202 | $13555.33 | 1851361778 - BON SECOURS ST. FRANCIS XAVIER HOSPITAL INC. | 571067254 - (SC) BON SECOURS-ST FRANCIS XAVIER HOSPITAL INC | SC | General Acute Care Hospital (282N00000X) |
United | 202 | $8815.41 | 1346544616 - COMANCHE COUNTY MEDICAL CENTER COMPANY | 273993262 - (TX) COMANCHE COUNTY MEDICAL CENTER COMPANY | TX | Critical Access Hospital (282NC0060X) |
United | 202 | $20819.39 | 1619176997 - PROVIDENCE HEALTH & SERVICES WASHINGTON | 910567732 | WA | General Acute Care Hospital (282N00000X) |
United | 202 | $15926.09 | 1831298926 - NORTHWESTERN MEMORIAL HOSPITAL | 370960170 - (IL) NORTHWESTERN MEMORIAL HOSPITAL | IL | Psychiatric Hospital Unit (273R00000X) |
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 202 vs. Other Diseases & Disorders of the Respiratory System Codes
The MS-DRG 202 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 202 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 |
|---|---|---|
| 201-APR-DRG | High | CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS |
| 201-MS-DRG | High | Pneumothorax without CC/MCC |
| 202-MS-DRG | High | Bronchitis and Asthma with CC/MCC |
| 203-APR-DRG | High | CHEST PAIN |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 202. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 202 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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