MS-DRG 207 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 207 by major payers:
$70,739.03
$79,973.66
$102,175.75
$101,987.65
| 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 207 | ||||||
United | 207 | $76183.61 | 1316279003 - METROSOUTH MEDICAL CENTER, HOSPITAL | 510382045 | IL | General Acute Care Hospital (282N00000X) |
United | 207 | $175597.40 | 1639108434 - WILLAMETTE FALLS HOSPITAL, PROVIDENCE WILLAMETTE FALLS MEDICAL CENTER | 611659489 | OR | General Acute Care Hospital (282N00000X) |
United | 207 | $8106.00 | 1598873796 - FREEMAN NEOSHO HOSPITAL | 431240629 - (MO) FREEMAN NEOSHO HOSPITAL | MO | Critical Access Hospital (282NC0060X) |
United | 207 | $110944.82 | 1336155738 - SAINT ELIZABETH REGIONAL MEDICAL CENTER, CHI HEALTH ST. ELIZABETH | 470379836 - (NE) SAINT ELIZABETH REGIONAL MEDICAL CENTER | NE | General Acute Care Hospital (282N00000X) |
United | 207 | $126140.07 | 1316000706 - COLUMBIA ST MARY'S HOSPITAL OZAUKEE, INC., ASCENSION COLUMBIA ST MARY'S HOSPITAL OZAUKEE | 390806315 - COLUMBIA ST MARYS HOSPITAL MILWAUKEE INC | WI | General Acute Care Hospital (282N00000X) |
United | 207 | $95598.14 | 1659523132 - THE METHODIST HOSPITAL, THE METHODIST HOSPITAL | 350868133 - METHODIST HOSPITALS INC | IN | General Acute Care Hospital (282N00000X) |
United | 207 | $265329.81 | 1073920898 - YALE NEW HAVEN HOSPITAL | 60646652 - YALE NEW HAVEN HOSPITAL | CT | General Acute Care Hospital (282N00000X) |
United | 207 | $70899.90 | 1104474006 - SSM SELECT REHAB ST. LOUIS, LLC, SSM HEALTH PT | 263694972 | MO | Rehabilitation Hospital (283X00000X) |
United | 207 | $135668.92 | 1457319485 - ALLINA HEALTH SYSTEM, UNITED HOSPITAL | 363261413 - ALLINA HEALTH SYSTEM | MN | General Acute Care Hospital (282N00000X) |
United | 207 | $60791.19 | 1942240189 - REFUGIO COUNTY MEMORIAL HOSPITAL DISTRICT | 741915330 - (TX) REFUGIO COUNTY MEMORIAL HOSPITAL DISTRICT | TX | Critical Access Hospital (282NC0060X) |
United | 207 | $57254.05 | 1326546797 - HENDERSON HOSPITAL, LLC, UTHEALTH EAST TEXAS HENDERSON HOSPITAL | 824019349 | TX | General Acute Care Hospital (282N00000X) |
United | 207 | $8578.00 | 1184709057 - ORLANDO HEALTH, INC. | 591726273 - (FL) ORLANDO HEALTH INC | FL | General Acute Care Hospital (282N00000X) |
United | 207 | $139410.34 | 1144471715 - PROVIDENCE HEALTH & SERVICES, PROV SCRED HRT MED CTR & CHLDS HOS | 364640211 | WA | General Acute Care Hospital (282N00000X) |
United | 207 | $104011.97 | 1861435042 - SAINT VINCENT HEALTH CENTER | 250965547 - (PA) HIGHMARK HEALTH | PA | General Acute Care Hospital (282N00000X) |
United | 207 | $69884.56 | 1023088168 - ASCENSION ST JOHN HOSPITAL, ST JOHN HOSPITAL AND MEDICAL CENTER | 381359063 - ASCENSION ST JOHN HOSPITAL | IL | 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 207 vs. Other Diseases & Disorders of the Respiratory System Codes
The MS-DRG 207 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 207 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 |
|---|---|---|
| 206-APR-DRG | High | MALFUNCTION,REACTION,COMPLICATION OF CARDIAC/VASC DEVICE OR PROCEDURE |
| 206-MS-DRG | High | Other Respiratory System Diagnoses without MCC |
| 207-MS-DRG | High | Respiratory System Diagnosis with Ventilator Support >96 Hours |
| 208-APR-DRG | Moderate | Open Craniotomy For Trauma |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 207. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 207 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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