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 | $107336.11 | 1396854543 - LIFECARE HOSPITAL OF NEW ORLEANS AT KENNER | 205432782 | LA | General Acute Care Hospital (282N00000X) |
United | 207 | $172745.37 | 1619967494 - COBB HOSPITAL, INC, WELLSTAR COBB HOSPITAL INPATIENT REHAB UNIT | 580968382 - COBB HOSPITAL | GA | Rehabilitation Hospital Unit (273Y00000X) |
United | 207 | $111364.22 | 1801937008 - OHIOHEALTH CORPORATION, DUBLIN METHODIST HOSPITAL | 314394942 - OHIOHEALTH CORPORATION GRANT RIVERSIDE DOCTORS DUBLIN MET | OH | 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 | $178889.21 | 1831143890 - INSPIRA MEDICAL CENTERS, INC., INSPIRA INPATIENT ADULT BEHAVIORAL HEALTH BRIDGETON | 210634484 - (NJ) INSPIRA MEDICAL CENTERS INC | NJ | Psychiatric Hospital Unit (273R00000X) |
United | 207 | $62104.51 | 1629024930 - MERCY MEDICAL CENTER, MERCY MEDICAL PSYCH UNIT | 420698295 - (IA) MERCY MEDICAL CENTER | IA | Psychiatric Hospital Unit (273R00000X) |
United | 207 | $4120.00 | 1386834547 - JOHNSTON MEMORIAL HOSPITAL, HOSPITALIST OF JOHNSTON MEMORIAL HOSPITAL | 540544705 - JOHNSTON MEMORIAL HOSPITAL INC | VA | Hospitalist Physician (208M00000X) |
United | 207 | $334664.65 | 1962472431 - COASTAL CAROLINA MEDICAL CENTER, INC., COASTAL CAROLINA HOSPITAL | 934580630 | SC | General Acute Care Hospital (282N00000X) |
United | 207 | $87798.71 | 1700828852 - THE METROHEALTH SYSTEM, METROHEALTH MEDICAL CENTER | 346004382 | OH | General Acute Care Hospital (282N00000X) |
United | 207 | $57254.05 | 1326546797 - HENDERSON HOSPITAL, LLC, UTHEALTH EAST TEXAS HENDERSON HOSPITAL | 824019349 | TX | General Acute Care Hospital (282N00000X) |
United | 207 | $107336.11 | 1396854543 - LIFECARE HOSPITAL OF NEW ORLEANS AT KENNER | 205432782 | LA | General Acute Care Hospital (282N00000X) |
United | 207 | $48036.00 | 1891795415 - SELECT SPECIALTY HOSPITAL | 251813117 - (AZ) SELECT SPECIALTY HOSPITAL | AZ | Long Term Care Hospital (282E00000X) |
United | 207 | $70899.90 | 1104474006 - SSM SELECT REHAB ST. LOUIS, LLC, SSM HEALTH PT | 263694972 | MO | Rehabilitation Hospital (283X00000X) |
United | 207 | $164532.04 | 1255684460 - INOVA HEALTH CARE SERVICES, INOVA ALEXANDRIA HOSPITAL | 540620889 - INOVA HEALTH CARE SERVICES | VA | General Acute Care Hospital (282N00000X) |
United | 207 | $53288.30 | 1306825997 - WILLIAM BEAUMONT HOSPITAL, BEAUMONT HOSPITAL, TROY | 381459362 - WILLIAM BEAUMONT HOSPITAL | MI | 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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