MS-DRG 615 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 | • Endocrine, Nutritional & Metabolic Diseases & Disorders |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 615 by major payers:
$19,529.62
$19,173.09
$22,854.49
$23,462.74
| 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 615 | ||||||
United | 615 | $24538.98 | 1326349135 - ST CLARE MEMORIAL HOSPITAL, INC, ST CLARE MEMORIAL HOSPITAL SWING BED | 390848401 - ST CLARE MEMORIAL HOSPITAL INC | WI | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 615 | $17669.38 | 1144249657 - DUBOIS REGIONAL MEDICAL CENTER, PENN HIGHLANDS DUBOIS | 251490707 - DUBOIS REGIONAL MEDICAL CENTER | PA | General Acute Care Hospital (282N00000X) |
United | 615 | $11034.09 | 1316182215 - PUBLIC HOSPITAL DISTRICT NO 2 SKAGIT COUNTY WASHINGTON, ISLAND HOSPITAL | 910729255 - (WA) PUBLIC HOSPITAL DISTRICT NO 2 | WA | Rural Acute Care Hospital (282NR1301X) |
United | 615 | $39638.21 | 1306817978 - SALEM HOSPITAL CORPORATION, MEMORIAL HOSPITAL OF SALEM COUNTY | 210634484 - (NJ) INSPIRA MEDICAL CENTERS INC | NJ | General Acute Care Hospital (282N00000X) |
United | 615 | $4346.00 | 1801107198 - ARNOT OGDEN MEDICAL CENTER | 160743905 - ARNOT OGDEN MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 615 | $24432.65 | 1770559726 - CAMDEN GENERAL HOSPITAL, INC., WEST TENNESSEE HEALTHCARE CAMDEN HOSPITAL | 581884314 - (TN) CAMDEN GENERAL HOSPITAL | TN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 615 | $3783.00 | 1265561450 - TAKOMA REGIONAL HOSPITAL, INC, GREENEVILLE COMMUNITY HOSPITAL PSYCHIATRIC | 510603966 - TAKOMA REGIONAL HOSPITAL INC | TN | Psychiatric Hospital Unit (273R00000X) |
United | 615 | $31630.60 | 1154748416 - AGH LAVEEN LLC, DIGNITY HEALTH ARIZONA GENERAL HOSPITAL | 471587223 - (AZ) AGH LAVEEN LLC | AZ | General Acute Care Hospital (282N00000X) |
United | 615 | $48722.05 | 1174615330 - EMANUEL MEDICAL CENTER, INC. | 752918774 | CA | General Acute Care Hospital (282N00000X) |
United | 615 | $25875.67 | 1619002284 - ADVOCATE LUTHERAN GENERAL HOSPITAL | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | General Acute Care Hospital (282N00000X) |
United | 615 | $10345.00 | 1609855139 - TEXAS HEART HOSPITAL OF THE SOUTHWEST, LLC, BAYLOR SCOTT & WHITE HEART AND VASCULAR HOSPITAL - DALLAS | 412101361 - (TX) TEXAS HEART HOSPITAL OF THE SOUTHWEST, L.L.P | TX | General Acute Care Hospital (282N00000X) |
United | 615 | $31025.88 | 1730158981 - UPMC HANOVER, HANOVER HOSPITAL, INC | 231360851 - (PA) UPMC HANOVER | PA | General Acute Care Hospital (282N00000X) |
United | 615 | $23359.59 | 1487253449 - VANDERBILT BEDFORD HOSPITAL, LLC, VANDERBILT BEDFORD HOSPITAL | 853419620 | TN | General Acute Care Hospital (282N00000X) |
United | 615 | $26206.69 | 1437172350 - MERCY HEALTH-ST CHARLES HOSPITAL LLC | 344428250 - MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC | OH | Rehabilitation Hospital Unit (273Y00000X) |
United | 615 | $6893.02 | 1740230648 - OAKWOOD HEALTHCARE, INC., BEAUMONT HOSPITAL - TRENTON | 381405141 - (MI) OAKWOOD HEALTHCARE INC | 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 615 vs. Other Endocrine, Nutritional & Metabolic Diseases & Disorders Codes
The MS-DRG 615 code is part of the Endocrine, Nutritional & Metabolic Diseases & Disorders 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 615 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 |
|---|---|---|
| 614-APR-DRG | High | NEONATE BWT 1500-1999G W OR W/O OTHER SIGNIFICANT CONDITION |
| 614-MS-DRG | High | Adrenal and Pituitary Procedures with CC/MCC |
| 615-MS-DRG | High | Adrenal and Pituitary Procedures without CC/MCC |
| 616-MS-DRG | High | Amputation of Lower Limb for Endocrine, Nutritional and Metabolic Disorders with MCC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 615. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 615 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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