MS-DRG 618 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 618 by major payers:
$17,474.21
$17,066.46
$19,614.03
$20,371.10
| 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 618 | ||||||
United | 618 | $36605.94 | 1104976703 - TEXAS HEALTH PRESBYTERIAN HOSPITAL KAUFMAN | 752771437 - (TX) TEXAS HEALTH PRESBYTERIAN HOSPITAL KAUFMAN | TX | General Acute Care Hospital (282N00000X) |
United | 618 | $5761.00 | 1598196206 - EBD BEMC BURLESON, LLC, BAYLOR EMERGENCY MEDICAL CENTER AT MANSFIELD | 364755936 | TX | General Acute Care Hospital (282N00000X) |
United | 618 | $10991.00 | 1497702575 - ORANGE COAST MEMORIAL MEDICAL CENTER | 330687414 - (CA) MEMORIAL HEALTH SERVICES | CA | General Acute Care Hospital (282N00000X) |
United | 618 | $15220.09 | 1194750232 - COXHEALTH | 440577118 - LESTER E COX MEDICAL CENTER | MO | General Acute Care Hospital (282N00000X) |
United | 618 | $13776.54 | 1902968688 - HEALTH AND HOSPITAL CORPORATION OF MARION CO, WISHARD HEALTH SERVICES | 356005697 | IN | Rehabilitation Hospital Unit (273Y00000X) |
United | 618 | $10339.53 | 1851619241 - BASTROP REHABILITATION HOSPITAL, LLC, RIVERBEND REHABILITATION HOSPITAL | 721460782 - (LA) BASTROP REHABILITATION HOSPITAL LLC | LA | Rehabilitation Hospital (283X00000X) |
United | 618 | $17087.98 | 1992159289 - THEDACARE MEDICAL CENTER, COMMUNITY HEALTH NETWORK, INC. AND BERLIN MEMORIAL HOSPITAL | 350983617 - COMMUNITY HEALTH NETWORK INC | WI | Critical Access Hospital (282NC0060X) |
United | 618 | $30819.96 | 1033124961 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION, HARLEM HOSPITAL CENTER | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | General Acute Care Hospital (282N00000X) |
United | 618 | $1200.00 | 1619057155 - SABINE MEDICAL CENTER | 262074318 | LA | General Acute Care Hospital (282N00000X) |
United | 618 | $26957.66 | 1235108481 - HANOVER HOSPITAL INC., CENTER FOR ACUTE REHABILITATIVE MEDICINE | 231360851 - (PA) UPMC HANOVER | PA | Rehabilitation Hospital Unit (273Y00000X) |
United | 618 | $31240.80 | 1932131489 - SAN RAMON REGIONAL MEDICAL CENTER, LLC | 752918809 | CA | General Acute Care Hospital (282N00000X) |
United | 618 | $10339.53 | 1184635229 - SHERIDAN COUNTY HOSPITAL | 480579744 - (KS) SHERIDAN COUNTY HOSPITAL | KS | Critical Access Hospital (282NC0060X) |
United | 618 | $13858.99 | 1427493246 - FRANCISCAN HEALTH MUNSTER, FRANCISCAN HEALTHCARE - MUNSTER | 352472136 - (IN) FRANCISCAN HEALTHCARE MUNSTER | IN | General Acute Care Hospital (282N00000X) |
United | 618 | $27400.11 | 1962577890 - INTEGRIS BASS BAPTIST HEALTH CENTER, INTEGRIS BASS BEHAVIORAL HEALTH CENTER ACUTE | 730612674 | OK | Psychiatric Hospital Unit (273R00000X) |
United | 618 | $14667.28 | 1023060472 - ST. JOSEPH HEALTH SYSTEM, LLC, LUTHERAN DOWNTOWN HOSPITAL | 510382045 | IN | 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 618 vs. Other Endocrine, Nutritional & Metabolic Diseases & Disorders Codes
The MS-DRG 618 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 618 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 |
|---|---|---|
| 617-MS-DRG | High | Amputation of Lower Limb for Endocrine, Nutritional and Metabolic Disorders with CC |
| 618-MS-DRG | High | Amputation of Lower Limb for Endocrine, Nutritional and Metabolic Disorders without CC/MCC |
| 619-MS-DRG | High | O.R. Procedures for Obesity 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 618. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 618 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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