MS-DRG 626 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 626 by major payers:
$18,155.43
$19,824.78
$23,658.87
$24,619.17
| 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 626 | ||||||
United | 626 | $48722.46 | 1184687790 - BON SECOURS ST MARY'S HOSPITAL OF RICHMOND LLC, BON SECOURS ST. MARY'S HOSPITAL OF RICHMOND PSYCHIATRIC UNIT | 540793767 - BON SECOURS ST MARYS HOSPITAL OF RICHMOND LLC | VA | Psychiatric Hospital Unit (273R00000X) |
United | 626 | $13476.59 | 1366431702 - HOLMES COUNTY HOSPITAL CORP, DOCTORS MEMORIAL HOSPITAL | 596031176 - (FL) HOLMES COUNTY HOSPITAL CORP | FL | Critical Access Hospital (282NC0060X) |
United | 626 | $23839.39 | 1285798918 - UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS, UT SOUTHWESTERN UNIVERSITY HOSPITAL | 753175630 | TX | General Acute Care Hospital (282N00000X) |
United | 626 | $8787.00 | 1891809679 - FREEMAN-OAK HILL HEALTH SYSTEM, FREEMAN HEALTH SYSTEM | 431704371 - FREEMAN HEALTH SYSTEM | MO | General Acute Care Hospital (282N00000X) |
United | 626 | $22730.06 | 1881758126 - KISHWAUKEE COMMUNITY HOSPITAL, NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL | 237087041 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | General Acute Care Hospital (282N00000X) |
United | 626 | $31592.66 | 1902878994 - COMMUNITY HOWARD REGIONAL HEALTH, INC | 351865344 - (IN) COMMUNITY HOWARD REGIONAL HEALTH INC | IN | General Acute Care Hospital (282N00000X) |
United | 626 | $9764.48 | 1346704756 - SELECT SPECIALTY HOSPITAL | 833307316 | FL | Long Term Care Hospital (282E00000X) |
United | 626 | $18490.60 | 1760482517 - ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC. | 481186704 - ASCENSION VIA CHRISTI HOSPITAL MANHATTAN INC | KS | General Acute Care Hospital (282N00000X) |
United | 626 | $22473.48 | 1083669683 - LEHIGH HMA LLC, LEHIGH REGIONAL MEDICAL CENTER | 871999484 | FL | General Acute Care Hospital (282N00000X) |
United | 626 | $29266.83 | 1245330281 - UNIVERSITY OF WASHINGTON, UNIVERSITY OF WASHINGTON MEDICAL CENTER | 916001537 | WA | Rehabilitation Hospital Unit (273Y00000X) |
United | 626 | $21534.68 | 1578504056 - MERCY HOSPITAL SPRINGFIELD, MERCY HOSPITAL SPRINGFIELD | 440552485 - MERCY HOSPITAL SPRINGFIELD | MO | General Acute Care Hospital (282N00000X) |
United | 626 | $30000.53 | 1073674040 - ENUMCLAW REGIONAL HOSPITAL ASSOCIATION, ST. ELIZABETH HOSPITAL | 910715805 - (WA) ENUMCLAW REGIONAL HOSPITAL ASSOCIATION | WA | Critical Access Hospital (282NC0060X) |
United | 626 | $32000.17 | 1518988310 - SMDC MEDICAL CENTER, ESSENTIA HEALTH DULUTH (REHAB UNIT) | 411878730 - (MN) SMDC MEDICAL CENTER | MN | Rehabilitation Hospital Unit (273Y00000X) |
United | 626 | $33622.94 | 1215003348 - NAPLES HMA LLC, PHYSICIANS REGIONA MEDICAL CENTER-COLLIER | 204401957 | FL | General Acute Care Hospital (282N00000X) |
United | 626 | $12609.38 | 1912085184 - ALEGENT HEALTH IMMANUEL MEDICAL CENTER, CHI HEALTH IMMANUEL | 470376615 - ALEGENT HEALTH-IMMANUEL MEDICAL CENTER | NE | 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 626 vs. Other Endocrine, Nutritional & Metabolic Diseases & Disorders Codes
The MS-DRG 626 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 626 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 |
|---|---|---|
| 625-APR-DRG | High | NEONATE BWT 2000-2499G W OTHER SIGNIFICANT CONDITION |
| 625-MS-DRG | High | Thyroid, Parathyroid and Thyroglossal Procedures with MCC |
| 626-MS-DRG | High | Thyroid, Parathyroid and Thyroglossal Procedures with CC |
| 627-MS-DRG | High | Thyroid, Parathyroid and Thyroglossal Procedures without CC/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 626. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 626 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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