MS-DRG 628 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 628 by major payers:
$44,211.82
$51,218.71
$61,479.42
$63,555.59
| 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 628 | ||||||
United | 628 | $30961.60 | 1346248986 - JOHNSON MEMORIAL HOSPITAL, JOHNSON MEMORIAL HOSPITAL | 351166081 - JOHNSON MEMORIAL HOSPITAL | IN | General Acute Care Hospital (282N00000X) |
United | 628 | $54927.14 | 1912388422 - SAINT THOMAS RIVER PARK HOSPITAL, LLC, ASCENSION SAINT THOMAS RIVER PARK | 474063149 | TN | Psychiatric Hospital Unit (273R00000X) |
United | 628 | $36758.14 | 1508859661 - MERCY HOSPITAL JEFFERSON, JEFFERSON MEMORIAL HOSPITAL ASSOCIATION | 430687077 - (MO) MERCY HOSPITAL JEFFERSON | MO | General Acute Care Hospital (282N00000X) |
United | 628 | $40471.85 | 1174553796 - BAPTIST HEALTH, BAPTIST HEALTH MEDICAL CENTER-ARKADELPHIA | 710236856 - (AR) BAPTIST HEALTH | AR | Critical Access Hospital (282NC0060X) |
United | 628 | $3524.00 | 1962435792 - HOUSTON HOSPITALS INC, HOUSTON MEDICAL CENTER | 711045290 - (GA) HOUSTON HOSPITALS INC | GA | General Acute Care Hospital (282N00000X) |
United | 628 | $51679.62 | 1184911877 - VHS BROWNSVILLE HOSPITAL COMPANY LLC, VALLEY BAPTIST MEDICAL CENTER - BROWNSVILLE | 452663071 | TX | General Acute Care Hospital (282N00000X) |
United | 628 | $56218.32 | 1710039508 - THE METHODIST HOSPITALS, INC. | 350868133 - METHODIST HOSPITALS INC | IN | Rehabilitation Hospital Unit (273Y00000X) |
United | 628 | $58400.30 | 1407897309 - HENNEPIN HEALTHCARE SYSTEM, INC, HENNEPIN COUNTY MEDICAL CENTER | 421707837 - (MN) HENNEPIN HEALTHCARE SYSTEM INC | MN | General Acute Care Hospital (282N00000X) |
United | 628 | $34876.03 | 1043646136 - MANAGED HEALTH CARE ADMINISTRATION, INC | 460928982 | AL | General Acute Care Hospital (282N00000X) |
United | 628 | $55116.67 | 1033611454 - UNIVERSITY HEALTHCARE SYSTEM, L.C., LAKEVIEW CAMPUS NICU | 621596506 | LA | General Acute Care Hospital (282N00000X) |
United | 628 | $48155.10 | 1528039039 - PHOENIXVILLE HOSPITAL COMPANY LLC, PHOENIXVILLE HOSPITAL | 822062413 | PA | General Acute Care Hospital (282N00000X) |
United | 628 | $1660.00 | 1104234376 - CARTHAGE AREA HOSPITAL, INC. | 150622079 - CARTHAGE AREA HOSPITAL INC | NY | Critical Access Hospital (282NC0060X) |
United | 628 | $61281.33 | 1770663031 - FAIRVIEW HEALTH SERVICES, FAIRVIEW SOUTHDALE HOSPITAL - PHYSICIANS | 410991680 - FAIRVIEW HEALTH SERVICES | MN | Hospitalist Physician (208M00000X) |
United | 628 | $24668.48 | 1477939296 - SELECT SPECIALTY HOSPITAL | 352498003 | GA | Special Hospital (284300000X) |
United | 628 | $64137.55 | 1467406132 - EASTSIDE MEDICAL CENTER, LLC, PIEDMONT EASTSIDE MEDICAL CENTER | 582433432 | GA | 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 628 vs. Other Endocrine, Nutritional & Metabolic Diseases & Disorders Codes
The MS-DRG 628 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 628 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 |
|---|---|---|
| 627-MS-DRG | High | Thyroid, Parathyroid and Thyroglossal Procedures without CC/MCC |
| 628-MS-DRG | High | Other Endocrine, Nutritional and Metabolic O.R. Procedures with MCC |
| 629-MS-DRG | High | Other Endocrine, Nutritional and Metabolic O.R. Procedures with CC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 628. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 628 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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