MS-DRG 654 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 Kidney & Urinary Tract |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 654 by major payers:
$33,586.73
$36,831.09
$44,392.63
$45,615.62
| 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 654 | ||||||
United | 654 | $29502.03 | 1518042605 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 654 | $75522.21 | 1164473138 - THE KINGSTON HOSPITAL | 141338470 - (NY) HEALTHALLIANCE HOSPITAL MARYS AVENUE CAMPUS | NY | Rehabilitation Hospital Unit (273Y00000X) |
United | 654 | $48887.23 | 1689121188 - AGH MESA LLC, DIGNITY HEALTH ARIZONA GENERAL HOSPITAL | 383990879 - (AZ) AGH MESA LLC | AZ | General Acute Care Hospital (282N00000X) |
United | 654 | $56674.46 | 1518382944 - UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER, RBC AT AMC | 341567805 - UNIVERSITY HOSPITALS HEALTH SYSTEM INC | OH | Children's Hospital (282NC2000X) |
United | 654 | $38541.42 | 1982625661 - NICHOLAS H. NOYES MEMORIAL HOSPITAL | 160743979 - (NY) NICHOLAS H NOYES MEMORIAL HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 654 | $31180.13 | 1679652192 - AHS HILLCREST MEDICAL CENTER LLC, HILLCREST MEDICAL CENTER | 770633896 - (OK) AHS HILLCREST MEDICAL CENTER LLC | OK | Rehabilitation Hospital Unit (273Y00000X) |
United | 654 | $41182.14 | 1003232976 - BANNER HEALTH, BANNER CASA GRANDE MEDICAL CENTER | 450233470 - BANNER HEALTH | AZ | General Acute Care Hospital (282N00000X) |
United | 654 | $26170.90 | 1760567168 - DELTA HEALTH SYSTEM, DELTA HEALTH-THE MEDICAL CENTER (IP REHAB) | 640586958 - (MS) DELTA HEALTH SYSTEM | MS | Rehabilitation Hospital Unit (273Y00000X) |
United | 654 | $36975.14 | 1902125529 - VHS WEST SUBURBAN MEDICAL CENTER INC | 611899386 | IL | General Acute Care Hospital (282N00000X) |
United | 654 | $90140.70 | 1013389089 - MAIMONIDES MEDICAL CENTER | 111635081 - (NY) MAIMONIDES MEDICAL CENTER- | NY | General Acute Care Hospital (282N00000X) |
United | 654 | $42500.82 | 1336638915 - VALLEY WEST COMMUNITY HOSPITAL, NORTHWESTERN MEDICINE VALLEY WEST HOSPITAL | 364244337 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 654 | $28706.40 | 1306227764 - PRIME HEALTHCARE SERVICES-PORT HURON LLC | 472361878 | MI | General Acute Care Hospital (282N00000X) |
United | 654 | $29502.03 | 1306212923 - SMSJ TUCSON HOLDINGS LLC, ST. JOSEPHS HOSPITAL | 474131755 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 654 | $60820.96 | 1285719328 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 654 | $53466.10 | 1285709261 - INTEGRIS BASS BAPTIST HEALTH CENTER, INTEGRIS BASS BEHAVIORAL HEALTH CENTER RTC | 730612674 | OK | Psychiatric Hospital Unit (273R00000X) |
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 654 vs. Other Diseases & Disorders of the Kidney & Urinary Tract Codes
The MS-DRG 654 code is part of the Diseases & Disorders of the Kidney & Urinary Tract 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 654 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 |
|---|---|---|
| 653-MS-DRG | High | Major Bladder Procedures with MCC |
| 654-MS-DRG | High | Major Bladder Procedures with CC |
| 655-MS-DRG | High | Major Bladder 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 654. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 654 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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