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 | $52143.89 | 1689121188 - AGH MESA LLC, DIGNITY HEALTH ARIZONA GENERAL HOSPITAL | 383990879 - (AZ) AGH MESA LLC | AZ | General Acute Care Hospital (282N00000X) |
United | 654 | $55631.48 | 1033770284 - ADVENTHEALTH POLK SOUTH INC, ADVENTHEALTH LAKE WALES | 834672945 | FL | Psychiatric Hospital Unit (273R00000X) |
United | 654 | $55631.48 | 1033770284 - ADVENTHEALTH POLK SOUTH INC, ADVENTHEALTH LAKE WALES | 834672945 | FL | Psychiatric Hospital Unit (273R00000X) |
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 | $71361.14 | 1346802915 - UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS, UT SOUTHWESTERN PSYCHIATRIC CARE UNIT | 753175630 | TX | Psychiatric Hospital Unit (273R00000X) |
United | 654 | $71361.14 | 1346802915 - UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS, UT SOUTHWESTERN PSYCHIATRIC CARE UNIT | 753175630 | TX | Psychiatric Hospital Unit (273R00000X) |
United | 654 | $60449.37 | 1811217243 - ST FRANCIS HOSPITAL | 582504530 - (SC) ST FRANCIS HOSPITAL INC | SC | General Acute Care Hospital (282N00000X) |
United | 654 | $26008.47 | 1326339862 - VALLEY MEDICAL FACILITIES, INC, HERITAGE VALLEY KENNEDY | 251801532 - (PA) HERITAGE VALLEY HEALTH SYSTEM | PA | Psychiatric Hospital Unit (273R00000X) |
United | 654 | $75034.32 | 1992736599 - DOCTORS HOSPITAL OF MANTECA, INC., DOCTORS HOSPITAL OF MANTECA | 752918966 - (CA) DOCTORS HOSPITAL OF MANTECA INC | CA | General Acute Care Hospital (282N00000X) |
United | 654 | $73035.95 | 1174615330 - EMANUEL MEDICAL CENTER, INC. | 752918774 | CA | General Acute Care Hospital (282N00000X) |
United | 654 | $47788.53 | 1487218509 - SMSJ TUCSON HOLDINGS, LLC, CARONDELET MARANA HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 654 | $20517.24 | 1689735235 - NELSON COUNTY HEALTH SYSTEM | 450119890 - (ND) NELSON COUNTY HEALTH SYSTEM | ND | Critical Access Hospital (282NC0060X) |
United | 654 | $68868.09 | 1619967494 - COBB HOSPITAL, INC, WELLSTAR COBB HOSPITAL INPATIENT REHAB UNIT | 580968382 - COBB HOSPITAL | GA | Rehabilitation Hospital Unit (273Y00000X) |
United | 654 | $33235.87 | 1710205844 - HENRY FORD WYANDOTTE HOSPITAL | 382791823 - (MI) HENRY FORD WYANDOTTE HOSPITAL CORPORATION | MI | General Acute Care Hospital (282N00000X) |
United | 654 | $36975.14 | 1902125529 - VHS WEST SUBURBAN MEDICAL CENTER INC | 611899386 | IL | 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 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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