MS-DRG 656 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 656 by major payers:
$37,232.06
$41,960.08
$50,706.28
$52,431.54
| 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 656 | ||||||
United | 656 | $104063.78 | 1780974618 - MAIMONIDES MEDICAL CENTER | 111635081 - (NY) MAIMONIDES MEDICAL CENTER- | NY | General Acute Care Hospital (282N00000X) |
United | 656 | $22101.93 | 1770155525 - SELECT SPECIALTY HOSPITAL TUCSON, LLC, CURAHEALTH TUCSON | 812297468 | AZ | Long Term Care Hospital (282E00000X) |
United | 656 | $26355.83 | 1184891343 - RIVERSIDE MEDICAL CENTER | 362414944 - (IL) RIVERSIDE MEDICAL CENTER | IL | General Acute Care Hospital (282N00000X) |
United | 656 | $31741.27 | 1578886636 - UPLAND HILLS HEALTHM, INC., UPLAND HILLS HEALTH AUDIOLOGY | 421017512 - (WI) UPLAND HILLS HEALTH INC | WI | Critical Access Hospital (282NC0060X) |
United | 656 | $61029.46 | 1497119218 - THEDACARE REGIONAL MEDICAL CENTER, APPLETON MEDICAL CENTER, INC. | 350983617 - COMMUNITY HEALTH NETWORK INC | WI | General Acute Care Hospital (282N00000X) |
United | 656 | $11494.00 | 1124305065 - BAYLOR SCOTT & WHITE MEDICAL CENTERS, BAYLOR SCOTT & WHITE MEDICAL CENTER - MCKINNEY | 751037591 - (TX) BAYLOR MEDICAL CENTERS AT GARLAND AND MCKINNEY | TX | General Acute Care Hospital (282N00000X) |
United | 656 | $54089.32 | 1891712485 - NASSAU HEALTH CARE CORPORATION, NASSAU UNIVER MED CENTER - REHAB | 113465690 | NY | Rehabilitation Hospital Unit (273Y00000X) |
United | 656 | $35750.12 | 1396109500 - GOTTLIEB MEMORIAL HOSPITAL | 362379649 - (IL) GOTTLIEB MEMORIAL HOSPITAL | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 656 | $20880.51 | 1619939071 - PRISMA HEALTH-BLOUNT MEMORIAL HOSPITAL, INC, BLOUNT MEMORIAL HOSPITAL | 620505512 | TN | General Acute Care Hospital (282N00000X) |
United | 656 | $31529.25 | 1962727271 - WHITE COUNTY MEDICAL CENTER, WHITE COUNTY HOSPITALISTS | 710772737 - WHITE COUNTY MEDICAL CENTER | AR | General Acute Care Hospital (282N00000X) |
United | 656 | $7264.00 | 1245216183 - MCCULLOUGH-HYDE MEMORIAL HOSPITAL, INC. | 310650283 - (OH) MCCULLOUGH-HYDE MEMORIAL HOSPITAL INCORPORATED | OH | General Acute Care Hospital (282N00000X) |
United | 656 | $21855.56 | 1437591708 - WEST FLORIDA, HCA FLORIDA PASADENA HOSPITAL | 800935610 | FL | General Acute Care Hospital (282N00000X) |
United | 656 | $34766.12 | 1770568123 - VHS ACQUISITION SUBSIDIARY NUMBER 3 INC, LOUIS A. WEISS MEMORIAL HOSPITAL | 352637418 | IL | General Acute Care Hospital (282N00000X) |
United | 656 | $87737.93 | 1598755324 - ST. ANTHONY COMMUNITY HOSPITAL | 141340100 - (NY) BON SECOURS CHARITY HEALTH SYSTEM INC | NY | General Acute Care Hospital (282N00000X) |
United | 656 | $34890.75 | 1134607005 - ADVOCATE NORTH SIDE HEALTH NETWORK, ADVOCATE ILLINOIS MASONIC MEDICAL CENTER REHAB UNIT | 363196629 - (IL) ADVOCATE NORTH SIDE HEALTH NETWORK | IL | Rehabilitation Hospital Unit (273Y00000X) |
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 656 vs. Other Diseases & Disorders of the Kidney & Urinary Tract Codes
The MS-DRG 656 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 656 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 |
|---|---|---|
| 655-MS-DRG | High | Major Bladder Procedures without CC/MCC |
| 656-MS-DRG | High | Kidney and Ureter Procedures for Neoplasm with MCC |
| 657-MS-DRG | High | Kidney and Ureter Procedures for Neoplasm 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 656. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 656 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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