MS-DRG 659 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 659 by major payers:
$31,790.71
$33,852.79
$41,111.33
$41,923.21
| 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 659 | ||||||
United | 659 | $23579.15 | 1225313448 - CRYSTAL CLINIC ORTHOPAEDIC CENTER, LLC, CRYSTAL CLINIC ORTHOPAEDIC CENTER - WADSWORTH | 261130649 - (OH) CRYSTAL CLINIC ORTHOPAEDIC CENTER, LLC | OH | Special Hospital (284300000X) |
United | 659 | $42235.21 | 1841844735 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL KELLY | 452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 659 | $55353.26 | 1154355188 - BANNER THUNDERBIRD MEDICAL CENTER | 270036484 - (AZ) BANNER THUNDERBIRD MEDICAL CENTER | AZ | General Acute Care Hospital (282N00000X) |
United | 659 | $44064.89 | 1023187416 - BEAVER DAM COMMUNITY HOSPITALS INC, MARSHFIELD MEDICAL CENTER - BEAVER DAM | 391157876 - BEAVER DAM COMMUNITY HOSPITALS INC | WI | General Acute Care Hospital (282N00000X) |
United | 659 | $70314.52 | 1508001405 - ST. LUKES ROOSEVELT HOSPITAL CENTER, PSYCHIATRIC UNIT | 132997301 - (NY) ST LUKES ROOSEVELT HOSPITAL CENTER | NY | Psychiatric Hospital Unit (273R00000X) |
United | 659 | $7140.60 | 1346456597 - HIGHLANDS-CASHIERS HOSPITAL | 832048950 | NC | Critical Access Hospital (282NC0060X) |
United | 659 | $16069.29 | 1871599829 - WILSON COUNTY MEMORIAL HOSPITAL DISTRICT | 742019736 - (TX) WILSON COUNTY MEMORIAL HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 659 | $30347.42 | 1235538927 - NATCHEZ HOSPITAL COMPANY LLC, MERIT HEALTH NATCHEZ | 371756496 | MS | Psychiatric Hospital Unit (273R00000X) |
United | 659 | $6632.00 | 1033187182 - SHASTA REGIONAL MEDICAL CENTER, LLC | 263487583 | CA | General Acute Care Hospital (282N00000X) |
United | 659 | $4008.00 | 1801826912 - WELLMONT HEALTH SYSTEM, LONESOME PINE HOSPITAL | 621636465 - WELLMONT HEALTH SYSTEM | VA | General Acute Care Hospital (282N00000X) |
United | 659 | $28325.27 | 1033163407 - ST JOSEPH HEALTH SYSTEM LLC, LUTHERAN DOWNTOWN HOSPITAL | 510382045 | IN | Rehabilitation Hospital Unit (273Y00000X) |
United | 659 | $35689.17 | 1831868033 - VHS SAN ANTONIO PARTNERS, LLC, NORTH CENTRAL BAPTIST HOSPITAL | 760714523 | TX | General Acute Care Hospital (282N00000X) |
United | 659 | $10509.54 | 1124545819 - LANDMARK OF MIDWEST CITY SPECIALTY HOSPITAL, LLC, INSPIRE POST-ACUTE CARE | 822269786 | OK | Special Hospital (284300000X) |
United | 659 | $31113.49 | 1699778985 - LAFAYETTE GENERAL SURGICAL HOSPITAL, LLC | 481300080 - (LA) LAFAYETTE GENERAL SURGICAL HOSPITAL LLC | LA | General Acute Care Hospital (282N00000X) |
United | 659 | $65796.28 | 1932654704 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH SURGERY/ORTHOPEDICS CLINIC | 811723202 - PRISMA HEALTH - UPSTATE | SC | 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 659 vs. Other Diseases & Disorders of the Kidney & Urinary Tract Codes
The MS-DRG 659 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 659 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 |
|---|---|---|
| 658-MS-DRG | High | Kidney and Ureter Procedures for Neoplasm without CC/MCC |
| 659-MS-DRG | High | Kidney and Ureter Procedures for Non-Neoplasm with MCC |
| 660-APR-DRG | High | MAJOR HEMATOLOGIC/IMMUNOLOGIC DIAG EXC SICKLE CELL CRISIS & COAGUL |
| 660-MS-DRG | High | Kidney and Ureter Procedures for Non-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 659. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 659 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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