MS-DRG 686 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 686 by major payers:
$21,032.10
$24,339.54
$29,411.24
$30,153.12
| 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 686 | ||||||
United | 686 | $31065.01 | 1982737136 - JAMAICA HOSPITAL | 111631788 - (NY) JAMAICA HOSPITAL MEDICAL CENTER | NY | Rehabilitation Hospital Unit (273Y00000X) |
United | 686 | $7587.00 | 1124143557 - APHMFP | 461175423 - LANDMARK MEDICAL CENTER | RI | General Acute Care Hospital (282N00000X) |
United | 686 | $15010.37 | 1700855533 - NORTH PLATTE NEBRASKA HOSPITAL CORPORATION, GREAT PLAINS HEALTH | 470662290 - (NE) NORTH PLATTE NEBRASKA HOSPITAL CORPORATION | NE | General Acute Care Hospital (282N00000X) |
United | 686 | $34853.39 | 1447806443 - NOVANT HEALTH ROWAN MEDICAL CENTER LLC, NOVANT HEALTH ROWAN MEDICAL CENTER | 560547479 - (NC) ROWAN REGIONAL MEDICAL CENTER, INC. | NC | General Acute Care Hospital (282N00000X) |
United | 686 | $20742.69 | 1063990901 - FARMERS UNION HOSPITAL ASSOCIATION, GREAT PLAINS REGIONAL MEDICAL CENTER INPATIENT REHAB | 730579295 - (OK) FARMERS UNION HOSPITAL ASSOCIATION | OK | Rehabilitation Hospital Unit (273Y00000X) |
United | 686 | $13642.79 | 1467493551 - MERCY HEALTH, MERCY HEALTH ST VINCENT MEDICAL CENTER | 344428250 - MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC | OH | General Acute Care Hospital (282N00000X) |
United | 686 | $70630.78 | 1841687787 - JOHN MUIR MEDICAL CENTER | 680396600 | CA | General Acute Care Hospital (282N00000X) |
United | 686 | $70630.78 | 1841687787 - JOHN MUIR MEDICAL CENTER | 680396600 | CA | General Acute Care Hospital (282N00000X) |
United | 686 | $30818.00 | 1225381197 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL HAUSMAN | 452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 686 | $55439.57 | 1245201656 - TEXAS INSTITUTE FOR SURGERY, LLP, TEXAS INSTITUTE FOR SURGERY AT TEXAS HEALTH PRESBYTERIAN DALLAS | 770628004 - (TX) TEXAS INSTITUTE FOR SURGERY, LLP | TX | General Acute Care Hospital (282N00000X) |
United | 686 | $17127.81 | 1326079534 - CHILDRESS COUNTY HOSPITAL DISTRICT, CHILDRESS REGIONAL MEDICAL CENTER | 751228349 | TX | General Acute Care Hospital (282N00000X) |
United | 686 | $17127.81 | 1326079534 - CHILDRESS COUNTY HOSPITAL DISTRICT, CHILDRESS REGIONAL MEDICAL CENTER | 751228349 | TX | General Acute Care Hospital (282N00000X) |
United | 686 | $20122.30 | 1770568123 - VHS ACQUISITION SUBSIDIARY NUMBER 3 INC, LOUIS A. WEISS MEMORIAL HOSPITAL | 352637418 | IL | General Acute Care Hospital (282N00000X) |
United | 686 | $3990.00 | 1679816201 - TEMECULA VALLEY HOSPITAL INC, TEMECULA VALLEY HOSPITAL | 461246570 - (CA) TEMECULA VALLEY HOSPITAL INC | CA | General Acute Care Hospital (282N00000X) |
United | 686 | $11052.00 | 1144683723 - CHILDREN'S HOSPITAL COLORADO, CHILDREN'S HOSPITAL COLORADO PARKER ADVENTIST HOSPITAL | 840166760 - CHILDRENS HOSPITAL COLORADO | CO | Children's Hospital (282NC2000X) |
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 686 vs. Other Diseases & Disorders of the Kidney & Urinary Tract Codes
The MS-DRG 686 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 686 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 |
|---|---|---|
| 684-MS-DRG | High | Renal Failure without CC/MCC |
| 686-MS-DRG | High | Kidney and Urological Tract Neoplasms with MCC |
| 687-MS-DRG | High | Kidney and Urological Tract Neoplasms 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 686. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 686 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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