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 | $4590.00 | 1780655332 - THE HEALTH CARE AUTHORITY OF THE CITY OF GREENVILLE, REGIONAL MEDICAL CENTER OF CENTRAL ALABAMA | 822445000 - (AL) THE HEALTH CARE AUTHORITY OF THE CITY OF GREENVILLE | AL | General Acute Care Hospital (282N00000X) |
United | 686 | $7587.00 | 1124143557 - APHMFP | 461175423 - LANDMARK MEDICAL CENTER | RI | General Acute Care Hospital (282N00000X) |
United | 686 | $22843.36 | 1548306343 - ELMHURST MEMORIAL HOSPITAL | 362167784 - (IL) ELMHURST MEMORIAL HEALTHCARE | IL | General Acute Care Hospital (282N00000X) |
United | 686 | $12823.01 | 1053844761 - STEWARD TRUMBULL MEMORIAL HOSPITAL, INC. | 815457243 | OH | General Acute Care Hospital (282N00000X) |
United | 686 | $17361.64 | 1306921887 - DELTA HEALTH SYSTEM, DELTA REGIONAL MEDICAL CENTER | 640586958 - (MS) DELTA HEALTH SYSTEM | MS | Rural Acute Care Hospital (282NR1301X) |
United | 686 | $20122.30 | 1912473927 - RESILIENCE HEALTHCARE, LOUIS A. WEISS MEMORIAL HOSPITAL | 352637418 | IL | Psychiatric Hospital Unit (273R00000X) |
United | 686 | $15511.76 | 1073601043 - HH HEALTH SYSTEM, RED BAY HOSPITAL | 472323163 - (AL) HH HEALTH SYSTEM | AL | Critical Access Hospital (282NC0060X) |
United | 686 | $50004.98 | 1013130145 - BANNER HEALTH | 900412842 | AZ | General Acute Care Hospital (282N00000X) |
United | 686 | $22630.14 | 1750661534 - AHS SOUTHCREST HOSPITAL, LLC., HILLCREST HOSPITAL SOUTH | 452711804 | OK | General Acute Care Hospital (282N00000X) |
United | 686 | $10845.00 | 1093808800 - STAMFORD HOSPITAL | 60646917 - (CT) STAMFORD HOSPITAL | CT | Psychiatric Hospital Unit (273R00000X) |
United | 686 | $17232.55 | 1396886297 - CHILDREN'S SPECIALIZED HOSPITAL | 221487148 - CHILDREN'S SPECIALIZED HOSPITAL | NJ | Children's Rehabilitation Hospital (283XC2000X) |
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 | $30859.48 | 1659461895 - NEBRASKA METHODIST HOSPITAL, METHODIST HOSPITAL | 470376604 - NEBRASKA METHODIST HOSPITAL | NE | Rehabilitation Hospital Unit (273Y00000X) |
United | 686 | $18860.76 | 1629132949 - WHITE COUNTY MEDICAL CENTER, WHITE COUNTY MEDICAL CENTER REHAB UNIT | 710772737 - WHITE COUNTY MEDICAL CENTER | AR | Rehabilitation Hospital Unit (273Y00000X) |
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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