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See a sample rate comparisonMS-DRG 686 Fee Schedule
Last Verified: October 2026
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.
KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC
| 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
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MS-DRG 686
5 of 25 sample ratesHigher to lower in this preview
Banner Health
$50,004.98Published rateWake Forest Baptist Health
North Carolina Baptist Hospital
$28,619.26Published rateResilience Healthcare, Louis A. Weiss Memorial Hospital
$20,122.30Published rateHh Health System, Red Bay Hospital
Hh Health System
$15,511.76Published rateThe Health Care Authority Of The City Of Greenville, Regional Medical Center Of Central Alabama
The Health Care Authority Of The City Of Greenville
$4,590.00Published rate
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See a sample payer proposalMS-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 URINARY TRACT NEOPLASMS WITH MCC |
| 687-MS-DRG | High | KIDNEY AND URINARY 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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