MS-DRG 694 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 694 by major payers:
$8,927.08
$10,812.35
$12,459.47
$12,891.42
| 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 694 | ||||||
United | 694 | $8348.48 | 1215164231 - EAST TEXAS MEDICAL CENTER HENDERSON, HENDERSON EPSDT | 824019349 | TX | Rural Acute Care Hospital (282NR1301X) |
United | 694 | $16395.00 | 1356828172 - HMH HOSPITALS CORPORATION, RARITAN BAY MEDICAL CENTER-OLD BRIDGE | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | General Acute Care Hospital (282N00000X) |
United | 694 | $7928.87 | 1790706851 - BLACKWELL HMA LLC, ALLIANCEHEALTH BLACKWELL | 730927647 | OK | General Acute Care Hospital (282N00000X) |
United | 694 | $7928.87 | 1790706851 - BLACKWELL HMA LLC, ALLIANCEHEALTH BLACKWELL | 730927647 | OK | General Acute Care Hospital (282N00000X) |
United | 694 | $9351.79 | 1689791360 - SILVER CROSS HOSPITAL & MEDICAL CENTERS | 362174832 - (IL) SILVER CROSS HOSPITAL & MEDICAL CENTERS | IL | Psychiatric Hospital Unit (273R00000X) |
United | 694 | $13322.87 | 1942225727 - JACKSON MADISON COUNTY GENERAL HOSPITAL, INFECTIOUS DISEASE | 626010402 - (TN) JACKSON MADISON COUNTY GENERAL HOSPITAL | TN | General Acute Care Hospital (282N00000X) |
United | 694 | $22791.00 | 1982141537 - ST. PETER'S HOSPITAL OF THE CITY OF ALBANY, ST. PETER'S HOSPITAL INTENSIVE CARE UNIT | 141348692 - (NY) ST PETERS HOSPITAL | NY | Hospitalist Physician (208M00000X) |
United | 694 | $3000.00 | 1578851770 - LANCASTER REGIONAL HOSPITAL, MEDICAL CENTER OF LANCASTER | 273815440 - (TX) LANCASTER REGIONAL HOSPITAL, LP | TX | General Acute Care Hospital (282N00000X) |
United | 694 | $14075.36 | 1801835970 - ST. LUKE'S HOSPITAL OF DULUTH, ASPIRUS ST LUKES HOSPITAL | 410714079 - ST LUKES HOSPITAL OF DULUTH | MN | General Acute Care Hospital (282N00000X) |
United | 694 | $3914.00 | 1497837330 - HOSPITAL SERVICE DISTRICT NO. 3, THIBODAUX REGIONAL MEDICAL CENTER | 842046902 - (LA) THIBODAUX REGIONAL HEALTH SYSTEM INC | LA | Rehabilitation Hospital (283X00000X) |
United | 694 | $17731.28 | 1285786228 - INOVA HEALTH CARE SERVICES, INOVA LOUDOUN HOSPITAL | 540620889 - INOVA HEALTH CARE SERVICES | VA | Psychiatric Hospital Unit (273R00000X) |
United | 694 | $11902.28 | 1386188068 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatric Hospital Unit (273R00000X) |
United | 694 | $8348.48 | 1215164231 - EAST TEXAS MEDICAL CENTER HENDERSON, HENDERSON EPSDT | 824019349 | TX | Rural Acute Care Hospital (282NR1301X) |
United | 694 | $10791.13 | 1962464016 - BON SECOURS ST. MARY'S HOSPITAL OF RICHMOND LLC, BON SECOURS ST MARY'S HOSPITAL | 540793767 - BON SECOURS ST MARYS HOSPITAL OF RICHMOND LLC | VA | General Acute Care Hospital (282N00000X) |
United | 694 | $5404.00 | 1629023502 - HCA HEALTHONE LLC, SWEDISH MEDICAL CENTER | 841321373 | CO | 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 694 vs. Other Diseases & Disorders of the Kidney & Urinary Tract Codes
The MS-DRG 694 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 694 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 |
|---|---|---|
| 693-MS-DRG | High | Urinary Stones with MCC |
| 694-MS-DRG | High | Urinary Stones without MCC |
| 695-APR-DRG | High | CHEMOTHERAPY FOR ACUTE LEUKEMIA |
| 695-MS-DRG | High | Kidney and Urological Tract Signs and Symptoms with MCC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 694. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 694 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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