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 | $3949.00 | 1205488996 - MOUNTAIN STATES HEALTH ALLIANCE, LEE COUNTY COMMUNITY HOSPITAL | 620476282 - MOUNTAIN STATES HEALTH ALLIANCE | VA | Critical Access Hospital (282NC0060X) |
United | 694 | $10765.34 | 1407989288 - THE BROOKDALE HOSPITAL MEDICAL CENTER | 111631746 - BROOKDALE HOSPITAL MEDICAL CENTER | NY | Psychiatric Hospital Unit (273R00000X) |
United | 694 | $11782.38 | 1760794044 - VHS SINAI-GRACE HOSPITAL INC, SINAI-GRACE HOSPITAL | 272844632 | MI | General Acute Care Hospital (282N00000X) |
United | 694 | $6080.06 | 1932390218 - SAINT JOSEPH HEALTH SYSTEM, INC, CHI SAINT JOSPEH BEREA SNF | 611334601 - (KY) SAINT JOSEPH HEALTH SYSTEM INC | KY | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 694 | $6034.00 | 1598756710 - PARADISE VALLEY HOSPITAL | 205837239 | CA | General Acute Care Hospital (282N00000X) |
United | 694 | $6034.00 | 1598756710 - PARADISE VALLEY HOSPITAL | 205837239 | CA | General Acute Care Hospital (282N00000X) |
United | 694 | $5404.00 | 1629023502 - HCA HEALTHONE LLC, SWEDISH MEDICAL CENTER | 841321373 | CO | Rehabilitation Hospital Unit (273Y00000X) |
United | 694 | $8147.66 | 1194757500 - COX-MONETT HOSPITAL, INC. | 431656689 - (MO) COX-MONETT HOSPITAL INC | MO | Critical Access Hospital (282NC0060X) |
United | 694 | $19102.00 | 1912396326 - TALLAHASSEE MEDICAL CENTER, INC., HCA FLORIDA CAPITAL HOSPITAL | 621091430 - (FL) TALLAHASSEE MEDICAL CENTER INC | FL | 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 | $17395.52 | 1669558771 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 694 | $9365.86 | 1780731737 - MADISON ST JOSEPH HEALTH CENTER, CHI ST JOSEPH HEALTH MADISON HOSPITAL | 742761145 - (TX) MADISON ST JOSEPH HEALTH CENTER | TX | Critical Access Hospital (282NC0060X) |
United | 694 | $19824.11 | 1316711633 - PEACEHEALTH | 261871008 | OR | Rehabilitation Hospital Unit (273Y00000X) |
United | 694 | $6856.00 | 1659330173 - MERCY MEDICAL CENTER | 111635088 - (NY) MERCY MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 694 | $6130.85 | 1922135367 - ADIRONDACK MEDICAL CENTER, ADIRONDACK MEDICAL CENTER - SL DIALYSIS | 141731786 - (NY) ADIRONDACK MEDICAL CENTER | NY | 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 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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