MS-DRG 695 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 695 by major payers:
$13,687.59
$15,592.23
$17,846.00
$18,240.56
| 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 695 | ||||||
United | 695 | $23874.31 | 1063426377 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION, ELMHURST HOSPITAL CENTER | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | General Acute Care Hospital (282N00000X) |
United | 695 | $15171.33 | 1528039039 - PHOENIXVILLE HOSPITAL COMPANY LLC, PHOENIXVILLE HOSPITAL | 822062413 | PA | General Acute Care Hospital (282N00000X) |
United | 695 | $12152.40 | 1346274537 - EPISCOPAL HEALTH SERVICES INC, ST JOHN'S EPISCOPAL HOSPITAL SS | 111665825 - (NY) EPISCOPAL HEALTH SERVICES INC | NY | General Acute Care Hospital (282N00000X) |
United | 695 | $18674.10 | 1316536253 - ADVENTHEALTH SOUTH OVERLAND PARK, INC. | 364595806 - (KS) ADVENTHEALTH SOUTH OVERLAND PARK INC | KS | General Acute Care Hospital (282N00000X) |
United | 695 | $24251.08 | 1992910152 - BRIDGEPORT HOSPITAL | 60646554 - (CT) BRIDGEPORT HOSPITAL | CT | General Acute Care Hospital (282N00000X) |
United | 695 | $26731.27 | 1326142498 - ST ELIZABETH MEDICAL CENTER, INC, ST ELIZABETH DEARBORN | 610445850 - ST ELIZABETH MEDICAL CENTER INC | IN | General Acute Care Hospital (282N00000X) |
United | 695 | $23025.16 | 1003822487 - LEGACY EMANUEL HOSPITAL & HEALTH CENTER, LEGACY EMANUEL HOSPITAL ADULT PSYCHIATRIC UNIT | 930386823 - LEGACY EMANUEL HOSPITAL & HEALTH CENTER | OR | Psychiatric Hospital Unit (273R00000X) |
United | 695 | $24872.17 | 1730494816 - VIERA HOSPITAL INC, VIERA HOSPITAL INC | 264019868 - (FL) VIERA HOSPITAL INC | FL | General Acute Care Hospital (282N00000X) |
United | 695 | $13745.62 | 1275583155 - METHODIST MEDICAL CENTER OF ILLINOIS | 370661223 - METHODIST MEDICAL CENTER OF ILLINOIS | IL | Psychiatric Hospital Unit (273R00000X) |
United | 695 | $8276.00 | 1114179025 - CLARA MAASS MEDICAL CENTER | 221500556 | NJ | Psychiatric Hospital Unit (273R00000X) |
United | 695 | $12750.71 | 1760418354 - BAPTIST HEALTH, BAPTIST HEALTH MEDICAL CENTER- ARKADELPHIA-SNF | 710236856 - (AR) BAPTIST HEALTH | AR | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 695 | $17497.82 | 1508258765 - EVERGREEN HEALTHCARE | 910844563 | WA | General Acute Care Hospital (282N00000X) |
United | 695 | $8276.00 | 1114179025 - CLARA MAASS MEDICAL CENTER | 221500556 | NJ | Psychiatric Hospital Unit (273R00000X) |
United | 695 | $18545.53 | 1033225172 - MUNSTER MEDICAL RESEARCH FOUNDATION INC, COMMUNITY HOSPITAL | 351107009 - (IN) MUNSTER MEDICAL RESEARCH FOUNDATION INC | IN | Rehabilitation Hospital Unit (273Y00000X) |
United | 695 | $11519.75 | 1801889969 - INDIANA REGIONAL MEDICAL CENTER | 250965404 - (PA) INDIANA REGIONAL MEDICAL CENTER | PA | Psychiatric Hospital Unit (273R00000X) |
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 695 vs. Other Diseases & Disorders of the Kidney & Urinary Tract Codes
The MS-DRG 695 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 695 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 |
|---|---|---|
| 694-APR-DRG | High | LYMPHATIC & OTHER MALIGNANCIES & NEOPLASMS OF UNCERTAIN BEHAVIOR |
| 694-MS-DRG | High | Urinary Stones without MCC |
| 695-MS-DRG | High | Kidney and Urological Tract Signs and Symptoms with MCC |
| 696-APR-DRG | High | OTHER CHEMOTHERAPY |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 695. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 695 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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