MS-DRG 696 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 696 by major payers:
$8,213.00
$9,786.57
$11,058.14
$11,375.88
| 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 696 | ||||||
United | 696 | $14164.23 | 1174500458 - HARTSVILLE, LLC, CAROLINA PINES REGIONAL MEDICAL CENTER | 571029438 - (SC) HARTSVILLE LLC | SC | General Acute Care Hospital (282N00000X) |
United | 696 | $6598.47 | 1407573132 - DEACONESS ILLINOIS RED BUD REGIONAL HOSPITAL INC, RED BUD REGIONAL HOSPITAL | 884142509 | IL | Critical Access Hospital (282NC0060X) |
United | 696 | $6598.47 | 1407573132 - DEACONESS ILLINOIS RED BUD REGIONAL HOSPITAL INC, RED BUD REGIONAL HOSPITAL | 884142509 | IL | Critical Access Hospital (282NC0060X) |
United | 696 | $10278.00 | 1043455108 - THE CHILDREN'S HOSPITAL AURORA CO | 840166760 - CHILDRENS HOSPITAL COLORADO | CO | Children's Hospital (282NC2000X) |
United | 696 | $5142.00 | 1598798597 - ST. TAMMANY PARISH HOSPITAL SERVICE DISTRICT NO 1, ST. TAMMANY PARISH HOSPITAL | 720478620 | LA | General Acute Care Hospital (282N00000X) |
United | 696 | $8829.44 | 1639186638 - PRESENCE CENTRAL AND SUBURBAN HOSPITALS NETWORK, PRESENCE MERCY MEDICAL CENTER - PSYCHIATRIC UNIT | 992367318 | IL | Psychiatric Hospital Unit (273R00000X) |
United | 696 | $8465.08 | 1992055305 - PRIME HEALTHCARE SERVICES LOWER BUCKS LLC, LOWER BUCKS HOSPITAL - PSYCH UNIT | 460750728 - (PA) PRIME HEALTHCARE SERVICES LOWER BUCKS, LLC | PA | Psychiatric Hospital Unit (273R00000X) |
United | 696 | $8829.44 | 1639186638 - PRESENCE CENTRAL AND SUBURBAN HOSPITALS NETWORK, PRESENCE MERCY MEDICAL CENTER - PSYCHIATRIC UNIT | 992367318 | IL | Psychiatric Hospital Unit (273R00000X) |
United | 696 | $13038.34 | 1891367629 - STEWARD NSMC, INC., STEWARD FLORIDA MEDICAL CENTER A CAMPUS OF NORTH SHORE | 862695690 | FL | General Acute Care Hospital (282N00000X) |
United | 696 | $13038.34 | 1891367629 - STEWARD NSMC, INC., STEWARD FLORIDA MEDICAL CENTER A CAMPUS OF NORTH SHORE | 862695690 | FL | General Acute Care Hospital (282N00000X) |
United | 696 | $6976.00 | 1649340415 - PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA, PHT JMH INPATIENT PSY UNIT | 591713947 - (FL) PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY FLORIDA | FL | Psychiatric Hospital Unit (273R00000X) |
United | 696 | $12786.54 | 1508843566 - NOVANT HEALTH ROWAN MEDICAL CENTER LLC, NOVANT HEALTH ROWAN MEDICAL CENTER | 560547479 - (NC) ROWAN REGIONAL MEDICAL CENTER, INC. | NC | General Acute Care Hospital (282N00000X) |
United | 696 | $8922.62 | 1548333214 - CAMBRIDGE MEMORIAL HOSPITAL INC, TRI VALLEY HEALTH SYSTEM | 476028103 - (NE) CAMBRIDGE MEMORIAL HOSPITAL INC | NE | Critical Access Hospital (282NC0060X) |
United | 696 | $10461.40 | 1548207608 - UNIVERSITY HEALTHCARE SYSTEM, L.C., EAST JEFFERSON GENERAL HOSPITAL | 621596506 | LA | Rehabilitation Hospital Unit (273Y00000X) |
United | 696 | $10461.40 | 1548207608 - UNIVERSITY HEALTHCARE SYSTEM, L.C., EAST JEFFERSON GENERAL HOSPITAL | 621596506 | LA | 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 696 vs. Other Diseases & Disorders of the Kidney & Urinary Tract Codes
The MS-DRG 696 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 696 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 |
|---|---|---|
| 695-APR-DRG | High | CHEMOTHERAPY FOR ACUTE LEUKEMIA |
| 695-MS-DRG | High | Kidney and Urological Tract Signs and Symptoms with MCC |
| 696-MS-DRG | High | Kidney and Urological Tract Signs and Symptoms without MCC |
| 697-MS-DRG | High | Urethral Stricture |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 696. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 696 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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