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 | $13038.34 | 1891367629 - STEWARD NSMC, INC., STEWARD FLORIDA MEDICAL CENTER A CAMPUS OF NORTH SHORE | 862695690 | FL | General Acute Care Hospital (282N00000X) |
United | 696 | $8645.01 | 1538163886 - DAMERON HOSPITAL ASSOCIATION | 941201197 - (CA) DAMERON HOSPITAL ASSOCIATION | CA | General Acute Care Hospital (282N00000X) |
United | 696 | $6300.22 | 1922001775 - LUBBOCK HEART HOSPITAL, LLC, LUBBOCK HEART HOSPITAL | 510436196 - (TX) LUBBOCK HEART HOSPITAL, LP | TX | General Acute Care Hospital (282N00000X) |
United | 696 | $6407.45 | 1275553521 - BERTRAND CHAFFEE HOSPITAL | 160743921 - (NY) BERTRAND CHAFFEE HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 696 | $500.00 | 1811566540 - SHAMROCK COMMUNITY HOSPITAL INC, HOUSTON COUNTY COMMUNITY HOSPITAL | 862345211 | TN | Critical Access Hospital (282NC0060X) |
United | 696 | $4485.00 | 1033937883 - OHMH, LLC | 994761958 | FL | General Acute Care Hospital (282N00000X) |
United | 696 | $9549.08 | 1053384776 - AHS HOSPITAL CORP., MORRISTOWN MEDICAL CENTER | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | General Acute Care Hospital (282N00000X) |
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 | $9863.46 | 1851452890 - MARY IMOGENE BASSETT HOSPITAL, BASSETT HEALTHCARE | 135596796 - MARY IMOGENE BASSETT HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 696 | $16300.75 | 1699884858 - BANNER GATEWAY MEDICAL CENTER | 900220728 | AZ | General Acute Care Hospital (282N00000X) |
United | 696 | $5855.00 | 1568899391 - HILLCREST BAPTIST MEDICAL CENTER, BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | 741161944 - (TX) HILLCREST BAPTIST MEDICAL CENTER | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 696 | $7253.89 | 1639263189 - LASALLE PARISH HOSPITAL SERVICE DIST NO1, HARDTNER MEDICAL CENTER | 720652984 - (LA) HARDTNER MEDICAL CENTER | LA | Critical Access Hospital (282NC0060X) |
United | 696 | $10443.50 | 1255712766 - SAINT THOMAS STONES RIVER HOSPITAL, LLC, ASCENSION SAINT THOMAS STONES RIVER | 474063232 | TN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 696 | $6380.45 | 1740876382 - DELTA HEALTH SYSTEM, DELTA HEALTH-NORTHWEST REGIONAL | 853959101 | MS | General Acute Care Hospital (282N00000X) |
United | 696 | $8149.39 | 1306897335 - IOM HEALTH SYSTEM LP, LUTHERAN HOSPITAL OF INDIANA | 351963748 | IN | 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 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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