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See a sample rate comparisonMS-DRG 696 Fee Schedule
Last Verified: October 2026
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.
KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC
| 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
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MS-DRG 696
5 of 25 sample ratesHigher to lower in this preview
Banner Gateway Medical Center
$16,300.75Published rateAppalachian Regional Healthcare, Inc., Tug Valley Arh Regional Medical Center
Appalachian Regional Healthcare Inc
$10,593.96Published rateIom Health System Lp, Lutheran Hospital Of Indiana
$8,149.39Published rateLubbock Heart Hospital, LLC, Lubbock Heart Hospital
Lubbock Heart Hospital, Lp
$6,300.22Published rateShamrock Community Hospital Inc, Houston County Community Hospital
$500.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-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 URINARY TRACT SIGNS AND SYMPTOMS WITH MCC |
| 696-MS-DRG | High | KIDNEY AND URINARY 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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