MS-DRG 697 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 697 by major payers:
$11,593.92
$13,232.09
$15,902.14
$16,235.83
| 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 697 | ||||||
United | 697 | $4841.08 | 1578505095 - HOSPITAL DISTRICT NO 1 CRAWFORD COUNTY, GIRARD MEDICAL CENTER | 480698644 | KS | Critical Access Hospital (282NC0060X) |
United | 697 | $12194.91 | 1629085659 - ST JAMES HOSPITAL AND HEALTH CENTER | 362167869 - FRANCISCAN HEALTH OLYMPIA FIELDS | IL | Psychiatric Hospital (283Q00000X) |
United | 697 | $24222.50 | 1083274930 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 697 | $5761.00 | 1669569984 - IRVING-COPPELL SURGICAL HOSPITAL LLP, BAYLOR SCOTT & WHITE SURGICAL HOSPITAL - LAS COLINAS | 542086863 | TX | General Acute Care Hospital (282N00000X) |
United | 697 | $5761.00 | 1669569984 - IRVING-COPPELL SURGICAL HOSPITAL LLP, BAYLOR SCOTT & WHITE SURGICAL HOSPITAL - LAS COLINAS | 542086863 | TX | General Acute Care Hospital (282N00000X) |
United | 697 | $500.00 | 1851642540 - HOUSTON COUNTY COMMUNITY HOSPITAL | 862345211 | TN | General Acute Care Hospital (282N00000X) |
United | 697 | $500.00 | 1851642540 - HOUSTON COUNTY COMMUNITY HOSPITAL | 862345211 | TN | General Acute Care Hospital (282N00000X) |
United | 697 | $11609.86 | 1164539730 - ADVOCATE HEALTH AND HOSPITALS CORPORATION, ADVOCATE LUTHERAN GENERAL HOSPITAL | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | General Acute Care Hospital (282N00000X) |
United | 697 | $29517.03 | 1255334173 - FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC., FROEDTERT HOSPITAL | 390987025 - (WI) COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INC | WI | General Acute Care Hospital (282N00000X) |
United | 697 | $23619.11 | 1639108434 - WILLAMETTE FALLS HOSPITAL, PROVIDENCE WILLAMETTE FALLS MEDICAL CENTER | 611659489 | OR | General Acute Care Hospital (282N00000X) |
United | 697 | $12639.70 | 1033100052 - HOLY REDEEMER HEALTH SYSTEM, SENIOR BEHAVORIAL HEALTH | 231534300 - HOLY REDEEMER HEALTH SYSTEM | PA | Psychiatric Hospital Unit (273R00000X) |
United | 697 | $6893.02 | 1982678827 - KANSAS REHABILITATION HOSPITAL INC, KANSAS REHABILITATION HOSPITAL, A JOINT VENTURE OF ENCOMPASS HEALTH | 521535077 - (KS) KANSAS REHABILITATION HOSPITAL INC | KS | Rehabilitation Hospital (283X00000X) |
United | 697 | $14773.05 | 1598829442 - METHODIST HEALTHCARE, METHODIST BEHAVIORAL HEALTH | 620479367 - METHODIST HEALTHCARE-MEMPHIS | TN | Psychiatric Hospital Unit (273R00000X) |
United | 697 | $8881.66 | 1720011810 - BANNER DESERT MEDICAL CENTER | 900054201 - (AZ) BANNER DESERT MEDICAL CENTER | AZ | General Acute Care Hospital (282N00000X) |
United | 697 | $25505.83 | 1851847974 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH CANCER INST-EASLEY | 811723202 - PRISMA HEALTH - UPSTATE | SC | 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 697 vs. Other Diseases & Disorders of the Kidney & Urinary Tract Codes
The MS-DRG 697 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 697 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 |
|---|---|---|
| 696-APR-DRG | High | OTHER CHEMOTHERAPY |
| 696-MS-DRG | High | Kidney and Urological Tract Signs and Symptoms without MCC |
| 697-MS-DRG | High | Urethral Stricture |
| 698-MS-DRG | High | Other Kidney and Urological Tract Diagnoses 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 697. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 697 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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