MS-DRG 698 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 698 by major payers:
$18,643.11
$21,630.25
$26,336.54
$26,896.74
| 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 698 | ||||||
United | 698 | $20933.92 | 1942509427 - MIDTOWN | 356005697 | IN | General Acute Care Hospital (282N00000X) |
United | 698 | $20796.08 | 1326064452 - SOLIS HEALTHCARE, LP, ROXBOROUGH MEMORIAL HOSPITAL | 454246163 - (PA) PRIME HEALTHCARE SERVICES ROXBOROUGH, LLC | PA | Psychiatric Hospital Unit (273R00000X) |
United | 698 | $17958.74 | 1417465824 - ATHENS HOSPITAL, LLC | 823934511 | TX | General Acute Care Hospital (282N00000X) |
United | 698 | $43691.62 | 1013514199 - KECK MEDICAL CENTER OF USC, KECK HOSPITAL OF USC | 851644866 - (CA) KECK MEDICAL CENTER OF USC | CA | General Acute Care Hospital (282N00000X) |
United | 698 | $26691.00 | 1306889597 - VANDERBILT UNIVERSITY MEDICAL CENTER, VANDERBILT WILSON COUNTY HOSPITAL | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | 698 | $18431.07 | 1326022765 - VHS OF ARROWHEAD, INC, ABRAZO ARROWHEAD CAMPUS | 621811285 | AZ | General Acute Care Hospital (282N00000X) |
United | 698 | $27252.92 | 1306868682 - CAMDEN GENERAL HOSPITAL, CAMDEN ER | 581884314 - (TN) CAMDEN GENERAL HOSPITAL | TN | General Acute Care Hospital (282N00000X) |
United | 698 | $24880.67 | 1780600577 - MARY IMOGENE BASSETT HOSPITAL, BASSETT HEALTHCARE | 135596796 - MARY IMOGENE BASSETT HOSPITAL | NY | Rural Acute Care Hospital (282NR1301X) |
United | 698 | $18662.72 | 1972605178 - ST CATHERINE HOSPITAL INC | 351738708 - (IN) ST CATHERINE HOSPITAL INC | IN | Rehabilitation Hospital Unit (273Y00000X) |
United | 698 | $4063.00 | 1457347239 - UHS-CORONA INC, CORONA REGIONAL MEDICAL CENTER | 432035443 | CA | General Acute Care Hospital (282N00000X) |
United | 698 | $6034.00 | 1972679694 - PRIME HEALTHCARE PARADISE VALLEY LLC, PARADISE VALLEY HOSPITAL | 205837239 | CA | Rehabilitation Hospital Unit (273Y00000X) |
United | 698 | $39781.85 | 1023193539 - VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY, MEDICAL COLLEGE OF VIRGINIA HOSPITALS | 541848065 | VA | Rehabilitation Hospital Unit (273Y00000X) |
United | 698 | $10925.84 | 1851591424 - WAYNE MEMORIAL HOSPITAL | 240798839 - (PA) WAYNE MEMORIAL HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 698 | $26371.64 | 1215135785 - NASSAU HEALTH CARE CORPORATION, NASSAU UNIVERSITTY MEDICAL CENTER - | 113465690 | NY | Substance Use Disorder Rehabilitation Hospital Unit (276400000X) |
United | 698 | $30918.64 | 1487730636 - MEDSTAR, GEORGETOWN UNIVERSITY HOSPITAL | 522218584 - (DC) MEDSTAR-GEORGETOWN MEDICAL CENTER INC | DC | 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 698 vs. Other Diseases & Disorders of the Kidney & Urinary Tract Codes
The MS-DRG 698 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 698 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 |
|---|---|---|
| 697-MS-DRG | High | Urethral Stricture |
| 698-MS-DRG | High | Other Kidney and Urological Tract Diagnoses with MCC |
| 699-MS-DRG | High | Other Kidney and Urological Tract Diagnoses with CC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 698. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 698 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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