MS-DRG 725 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 Male Reproductive System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 725 by major payers:
$14,563.96
$17,959.49
$19,866.46
$20,303.34
| 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 725 | ||||||
United | 725 | $15441.34 | 1114021292 - HURLEY MEDICAL CENTER | 386005601 | MI | Psychiatric Hospital Unit (273R00000X) |
United | 725 | $12923.96 | 1679679146 - SAINT JOSEPH HEALTH SYSTEM, INC, CHI SAINT JOSEPH MOUNT STERLING | 611334601 - (KY) SAINT JOSEPH HEALTH SYSTEM INC | KY | General Acute Care Hospital (282N00000X) |
United | 725 | $8888.00 | 1215165832 - COOPER UNIVERSITY HOSPITAL | 210634462 - (NJ) COOPER HEALTH SYSTEM A NEW JERSEY NON-PROFIT CORPORATION | NJ | General Acute Care Hospital (282N00000X) |
United | 725 | $15577.95 | 1871977751 - GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION, MACNEAL HOSPITAL | 363332852 - (IL) GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 725 | $33177.33 | 1366932162 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY, UCHEALTH EMERGENCY ROOM - THORNTON | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 725 | $4120.00 | 1902280050 - JOHNSTON MEMORIAL HOSPITAL, INC, JOHNSTON MEMORIAL HOSPITAL REHABILITATION | 540544705 - JOHNSTON MEMORIAL HOSPITAL INC | VA | General Acute Care Hospital (282N00000X) |
United | 725 | $28108.00 | 1538535158 - SMSJ TUCSON HOLDINGS LLC, ST. JOSEPHS HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 725 | $12507.32 | 1376562678 - CONWAY REGIONAL MEDICAL CENTER INC | 710249735 - CONWAY REGIONAL MEDICAL CENTER INC | AR | Psychiatric Hospital Unit (273R00000X) |
United | 725 | $16806.47 | 1760794044 - VHS SINAI-GRACE HOSPITAL INC, SINAI-GRACE HOSPITAL | 272844632 | MI | General Acute Care Hospital (282N00000X) |
United | 725 | $4772.33 | 1760696546 - ST CHARLES PARISH HOSPITAL | 726014606 | LA | General Acute Care Hospital (282N00000X) |
United | 725 | $17436.50 | 1487633509 - VHS SAN ANTONIO PARTNERS LLC, BAPTIST HEALTH SYSTEM | 760714523 | TX | Psychiatric Hospital Unit (273R00000X) |
United | 725 | $15441.34 | 1114021292 - HURLEY MEDICAL CENTER | 386005601 | MI | Psychiatric Hospital Unit (273R00000X) |
United | 725 | $17989.51 | 1710039508 - THE METHODIST HOSPITALS, INC. | 350868133 - METHODIST HOSPITALS INC | IN | Rehabilitation Hospital Unit (273Y00000X) |
United | 725 | $42251.64 | 1841233780 - SCRIPPS HEALTH, SCRIPPS GREEN HOSPITAL | 951684089 - SCRIPPS HEALTH | CA | General Acute Care Hospital (282N00000X) |
United | 725 | $13463.70 | 1891870812 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | 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 725 vs. Other Diseases & Disorders of the Male Reproductive System Codes
The MS-DRG 725 code is part of the Diseases & Disorders of the Male Reproductive System 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 725 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 |
|---|---|---|
| 724-APR-DRG | High | OTHER INFECTIOUS & PARASITIC DISEASES |
| 724-MS-DRG | High | Malignancy, Male Reproductive System without CC/MCC |
| 725-MS-DRG | High | Benign Prostatic Hypertrophy with MCC |
| 726-MS-DRG | High | Benign Prostatic Hypertrophy without 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 725. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 725 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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