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See a sample rate comparisonMS-DRG 726 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.
BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC
| 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 726 by major payers:
$8,795.39
$10,372.72
$11,824.81
$12,201.16
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MS-DRG 726
5 of 25 sample ratesHigher to lower in this preview
Coastal Carolina Medical Center, Inc., Coastal Carolina Hospital
$30,751.16Published rateMemorial Hermann Health System
$15,134.16Published rateSaint Thomas Stones River Hospital, LLC, Ascension Saint Thomas Stones River
$11,891.04Published rateIom Health System Lp, Lutheran Hospital Of Indiana
$9,125.70Published rateLion Star Nacogdoches Hospital, LLC, Nacogdoches Memorial Hospital
Lion Star Nacogdoches Hospital, LLC Dba Nacogdoches Memorial Hospital
$1,800.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 726 vs. Other Diseases & Disorders of the Male Reproductive System Codes
The MS-DRG 726 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 726 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 |
|---|---|---|
| 725-MS-DRG | High | BENIGN PROSTATIC HYPERTROPHY WITH MCC |
| 726-MS-DRG | High | BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC |
| 727-MS-DRG | High | INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM 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 726. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 726 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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