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MS-DRG 726 Fee Schedule

Last Verified: March 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 FactDetail
Service Type

Diseases & Disorders of the Male Reproductive System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Complexity LevelHigh

National average reimbursement for MS-DRG 726 by major payers:

bcbs

$8,795.39

uhc

$10,372.72

aetna

$11,824.81

cigna

$12,201.16

Preview provider-level rates for...
For billing codeMS-DRG 726
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for MS-DRG 726

United
726$10774.451184726390 - ST MARY MEDICAL CENTER INC352007327 - (IN) ST MARY MEDICAL CENTER INCINRehabilitation Hospital Unit (273Y00000X)
United
726$16101.371942352273 - DECATUR MEMORIAL HOSPITAL370661199 - DECATUR MEMORIAL HOSPITALILGeneral Acute Care Hospital (282N00000X)
United
726$5869.101245294826 - SARASOTA COUNTY PUBLIC HOSPITAL DISTRICT, SARASOTA COUNTY PUBLIC HOSPITAL BOARD596012500 - (FL) SARASOTA COUNTY PUBLIC HOSPITAL DISTRICTFLGeneral Acute Care Hospital (282N00000X)
United
726$11891.041336520840 - SAINT THOMAS STONES RIVER HOSPITAL, LLC, ASCENSION SAINT THOMAS STONES RIVER474063232TNRehabilitation Hospital Unit (273Y00000X)
United
726$4672.161134130289 - VALLEY MEDICAL FACILITIES, INC., VALLEY MEDICAL FACILITIES, HERITAGE VALLEY BEAVER251801532 - (PA) HERITAGE VALLEY HEALTH SYSTEMPAPsychiatric Hospital Unit (273R00000X)
United
726$13443.861013312511 - MERCY HEALTH310830955OHPsychiatric Hospital Unit (273R00000X)
United
726$16542.061457382483 - AMISUB OF SOUTH CAROLINA, INC., PIEDMONT MEDICAL CENTER953561198 - (SC) AMISUB OF SOUTH CAROLINA INCSCGeneral Acute Care Hospital (282N00000X)
United
726$14029.701487226106 - STEWARD NSMC, INC., PSYCH995054044FLPsychiatric Hospital (283Q00000X)
United
726$10410.201053354100 - LONG ISLAND COMMUNITY HOSPITAL AT NYU LANGONE HEALTH, LONG ISLAND COMMUNITY HOSPITAL111704595 - (NY) LONG ISLAND COMMUNITY HOSPITAL AT NYU LANGONE HEALTHNYGeneral Acute Care Hospital (282N00000X)
United
726$30751.161962472431 - COASTAL CAROLINA MEDICAL CENTER, INC., COASTAL CAROLINA HOSPITAL934580630SCGeneral Acute Care Hospital (282N00000X)
United
726$14688.501215903018 - COMMUNITY MEMORIAL HEALTH SYSTEM, COMMUNITY MEMORIAL HOSPITAL OF SAN BUENA VENTURA951683892 - COMMUNITY MEMORIAL HEALTH SYSTEMCAGeneral Acute Care Hospital (282N00000X)
United
726$6893.021700991700 - MOORE COUNTY HOSPITAL DISTRICT, MEMORIAL HOSPITAL751302152 - (TX) MOORE COUNTY HOSPITAL DISTRICTTXCritical Access Hospital (282NC0060X)
United
726$18106.781053321919 - UNIVERSITY COMMUNITY HOSPITAL, INC, ADVENTHEALTH TAMPA591113901 - (FL) UNIVERSITY COMMUNITY HOSPITAL INCFLGeneral Acute Care Hospital (282N00000X)
United
726$13693.981790881118 - UNIVERSITY OF NORTH CAROLINA561118388NCGeneral Acute Care Hospital (282N00000X)
United
726$12589.751043269798 - ST. CLOUD HOSPITAL410695596 - (MN) ST CLOUD HOSPITALMNGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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MS-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.

CodeComplexityDescription
725-MS-DRGHighBenign Prostatic Hypertrophy with MCC
726-MS-DRGHighBenign Prostatic Hypertrophy without MCC
727-MS-DRGHighInflammation 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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