MS-DRG 726 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 726 by major payers:

$8,795.39

$10,372.72

$11,824.81

$12,201.16
| 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 726 | ||||||
United | 726 | $10774.45 | 1184726390 - ST MARY MEDICAL CENTER INC | 352007327 - (IN) ST MARY MEDICAL CENTER INC | IN | Rehabilitation Hospital Unit (273Y00000X) |
United | 726 | $16101.37 | 1942352273 - DECATUR MEMORIAL HOSPITAL | 370661199 - DECATUR MEMORIAL HOSPITAL | IL | General Acute Care Hospital (282N00000X) |
United | 726 | $5869.10 | 1245294826 - SARASOTA COUNTY PUBLIC HOSPITAL DISTRICT, SARASOTA COUNTY PUBLIC HOSPITAL BOARD | 596012500 - (FL) SARASOTA COUNTY PUBLIC HOSPITAL DISTRICT | FL | General Acute Care Hospital (282N00000X) |
United | 726 | $11891.04 | 1336520840 - SAINT THOMAS STONES RIVER HOSPITAL, LLC, ASCENSION SAINT THOMAS STONES RIVER | 474063232 | TN | Rehabilitation Hospital Unit (273Y00000X) |
United | 726 | $4672.16 | 1134130289 - VALLEY MEDICAL FACILITIES, INC., VALLEY MEDICAL FACILITIES, HERITAGE VALLEY BEAVER | 251801532 - (PA) HERITAGE VALLEY HEALTH SYSTEM | PA | Psychiatric Hospital Unit (273R00000X) |
United | 726 | $13443.86 | 1013312511 - MERCY HEALTH | 310830955 | OH | Psychiatric Hospital Unit (273R00000X) |
United | 726 | $16542.06 | 1457382483 - AMISUB OF SOUTH CAROLINA, INC., PIEDMONT MEDICAL CENTER | 953561198 - (SC) AMISUB OF SOUTH CAROLINA INC | SC | General Acute Care Hospital (282N00000X) |
United | 726 | $14029.70 | 1487226106 - STEWARD NSMC, INC., PSYCH | 995054044 | FL | Psychiatric Hospital (283Q00000X) |
United | 726 | $10410.20 | 1053354100 - LONG ISLAND COMMUNITY HOSPITAL AT NYU LANGONE HEALTH, LONG ISLAND COMMUNITY HOSPITAL | 111704595 - (NY) LONG ISLAND COMMUNITY HOSPITAL AT NYU LANGONE HEALTH | NY | General Acute Care Hospital (282N00000X) |
United | 726 | $30751.16 | 1962472431 - COASTAL CAROLINA MEDICAL CENTER, INC., COASTAL CAROLINA HOSPITAL | 934580630 | SC | General Acute Care Hospital (282N00000X) |
United | 726 | $14688.50 | 1215903018 - COMMUNITY MEMORIAL HEALTH SYSTEM, COMMUNITY MEMORIAL HOSPITAL OF SAN BUENA VENTURA | 951683892 - COMMUNITY MEMORIAL HEALTH SYSTEM | CA | General Acute Care Hospital (282N00000X) |
United | 726 | $6893.02 | 1700991700 - MOORE COUNTY HOSPITAL DISTRICT, MEMORIAL HOSPITAL | 751302152 - (TX) MOORE COUNTY HOSPITAL DISTRICT | TX | Critical Access Hospital (282NC0060X) |
United | 726 | $18106.78 | 1053321919 - UNIVERSITY COMMUNITY HOSPITAL, INC, ADVENTHEALTH TAMPA | 591113901 - (FL) UNIVERSITY COMMUNITY HOSPITAL INC | FL | General Acute Care Hospital (282N00000X) |
United | 726 | $13693.98 | 1790881118 - UNIVERSITY OF NORTH CAROLINA | 561118388 | NC | General Acute Care Hospital (282N00000X) |
United | 726 | $12589.75 | 1043269798 - ST. CLOUD HOSPITAL | 410695596 - (MN) ST CLOUD HOSPITAL | MN | 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 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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