MS-DRG 728 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 728 by major payers:

$9,430.03

$11,631.86

$13,140.03

$13,408.53
| 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 728 | ||||||
United | 728 | $9681.20 | 1598835308 - SSM HEALTH CARE ST. LOUIS, SSM HEALTH DEPAUL HOSPITAL - ST. LOUIS | 431343281 - SSM HEALTH CARE ST LOUIS | MO | General Acute Care Hospital (282N00000X) |
United | 728 | $13315.65 | 1841701562 - NAVICENT HEALTH BALDWIN, INC, NAVICENT HEALTH BALDWIN | 823914925 - (GA) NAVICENT HEALTH BALDWIN | GA | General Acute Care Hospital (282N00000X) |
United | 728 | $3308.00 | 1790115426 - CREEK NATION HOSPITAL & CLINICS, MUSCOGEE (CREEK) NATION MEDICAL CENTER | 731357965 - MUSCOGEE (CREEK) NATION DEPARTMENT OF HEALTH | OK | Psychiatric Hospital Unit (273R00000X) |
United | 728 | $22565.52 | 1538173372 - THE MOUNT VERNON HOSPITAL | 462916938 - (NY) MONTEFIORE MOUNT VERNON HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 728 | $12916.71 | 1679545966 - COMMUNITY HEALTH NETWORK, INC., COMMUNITY HOSPITAL NORTH | 743230935 | IN | Psychiatric Hospital Unit (273R00000X) |
United | 728 | $9823.62 | 1467594432 - MUSKOGEE REGIONAL MEDICAL CENTER LLC, MUSKOGEE REGIONAL MEDICAL CENTER PSYCHIATRIC UNIT | 814322087 - (OK) SAINT FRANCIS HOSPITAL MUSKOGEE INC | OK | Psychiatric Hospital Unit (273R00000X) |
United | 728 | $13968.00 | 1568590115 - JOHN T. MATHER MEMORIAL HOSPITAL, PORT JEFF MRI | 111639818 - (NY) JOHN T MATHER MEMORIAL HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 728 | $7846.60 | 1629024930 - MERCY MEDICAL CENTER, MERCY MEDICAL PSYCH UNIT | 420698295 - (IA) MERCY MEDICAL CENTER | IA | Psychiatric Hospital Unit (273R00000X) |
United | 728 | $9946.55 | 1588771919 - FRANCISCAN HEALTH OLYMPIA FIELDS, FRANCISCAN HEALTH OLYMPIA FIELDS & CHICAGO HEIGHTS | 362167869 - FRANCISCAN HEALTH OLYMPIA FIELDS | IL | General Acute Care Hospital (282N00000X) |
United | 728 | $6408.52 | 1710396932 - OSF HEALTHCARE SYSTEM, OSF SAINT ANTHONY'S HEALTH CENTER | 370813229 - (IL) OSF HEALTHCARE SYSTEM | IL | General Acute Care Hospital (282N00000X) |
United | 728 | $11301.30 | 1053508820 - HUTCHINSON HEALTH, HUTCHINSON HEALTH HOSPITAL | 841715908 - (MN) HUTCHINSON HEALTH | MN | General Acute Care Hospital (282N00000X) |
United | 728 | $24571.83 | 1669171740 - MEDICAL UNIVERSITY HOSPITAL AUTHORITY | 571098556 - (SC) MEDICAL UNIVERSITY HOSPITAL AUTHORITY | SC | Psychiatric Hospital (283Q00000X) |
United | 728 | $24859.91 | 1801212410 - WESTCHESTER COUNTY HEALTH CARE CORPORATION, MID-HUDSON VALLEY DIVISION OF WESTCHESTER MEDICAL CENTER | 133964321 - (NY) PEO MID-HUDSON VALLEY STAFFCO | NY | Rehabilitation Hospital Unit (273Y00000X) |
United | 728 | $9654.98 | 1871918870 - PROSPECT CHARTERCARE SJHSRI, LLC, OUR LADY OF FATIMA HOSPITAL | 464661337 | RI | General Acute Care Hospital (282N00000X) |
United | 728 | $9654.98 | 1871918870 - PROSPECT CHARTERCARE SJHSRI, LLC, OUR LADY OF FATIMA HOSPITAL | 464661337 | RI | 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 728 vs. Other Diseases & Disorders of the Male Reproductive System Codes
The MS-DRG 728 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 728 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 |
|---|---|---|
| 727-MS-DRG | High | Inflammation of the Male Reproductive System with MCC |
| 728-MS-DRG | High | Inflammation of the Male Reproductive System without MCC |
| 729-MS-DRG | High | Other Male Reproductive System Diagnoses with CC/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 728. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 728 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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