MS-DRG 738 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 Female Reproductive System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 738 by major payers:
$17,994.90
$20,260.18
$23,686.89
$24,714.07
| 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 738 | ||||||
United | 738 | $27269.31 | 1306857974 - CATHOLIC HEALTH INITIATIVES COLORADO, ST. MARY-CORWIN HOSPITAL | 840405257 - CATHOLIC HEALTH INITIATIVES COLORADO | CO | General Acute Care Hospital (282N00000X) |
United | 738 | $18915.33 | 1922428796 - ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL INC, ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL SOMERSET | 221487243 - (NJ) ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL | NJ | Psychiatric Hospital Unit (273R00000X) |
United | 738 | $17459.51 | 1396849303 - HUDSON HOSPITAL, INC., HUDSON HOSPITAL & CLINICS | 390804125 - HUDSON HOSPITAL INC | WI | Critical Access Hospital (282NC0060X) |
United | 738 | $48179.78 | 1972709970 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE EAST CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 738 | $6143.00 | 1992069967 - BROOKLYN HOSPITAL CENTER, NO | 111630755 - (NY) THE BROOKLYN HOSPITAL CENTER | NY | Substance Use Disorder Rehabilitation Hospital Unit (276400000X) |
United | 738 | $49543.17 | 1487868097 - PRISMA HEALTH-MIDLANDS | 582296052 - (SC) PRISMA HEALTH-MIDLANDS | SC | General Acute Care Hospital (282N00000X) |
United | 738 | $20242.80 | 1629017793 - ST. LUKE'S HOSPITAL OF DULUTH, ASPIRUS ST LUKES SUPERIOR SURGERY CENTER | 410714079 - ST LUKES HOSPITAL OF DULUTH | WI | General Acute Care Hospital (282N00000X) |
United | 738 | $27137.33 | 1720056138 - JEFFERSON REGIONAL MEDICAL CENTER, JEFFERSON HOSPITAL COUNSELING SERVICES | 251260215 - (PA) HIGHMARK HEALTH | PA | Psychiatric Hospital Unit (273R00000X) |
United | 738 | $20472.08 | 1679625511 - BAPTIST MEMORIAL HOSPITAL- DESOTO | 640682111 - (MS) BAPTIST MEMORIAL HOSPITAL-DESOTO INC | MS | General Acute Care Hospital (282N00000X) |
United | 738 | $12596.49 | 1619163854 - COMMUNITY HEALTH NETWORK, INC, COMMUNITY HOSPITAL NORTH | 743230935 | IN | General Acute Care Hospital (282N00000X) |
United | 738 | $30793.69 | 1669414884 - MEMORIAL HERMANN HEALTH SYSTEM, MEMORIAL HERMANN HOSPITAL SYSTEM REHABILITATION UNIT | 741152597 - (TX) MEMORIAL HERMANN HEALTH SYSTEM | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 738 | $13036.01 | 1962437681 - HOSPITAL SERVICE DISTRICT 1 OF EAST BATON ROUGE PARISH, LANE REGIONAL MEDICAL CENTER-PROFESSIONAL | 726015227 | LA | General Acute Care Hospital (282N00000X) |
United | 738 | $16675.27 | 1609957141 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 738 | $19319.49 | 1073555462 - CLARKE COUNTY PUBLIC HOSPITAL, CLARKE COUNTY HOSPITAL | 426037982 | IA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 738 | $40305.55 | 1881701217 - WASHINGTON HOSPITAL CENTER CORPORATION | 521272129 - (DC) WASHINGTON HOSPITAL CENTER CORPORATION | DC | Psychiatric Hospital (283Q00000X) |
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 738 vs. Other Diseases & Disorders of the Female Reproductive System Codes
The MS-DRG 738 code is part of the Diseases & Disorders of the Female 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 738 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 |
|---|---|---|
| 737-APR-DRG | Moderate | Orbit And Eye Procedures |
| 737-MS-DRG | High | Uterine and Adnexa Procedures for Ovarian or Adnexal Malignancy with CC |
| 738-MS-DRG | High | Uterine and Adnexa Procedures for Ovarian or Adnexal Malignancy without CC/MCC |
| 739-MS-DRG | High | Uterine and Adnexa Procedures for Non-Ovarian and Non-Adnexal Malignancy 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 738. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 738 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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