MS-DRG 742 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 742 by major payers:
$19,837.36
$23,192.82
$27,750.62
$29,268.18
| 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 742 | ||||||
United | 742 | $18335.58 | 1427132604 - GENESIS HEALTH SYSTEM, GENESIS MEDICAL CENTER - SILVIS | 363616314 - GENESIS HEALTH SYSTEM | IL | General Acute Care Hospital (282N00000X) |
United | 742 | $19203.53 | 1710353339 - SMSJ TUCSON HOLDINGS LLC, ST. MARYS HOSPITAL | 474131755 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 742 | $31634.78 | 1538174347 - LCMC HEALTH HOLDINGS INC, EAST JEFFERSON GENERAL HOSPITAL | 621596506 | LA | General Acute Care Hospital (282N00000X) |
United | 742 | $28852.73 | 1851944029 - UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS, UT SOUTHWESTERN INPATIENT REHABILITATION | 753175630 | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 742 | $5392.00 | 1649417643 - MANCHESTER MEMORIAL HOSPITAL | 812216981 | CT | General Acute Care Hospital (282N00000X) |
United | 742 | $31634.78 | 1982650206 - LAKEVIEW MEDICAL CENTER, LLC, LAKEVIEW REGIONAL MEDICAL CENTER | 621596506 | LA | Psychiatric Hospital Unit (273R00000X) |
United | 742 | $39999.41 | 1508899204 - TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE | 751748586 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE | TX | General Acute Care Hospital (282N00000X) |
United | 742 | $32517.89 | 1154764819 - ST. CATHERINE OF SIENA MEDICAL CENTER | 61562701 - (NY) ST CATHERINE OF SIENA MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 742 | $26583.97 | 1518993880 - THEDACARE REGIONAL MEDICAL CENTER-NEENAH, INC., THEDA CLARK MEDICAL CENTER INC. | 390830664 - (WI) THEDACARE REGIONAL MEDICAL CENTER - NEENAH INC | WI | General Acute Care Hospital (282N00000X) |
United | 742 | $51905.67 | 1013924927 - GLEN COVE HOSPITAL, GLEN COVE PSYCHIATRIC UNIT | 111633487 - (NY) GLEN COVE HOSPITAL | NY | Psychiatric Hospital Unit (273R00000X) |
United | 742 | $7812.00 | 1891809679 - FREEMAN-OAK HILL HEALTH SYSTEM, FREEMAN HEALTH SYSTEM | 431704371 - FREEMAN HEALTH SYSTEM | MO | General Acute Care Hospital (282N00000X) |
United | 742 | $10551.00 | 1730620428 - JERSEY CITY MEDICAL CENTER-RWJ BARNABAS HEALTH | 222783298 - (NJ) JERSEY CITY MEDICAL CENTER | NJ | General Acute Care Hospital (282N00000X) |
United | 742 | $32526.22 | 1467537506 - CARONDELET HEALTH NETWORK, ST. MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 742 | $27515.58 | 1053362624 - RIPON MEDICAL CENTER INC, SSM HEALTH RIPON COMMUNITY HOSPITAL | 391101287 - RIPON MEDICAL CENTER INC | WI | Critical Access Hospital (282NC0060X) |
United | 742 | $44410.73 | 1487821237 - UNIVERSITY HOSPITAL @ SYRACUSE | 161469571 | NY | Critical Access Hospital (282NC0060X) |
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 742 vs. Other Diseases & Disorders of the Female Reproductive System Codes
The MS-DRG 742 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 742 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 |
|---|---|---|
| 741-MS-DRG | High | Uterine and Adnexa Procedures for Non-Ovarian and Non-Adnexal Malignancy without CC/MCC |
| 742-MS-DRG | High | Uterine and Adnexa Procedures for Non-Malignancy with CC/MCC |
| 743-MS-DRG | High | Uterine and Adnexa Procedures for Non-Malignancy without 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 742. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 742 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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