MS-DRG 769 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 | • Pregnancy, Childbirth & the Puerperium |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 769 by major payers:
$18,217.35
$18,587.60
$22,069.31
$22,539.72
| 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 769 | ||||||
United | 769 | $17748.74 | 1144261728 - UNIVERSITY MEDICAL CENTER MANAGEMENT CORPORATION, UNIVERSITY MEDICAL CENTER NEW ORLEANS | 251925187 - UNIVERSITY MEDICAL CENTER MANAGEMENT CORPORATON | LA | Psychiatric Hospital Unit (273R00000X) |
United | 769 | $6169.58 | 1568695781 - HEARTLAND LONG TERM ACUTE CARE HOSPITAL, LONG TERM ACUTE CARE HOSPITAL, MOSAIC LIFE CARE AT ST. JOSEPH | 261972987 - (MO) HEARTLAND LONG TERM ACUTE CARE HOSPITAL | MO | Long Term Care Hospital (282E00000X) |
United | 769 | $20930.03 | 1619401528 - STEWARD SEBASTIAN RIVER MEDICAL CENTER, INC. | 994762475 | FL | General Acute Care Hospital (282N00000X) |
United | 769 | $28226.30 | 1255387726 - BAYCARE AURORA, LLC, AURORA BAYCARE MEDICAL CENTER | 391947472 | WI | General Acute Care Hospital (282N00000X) |
United | 769 | $32499.09 | 1982604021 - GEORGETOWN MEMORIAL HOSPITAL, TIDELANDS GEORGETOWN MEMORIAL HOSPITAL | 570341194 - GEORGETOWN MEMORIAL HOSPITAL | SC | General Acute Care Hospital (282N00000X) |
United | 769 | $15381.76 | 1710353339 - SMSJ TUCSON HOLDINGS LLC, ST. MARYS HOSPITAL | 474131755 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 769 | $65017.48 | 1073510277 - PEACEHEALTH, ST. JOHN MEDICAL CENTER | 910564987 | WA | General Acute Care Hospital (282N00000X) |
United | 769 | $9343.25 | 1356492953 - JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2, JEFFERSON HEALTHCARE | 910928081 | WA | Critical Access Hospital (282NC0060X) |
United | 769 | $29172.42 | 1285667493 - WEST PENN ALLEGHENY HEALTH SYSTEM INC., ALLEGHENY GENERAL HOSPITAL | 250969492 - (PA) HIGHMARK HEALTH | PA | General Acute Care Hospital (282N00000X) |
United | 769 | $17513.25 | 1730425190 - BSA HOSPITAL LLC | 300754305 | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 769 | $21909.48 | 1053353490 - SAINT LUKES EAST HOSPITAL, SAINT LUKE'S EAST LEE'S SUMMIT HOSPITAL | 562488077 - (MO) SAINT LUKES EAST HOSPITAL | MO | General Acute Care Hospital (282N00000X) |
United | 769 | $13452.33 | 1922106152 - HOWARD COUNTY MEDICAL CENTER | 470681056 - HOWARD COUNTY MEDICAL CENTER | NE | Critical Access Hospital (282NC0060X) |
United | 769 | $24919.50 | 1316002520 - VALLEY WEST COMMUNITY HOSPITAL | 364244337 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Critical Access Hospital (282NC0060X) |
United | 769 | $4158.00 | 1821477456 - JOHNSTON MEMORIAL HOSPITAL, INC, CENTER FOR SLEEP DISORDERS AT JMH | 540544705 - JOHNSTON MEMORIAL HOSPITAL INC | VA | General Acute Care Hospital (282N00000X) |
United | 769 | $6976.00 | 1104857119 - PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA, JACKSON NORTH MEDICAL CENTER | 591713947 - (FL) PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY FLORIDA | FL | 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 769 vs. Other Pregnancy, Childbirth & the Puerperium Codes
The MS-DRG 769 code is part of the Pregnancy, Childbirth & the Puerperium 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 769 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 |
|---|---|---|
| 768-MS-DRG | High | Vaginal Delivery with O.R. Procedures except Sterilization and/or D&C |
| 769-MS-DRG | High | Postpartum and Post Abortion Diagnoses with O.R. Procedures |
| 770-APR-DRG | High | DRUG & ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE |
| 770-MS-DRG | High | Abortion with D&C, Aspiration Curettage or Hysterectomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 769. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 769 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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