MS-DRG 787 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 787 by major payers:
$12,488.14
$12,278.33
$16,035.83
$17,305.36
| 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 787 | ||||||
United | 787 | $5575.00 | 1134178130 - JOHNSON REGIONAL MEDICAL CENTER, JRMC SWINGBED | 710403278 - JOHNSON COUNTY REGIONAL HOSPITAL | AR | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 787 | $28143.00 | 1548421837 - UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER | 943281657 | CA | General Acute Care Hospital (282N00000X) |
United | 787 | $15826.41 | 1932208576 - UNIVERSITY OF NORTH CAROLINA HOSPITALS AT CHAPEL HILL, UNC HOSPITALS | 561118388 | NC | General Acute Care Hospital (282N00000X) |
United | 787 | $1873.00 | 1710914734 - MEMORIAL HOSPITAL OF WASHINGTON COUNTY, WASHINGTON COUNTY REGIONAL MEDICAL CENTER & ECF | 586012329 - (GA) HOSPITAL AUTHORITY OF WASHINGTON COUNTY | GA | Rural Acute Care Hospital (282NR1301X) |
United | 787 | $28143.00 | 1548421837 - UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER | 943281657 | CA | General Acute Care Hospital (282N00000X) |
United | 787 | $16234.00 | 1063596443 - BEAUFORT COUNTY MEMORIAL HOSPITAL, BEAUFORT MEMORIAL HOSPITAL | 576000094 - BEAUFORT COUNTY MEMORIAL HOSPITAL | SC | General Acute Care Hospital (282N00000X) |
United | 787 | $14829.00 | 1407007784 - DENVER HEALTH MEDICAL CENTER | 841343242 | CO | Substance Use Disorder Rehabilitation Hospital Unit (276400000X) |
United | 787 | $19326.00 | 1396087672 - DOCTORS MEDICAL CENTER OF MODESTO, INC., EMANUEL MEDICAL CENTER | 752918774 | CA | General Acute Care Hospital (282N00000X) |
United | 787 | $19326.00 | 1396087672 - DOCTORS MEDICAL CENTER OF MODESTO, INC., EMANUEL MEDICAL CENTER | 752918774 | CA | General Acute Care Hospital (282N00000X) |
United | 787 | $10038.00 | 1760549562 - SKAGGS COMMUNITY HOSPITAL ASSOCIATION, COX MEDICAL CENTER BRANSON | 440577118 - LESTER E COX MEDICAL CENTER | MO | Rehabilitation Hospital Unit (273Y00000X) |
United | 787 | $14296.00 | 1144627050 - ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL | 221487243 - (NJ) ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL | NJ | Children's Hospital (282NC2000X) |
United | 787 | $15952.48 | 1083617005 - OKLAHOMA HEART HOSPITAL, LLC | 731575187 - (OK) OKLAHOMA HEART HOSPITAL, LLC | OK | General Acute Care Hospital (282N00000X) |
United | 787 | $32524.18 | 1316954449 - FOREST HILLS HOSPITAL | 112241326 - LONG ISLAND JEWISH MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 787 | $5095.00 | 1548207608 - UNIVERSITY HEALTHCARE SYSTEM, L.C., EAST JEFFERSON GENERAL HOSPITAL | 621596506 | LA | Rehabilitation Hospital Unit (273Y00000X) |
United | 787 | $21554.53 | 1295843787 - MEMORIAL HERMANN HEALTH SYSTEM, MEMORIAL HERMANN NORTHEAST | 741152597 - (TX) MEMORIAL HERMANN HEALTH SYSTEM | TX | 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 787 vs. Other Pregnancy, Childbirth & the Puerperium Codes
The MS-DRG 787 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 787 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 |
|---|---|---|
| 786-MS-DRG | High | Cesarean Section without Sterilization with MCC |
| 787-MS-DRG | High | Cesarean Section without Sterilization with CC |
| 788-MS-DRG | High | Cesarean Section without Sterilization 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 787. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 787 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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