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 | $12952.00 | 1508843566 - NOVANT HEALTH ROWAN MEDICAL CENTER LLC, NOVANT HEALTH ROWAN MEDICAL CENTER | 560547479 - (NC) ROWAN REGIONAL MEDICAL CENTER, INC. | NC | General Acute Care Hospital (282N00000X) |
United | 787 | $19056.00 | 1699910174 - SODEXO | 953561198 - (SC) AMISUB OF SOUTH CAROLINA INC | SC | General Acute Care Hospital (282N00000X) |
United | 787 | $26749.92 | 1972523348 - UNIVERSITY HOSPITAL AT STONY BROOK, STONY BROOK UNIVERSITY HOSPITAL | 113243405 | NY | General Acute Care Hospital (282N00000X) |
United | 787 | $15381.51 | 1548681091 - RCHP OTTUMWA LLC, SENIOR BEHAVIORAL CARE CENTER | 272200283 | IA | Psychiatric Hospital Unit (273R00000X) |
United | 787 | $10339.53 | 1043311715 - SHEPHERD CENTER INC | 510141601 - (GA) SHEPHERD CENTER INC | GA | Long Term Care Hospital (282E00000X) |
United | 787 | $6736.00 | 1952954307 - LEHIGH VALLEY HOSPITAL | 231689692 - LEHIGH VALLEY HOSPITAL | PA | Children's Hospital (282NC2000X) |
United | 787 | $11734.28 | 1083708226 - ST LUKE'S METHODIST HOSPITAL | 420504780 - ST LUKES METHODIST HOSPITAL | IA | General Acute Care Hospital (282N00000X) |
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 | 787 | $13679.00 | 1891367629 - STEWARD NSMC, INC., STEWARD FLORIDA MEDICAL CENTER A CAMPUS OF NORTH SHORE | 862695690 | FL | General Acute Care Hospital (282N00000X) |
United | 787 | $15368.49 | 1396847596 - ST CATHERINE HOSPITAL INC | 351738708 - (IN) ST CATHERINE HOSPITAL INC | IN | General Acute Care Hospital (282N00000X) |
United | 787 | $18924.46 | 1942252705 - NORTHWEST ARKANSAS HOSPITALS, LLC, NORTHWEST MEDICAL CENTER | 205896848 | AR | Rehabilitation Hospital Unit (273Y00000X) |
United | 787 | $21891.00 | 1053359729 - HARBORVIEW MEDICAL CENTER | 911631806 | WA | General Acute Care Hospital (282N00000X) |
United | 787 | $12514.00 | 1174977557 - BBH CBMC, LLC, CITIZENS BAPTIST MEDICAL CENTER | 474802869 | AL | General Acute Care Hospital (282N00000X) |
United | 787 | $12400.00 | 1295780476 - HTI MEMORIAL HOSPITAL CORPORATION, TRISTAR SKYLINE MEDICAL CENTER | 621560757 | TN | General Acute Care Hospital (282N00000X) |
United | 787 | $20506.53 | 1386649804 - CENTRAL SUFFOLK HOSPITAL, PECONIC BAY MEDICAL CENTER | 111661359 - (NY) CENTRAL SUFFOLK HOSPITAL | NY | 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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