MS-DRG 790 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 790 by major payers:
$37,314.56
$71,001.90
$92,714.68
$78,275.70
| 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 790 | ||||||
United | 790 | $94433.14 | 1548280225 - MERITER HOSPITAL, INC., UNITYPOINT HEALTH - MERITER | 390806367 - MERITER HOSPITAL INC | WI | Psychiatric Hospital Unit (273R00000X) |
United | 790 | $60024.64 | 1881654259 - BAPTIST HEALTHCARE SYSTEM INC, BAPTIST HEALTH CORBIN | 610444707 - BAPTIST HEALTHCARE SYSTEM INC | KY | Psychiatric Hospital Unit (273R00000X) |
United | 790 | $96180.92 | 1225543630 - CATHOLIC HEALTH INIATIVES COLORADO, ST MARY-CORWIN MEDICAL CENTER | 840405257 - CATHOLIC HEALTH INITIATIVES COLORADO | CO | General Acute Care Hospital (282N00000X) |
United | 790 | $2533.00 | 1851491187 - HIGHLANDS HOSPITAL AND HEALTH CENTER, HIGHLANDS HOSPITAL EMERGENCY DEPT PHYSICIANS | 251494705 - HIGHLANDS HOSPITAL AND HEALTH CENTER | PA | General Acute Care Hospital (282N00000X) |
United | 790 | $70392.38 | 1982835708 - OCONNOR HOSPITAL | 161540394 - (NY) OCONNOR HOSPITAL | NY | Critical Access Hospital (282NC0060X) |
United | 790 | $52433.14 | 1538208210 - RIVERSIDE MEDICAL CENTER | 362414944 - (IL) RIVERSIDE MEDICAL CENTER | IL | General Acute Care Hospital (282N00000X) |
United | 790 | $76401.74 | 1184622847 - CHI ST. LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER | 741161938 - CHI ST LUKES HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 790 | $141134.34 | 1013130145 - BANNER HEALTH | 900412842 | AZ | General Acute Care Hospital (282N00000X) |
United | 790 | $82695.00 | 1336157791 - GLEN COVE HOSPITAL, GLEN COVE REHAB EXEMPT UNIT | 111633487 - (NY) GLEN COVE HOSPITAL | NY | Rehabilitation Hospital Unit (273Y00000X) |
United | 790 | $6498.00 | 1174977557 - BBH CBMC, LLC, CITIZENS BAPTIST MEDICAL CENTER | 474802869 | AL | General Acute Care Hospital (282N00000X) |
United | 790 | $8580.00 | 1154406254 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 790 | $62182.60 | 1689628232 - CHI ST VINCENT HOSPITAL HOT SPRINGS | 710236913 - CHI ST VINCENT HOSPITAL HOT SPRINGS | AR | General Acute Care Hospital (282N00000X) |
United | 790 | $92478.07 | 1366488108 - JEFFERSON REGIONAL MEDICAL CENTER | 251260215 - (PA) HIGHMARK HEALTH | PA | General Acute Care Hospital (282N00000X) |
United | 790 | $98101.64 | 1215903018 - COMMUNITY MEMORIAL HEALTH SYSTEM, COMMUNITY MEMORIAL HOSPITAL OF SAN BUENA VENTURA | 951683892 - COMMUNITY MEMORIAL HEALTH SYSTEM | CA | General Acute Care Hospital (282N00000X) |
United | 790 | $58518.98 | 1962594622 - NORTHWEST IOWA HOSPITAL CORPORATION, ST LUKES REGIONAL MEDICAL CENTER | 421019872 - (IA) NORTHWEST IOWA HOSPITAL CORPORATION | IA | 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 790 vs. Other Pregnancy, Childbirth & the Puerperium Codes
The MS-DRG 790 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 790 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 |
|---|---|---|
| 789-MS-DRG | High | Neonates, Died or Transferred to Another Acute Care Facility |
| 790-MS-DRG | High | Extreme Immaturity or Respiratory Distress Syndrome, Neonate |
| 791-APR-DRG | High | O.R. Procedure For Other Complications Of Treatment |
| 791-MS-DRG | High | Prematurity with Major Problems |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 790. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 790 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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