MS-DRG 792 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 792 by major payers:
$12,807.39
$29,294.34
$38,104.39
$32,378.80
| 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 792 | ||||||
United | 792 | $5270.00 | 1891882833 - HILLCREST BAPTIST MEDICAL CENTER, BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | 741161944 - (TX) HILLCREST BAPTIST MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 792 | $86981.50 | 1972778447 - WESTCHESTER COUNTY HEALTH CARE CORPORATION, WESTCHESTER MEDICAL CENTER | 133964321 - (NY) PEO MID-HUDSON VALLEY STAFFCO | NY | Rehabilitation Hospital Unit (273Y00000X) |
United | 792 | $2504.00 | 1245676345 - MILLCREEK COMMUNITY HOSPITAL, MILLCREEK COMMUNITY HOSPITAL INPATIENT REHAB UNIT | 251002937 - (PA) MILLCREEK COMMUNITY HOSPITAL | PA | Rehabilitation Hospital Unit (273Y00000X) |
United | 792 | $2894.00 | 1225060312 - OHIOHEALTH CORPORATION, RIVERSIDE METHODIST HOSPITAL | 314394942 - OHIOHEALTH CORPORATION GRANT RIVERSIDE DOCTORS DUBLIN MET | OH | Psychiatric Hospital Unit (273R00000X) |
United | 792 | $51277.12 | 1992159289 - THEDACARE MEDICAL CENTER, COMMUNITY HEALTH NETWORK, INC. AND BERLIN MEMORIAL HOSPITAL | 350983617 - COMMUNITY HEALTH NETWORK INC | WI | Critical Access Hospital (282NC0060X) |
United | 792 | $57484.66 | 1679678486 - MEMORIAL HOSPITAL FLAGLER INC, ADVENTHEALTH PALM COAST | 592951990 - MEMORIAL HOSPITAL FLAGLER INC | FL | General Acute Care Hospital (282N00000X) |
United | 792 | $6064.00 | 1104856095 - DESERT REGIONAL MEDICAL CENTER, INC., DESERT REGIONAL MEDICAL CENTER | 752694137 | CA | General Acute Care Hospital (282N00000X) |
United | 792 | $6064.00 | 1104856095 - DESERT REGIONAL MEDICAL CENTER, INC., DESERT REGIONAL MEDICAL CENTER | 752694137 | CA | General Acute Care Hospital (282N00000X) |
United | 792 | $5903.00 | 1740059948 - EAST COOPER MEDICAL CENTER LLC | 934555562 | SC | Rehabilitation Hospital Unit (273Y00000X) |
United | 792 | $6055.00 | 1841444718 - MONTCLAIR HOSPITAL LLC, PSYCH UNIT | 208489105 - (NJ) MERIT MOUNTAINSIDE, LLC | NJ | Psychiatric Hospital Unit (273R00000X) |
United | 792 | $28697.56 | 1326140583 - RUSH UNIVERSITY MEDICAL CENTER | 362174823 - (IL) RUSH UNIVERSITY MEDICAL CENTER | IL | Psychiatric Hospital Unit (273R00000X) |
United | 792 | $3659.80 | 1932145505 - MCBRIDE CLINIC ORTHOPEDIC HOSPITAL, LLC | 200561474 - (OK) MCBRIDE ORTHOPEDIC HOSPITAL | OK | General Acute Care Hospital (282N00000X) |
United | 792 | $52847.21 | 1063685733 - EPHRATA COMMUNITY HOSPITAL, WORKPLACE PARTNERS | 231370484 - EPHRATA COMMUNITY HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 792 | $78245.86 | 1871883702 - MAIMONIDES MEDICAL CENTER | 111635081 - (NY) MAIMONIDES MEDICAL CENTER- | NY | General Acute Care Hospital (282N00000X) |
United | 792 | $4755.00 | 1104856095 - DESERT REGIONAL MEDICAL CENTER, INC., DESERT REGIONAL MEDICAL CENTER | 752694137 | CA | 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 792 vs. Other Pregnancy, Childbirth & the Puerperium Codes
The MS-DRG 792 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 792 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 |
|---|---|---|
| 791-APR-DRG | High | O.R. Procedure For Other Complications Of Treatment |
| 791-MS-DRG | High | Prematurity with Major Problems |
| 792-MS-DRG | High | Prematurity without Major Problems |
| 793-APR-DRG | High | MODERATELY EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 792. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 792 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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