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MS-DRG 793 Fee Schedule

Last Verified: December 2025

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.

Full Term Neonate with Major Problems
Key FactDetail
Service Type

Pregnancy, Childbirth & the Puerperium

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Complexity LevelHigh

National average reimbursement for MS-DRG 793 by major payers:

bcbs

$17,671.94

uhc

$45,410.01

aetna

$64,458.59

cigna

$54,876.74

Preview provider-level rates for...
For billing codeMS-DRG 793
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for MS-DRG 793

United
793$35113.731699773465 - UPMC ALTOONA231352155 - UPMCPAPsychiatric Hospital Unit (273R00000X)
United
793$78764.061508877689 - PROVIDENCE HEALTH & SERVICES WASHINGTON, PROVIDENCE ST. PETER HOSPITAL910567732WAPsychiatric Hospital Unit (273R00000X)
United
793$1507.001205402468 - BURKE HOSPITAL COMPANY853939331 - BURKE HOSPITAL COMPANY, LLCGAMedicare Defined Swing Bed Hospital Unit (275N00000X)
United
793$67947.251245789981 - MERCY HEALTH, ANDERSON HOSPITAL - REHAB UNIT310537085OHRehabilitation Hospital Unit (273Y00000X)
United
793$67947.251245789981 - MERCY HEALTH, ANDERSON HOSPITAL - REHAB UNIT310537085OHRehabilitation Hospital Unit (273Y00000X)
United
793$113402.751184800468 - 390987025 - (WI) COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INCWIPsychiatric Hospital Unit (273R00000X)
United
793$47894.011891799227 - NORTON HOSPITALS, INC, NORTON HOSPITAL610703799 - (KY) NORTON HOSPITALS INCKYGeneral Acute Care Hospital (282N00000X)
United
793$78764.061508877689 - PROVIDENCE HEALTH & SERVICES WASHINGTON, PROVIDENCE ST. PETER HOSPITAL910567732WAPsychiatric Hospital Unit (273R00000X)
United
793$126011.651881690691 - UNIVERSITY HOSPITAL AT STONY BROOK, STONY BROOK EASTERN LONG ISLAND HOSPITAL113243405NYGeneral Acute Care Hospital (282N00000X)
United
793$5821.001205382413 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL ZARZAMORA452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLCTXGeneral Acute Care Hospital (282N00000X)
United
793$3783.001265561450 - TAKOMA REGIONAL HOSPITAL, INC, GREENEVILLE COMMUNITY HOSPITAL PSYCHIATRIC510603966 - TAKOMA REGIONAL HOSPITAL INCTNPsychiatric Hospital Unit (273R00000X)
United
793$4158.001376933580 - DICKENSON COMMUNITY HOSPITAL, INC, DICKENSON COMMUNITY HOSPITAL PSYCHIATRIC UNIT770599553 - DICKENSON COMMUNITY HOSPITAL INCVAPsychiatric Hospital Unit (273R00000X)
United
793$56387.781003822487 - LEGACY EMANUEL HOSPITAL & HEALTH CENTER, LEGACY EMANUEL HOSPITAL ADULT PSYCHIATRIC UNIT930386823 - LEGACY EMANUEL HOSPITAL & HEALTH CENTERORPsychiatric Hospital Unit (273R00000X)
United
793$30522.611477537017 - ROME MEMORIAL HOSPITAL, INC.161471634 - (NY) ROME MEMORIAL HOSPITAL INCNYRehabilitation Hospital Unit (273Y00000X)
United
793$65051.461154764819 - ST. CATHERINE OF SIENA MEDICAL CENTER61562701 - (NY) ST CATHERINE OF SIENA MEDICAL CENTERNYGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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MS-DRG 793 vs. Other Pregnancy, Childbirth & the Puerperium Codes

The MS-DRG 793 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 793 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.

CodeComplexityDescription
792-APR-DRGHighEXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT
792-MS-DRGHighPrematurity without Major Problems
793-MS-DRGHighFull Term Neonate with Major Problems
794-APR-DRGHighNON-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 793. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 793 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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