MS-DRG 796 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 796 by major payers:
$14,043.94
$11,768.02
$16,763.46
$20,400.03
| 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 796 | ||||||
United | 796 | $15323.03 | 1538219944 - UCHEALTH PIKES PEAK REGIONAL HOSPITAL | 824191576 - (CO) UCHEALTH PIKES PEAK REGIONAL HOSPITAL | CO | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 796 | $22907.16 | 1952497489 - OUR LADY OF LOURDES REGIONAL MEDICAL CENTER INC | 720423635 - OUR LADY OF LOURDES REGIONAL MEDICAL CENTER INC | LA | General Acute Care Hospital (282N00000X) |
United | 796 | $5947.00 | 1750788667 - CARONDELET HEALTH NETWORK, BRIDGES GEROPSYCHIATRIC PROGRAM AT ST. MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 796 | $29451.90 | 1518969419 - AHS HOSPITAL CORP, HACKETTSTOWN MEDICAL CENTER | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | General Acute Care Hospital (282N00000X) |
United | 796 | $7844.00 | 1841299039 - EMH REGIONAL MEDICAL CENTER, UNIVERSITY HOSPITALS ELYRIA MEDICAL CENTER | 340714612 - (OH) UNIVERSITY HOSPITALS HEALTH SYSTEM INC | OH | General Acute Care Hospital (282N00000X) |
United | 796 | $9093.00 | 1184655953 - BROOKWOOD HEALTH SERVICES, INC., BROOKWOOD MEDICAL CENTER | 474757851 | AL | Psychiatric Hospital Unit (273R00000X) |
United | 796 | $28526.85 | 1659751360 - PROVIDENCE HEALTH & SERVICES OREGON, PROVIDENCE MILWAUKIE HOSPITAL - GERIATRIC PSYCHIATRIC UNIT | 930924302 - (OR) PROVIDENCE HEALTH & SERVICES OREGON | OR | Psychiatric Hospital Unit (273R00000X) |
United | 796 | $31943.98 | 1437119310 - SENTARA HOSPITALS, SENTARA NORFOLK GENERAL HOSPITAL | 541547408 - SENTARA HOSPITALS | VA | General Acute Care Hospital (282N00000X) |
United | 796 | $21122.61 | 1598797094 - SLH VISTA, INC., SAINT LOUIS UNIVERSITY HOSPITAL | 474196634 - (MO) SSM-SLUH INC | MO | General Acute Care Hospital (282N00000X) |
United | 796 | $9250.67 | 1144339839 - SIMPSON COMMUNITY HEALTHCARE, INC., SIMPSON GENERAL HOSPITAL | 870741588 - (MS) SIMPSON COMMUNITY HEALTHCARE INC | MS | Critical Access Hospital (282NC0060X) |
United | 796 | $8253.00 | 1043304975 - UNIVERSITY OF NORTH CAROLINA HOSPITALS AT CHAPEL HILL, UNC HOSPITALS REHABILITATION CENTER | 561118388 | NC | Rehabilitation Hospital Unit (273Y00000X) |
United | 796 | $11152.40 | 1831151257 - SWEDISH COVENANT HEALTH, SWEDISH COVENANT HOSPITAL | 362179813 - (IL) SWEDISH COVENANT HEALTH | IL | General Acute Care Hospital (282N00000X) |
United | 796 | $20506.00 | 1073504528 - SOUTHERN OCEAN COUNTY HOSPITAL | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | General Acute Care Hospital (282N00000X) |
United | 796 | $9854.46 | 1982675955 - SAINT FRANCIS MEDICAL CENTER, CHI HEALTH ST. FRANCIS | 470376601 - (NE) SAINT FRANCIS MEDICAL CENTER | NE | General Acute Care Hospital (282N00000X) |
United | 796 | $2320.00 | 1134166036 - CLHG-WINN, LLC, WINN PARISH MEDICAL CENTER | 813465517 | LA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
MS-DRG 796 vs. Other Pregnancy, Childbirth & the Puerperium Codes
The MS-DRG 796 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 796 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 |
|---|---|---|
| 795-MS-DRG | High | Normal Newborn |
| 796-MS-DRG | High | Vaginal Delivery with Sterilization and/or D&C with MCC |
| 797-MS-DRG | High | Vaginal Delivery with Sterilization and/or D&C with CC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 796. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 796 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like MS-DRG 796) and we'll show you how you compare in 15 minutes or less.