MS-DRG 798 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 798 by major payers:
$10,028.55
$9,816.67
$13,619.37
$15,672.36
| 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 798 | ||||||
United | 798 | $5802.00 | 1497775381 - SOUTHCOAST HOSPITALS GROUP, INC, ST. LUKE'S HOSPITAL - PSYCH | 222592333 - SOUTHCOAST HOSPITALS GROUP INC | MA | Psychiatric Hospital Unit (273R00000X) |
United | 798 | $1825.00 | 1114627072 - STONEBRIDGE HEALTH SYSTEMS, LLC | 464145136 - (LA) STONEBRIDGE HEALTH SYSTEMS LLC | LA | Psychiatric Hospital (283Q00000X) |
United | 798 | $10964.00 | 1265568638 - SCOTT & WHITE HOSPITAL, BAYLOR SCOTT & WHITE MEDICAL CENTER - ROUND ROCK | 203749695 - (TX) SCOTT & WHITE HOSPITAL ROUND ROCK | TX | General Acute Care Hospital (282N00000X) |
United | 798 | $7650.00 | 1326564071 - MULTICARE HEALTH SYSTEM, MULTICARE COVINGTON MEDICAL CENTER | 911352172 - MULTICARE HEALTH SYSTEM | WA | General Acute Care Hospital (282N00000X) |
United | 798 | $7012.00 | 1275997264 - TEXAS HEALTH PRESBYTERIAN HOSPITAL ALLEN, TEXAS HEALTH BEHAVIORAL HEALTH HOSPITAL ALLEN | 752771569 - (TX) MOTHER FRANCES HOSPITAL-WINNSBORO | TX | Psychiatric Hospital Unit (273R00000X) |
United | 798 | $13938.20 | 1386896306 - LANSDALE HOSPITAL CORPORATION, LANSDALE HOSPITAL | 263359979 - (PA) LANSDALE HOSPITAL CORPORATION | PA | General Acute Care Hospital (282N00000X) |
United | 798 | $15356.62 | 1730194259 - MEMORIAL MEDICAL CENTER, CENTEGRA HOSPITAL WOODSTOCK | 362338884 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | General Acute Care Hospital (282N00000X) |
United | 798 | $5320.00 | 1386697688 - ORO VALLEY HOSPITAL LLC, ORO VALLEY HOSPITAL | 522379881 | AZ | General Acute Care Hospital (282N00000X) |
United | 798 | $5320.00 | 1386697688 - ORO VALLEY HOSPITAL LLC, ORO VALLEY HOSPITAL | 522379881 | AZ | General Acute Care Hospital (282N00000X) |
United | 798 | $13027.12 | 1740475847 - ALTRU HEALTH SYSTEM, ALTRU HEALTH SYSTEM (CHRONIC PAIN PROGRAM) | 450310462 - ALTRU HEALTH SYSTEM | ND | Rehabilitation Hospital Unit (273Y00000X) |
United | 798 | $8884.00 | 1164876546 - BBH PBMC, LLC, PRINCETON BAPTIST MEDICAL CENTER | 474775351 | AL | General Acute Care Hospital (282N00000X) |
United | 798 | $8884.00 | 1164876546 - BBH PBMC, LLC, PRINCETON BAPTIST MEDICAL CENTER | 474775351 | AL | General Acute Care Hospital (282N00000X) |
United | 798 | $11187.00 | 1942223482 - LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER | 930386793 - LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER PAYROLL DEPT | OR | Rehabilitation Hospital Unit (273Y00000X) |
United | 798 | $11843.00 | 1336637438 - CHILDREN'S HOSPITAL COLORADO, CHILDREN'S HOSPITAL COLORADO, COLORADO SPRINGS | 840166760 - CHILDRENS HOSPITAL COLORADO | CO | Children's Hospital (282NC2000X) |
United | 798 | $7128.00 | 1942247598 - LEA REGIONAL HOSPITAL LLC | 844273963 - (NM) COVENANT HOSPITAL HOBBS | NM | Rehabilitation Hospital Unit (273Y00000X) |
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 798 vs. Other Pregnancy, Childbirth & the Puerperium Codes
The MS-DRG 798 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 798 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 |
|---|---|---|
| 797-MS-DRG | High | Vaginal Delivery with Sterilization and/or D&C with CC |
| 798-MS-DRG | High | Vaginal Delivery with Sterilization and/or D&C without CC/MCC |
| 799-MS-DRG | High | Spleenic Procedures with 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 798. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 798 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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