MS-DRG 799 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 799 by major payers:

$55,408.97

$60,570.61

$74,752.01

$76,601.43
| 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 799 | ||||||
United | 799 | $121953.92 | 1447227491 - HEALTHALLIANCE MARYS AVENUE CAMPUS, BENEDICTINE HOSPITAL | 141338470 - (NY) HEALTHALLIANCE HOSPITAL MARYS AVENUE CAMPUS | NY | Rehabilitation Hospital Unit (273Y00000X) |
United | 799 | $98609.79 | 1063426377 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION, ELMHURST HOSPITAL CENTER | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | General Acute Care Hospital (282N00000X) |
United | 799 | $44452.92 | 1891776217 - JEFFERSON COUNTY HMA, LLC, TENNOVA HEALTHCARE-JEFFERSON MEMORIAL HOSPITAL | 452528414 | TN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 799 | $44452.92 | 1891776217 - JEFFERSON COUNTY HMA, LLC, TENNOVA HEALTHCARE-JEFFERSON MEMORIAL HOSPITAL | 452528414 | TN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 799 | $90515.59 | 1881651990 - ALLINA HEALTH SYSTEM, OWATONNA HOSPITAL | 363261413 - ALLINA HEALTH SYSTEM | MN | Psychiatric Hospital Unit (273R00000X) |
United | 799 | $79714.25 | 1568461440 - APPALACHIAN REGIONAL HEALTHCARE, INC, BECKLEY ARH HOSPITAL | 520795508 - APPALACHIAN REGIONAL HEALTHCARE INC | WV | General Acute Care Hospital (282N00000X) |
United | 799 | $92077.34 | 1891904942 - ST JUDE HOSPITAL INC, PROVIDENCE ST. JUDE MEDICAL CENTER | 951643325 - (CA) ST JUDE HOSPITAL | CA | General Acute Care Hospital (282N00000X) |
United | 799 | $141693.04 | 1558576280 - PRISMA HEALTH-MIDLANDS | 582296052 - (SC) PRISMA HEALTH-MIDLANDS | SC | General Acute Care Hospital (282N00000X) |
United | 799 | $79143.64 | 1609345685 - MOUNTAIN VISTA MEDICAL CENTER, LP, FLORENCE HOSPITAL, A CAMPUS OF MOUNTAIN VISTA MEDICAL CENTER | 860181654 - HONORHEALTH | AZ | General Acute Care Hospital (282N00000X) |
United | 799 | $9314.00 | 1609800432 - THE BROOKLYN HOSPITAL CENTER | 111630755 - (NY) THE BROOKLYN HOSPITAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 799 | $52126.87 | 1477101376 - SSM SELECT REHAB ST. LOUIS, LLC, SSM HEALTH PHYSICAL THERAPY | 263694972 | MO | Rehabilitation Hospital (283X00000X) |
United | 799 | $52126.87 | 1477101376 - SSM SELECT REHAB ST. LOUIS, LLC, SSM HEALTH PHYSICAL THERAPY | 263694972 | MO | Rehabilitation Hospital (283X00000X) |
United | 799 | $99217.10 | 1659381895 - BON SECOURS-RICHMOND COMMUNITY HOSPITAL LLC, BON SECOURS RICHMOND COMMUNITY HOSPITAL PRO FEE SERVICE | 540647482 | VA | General Acute Care Hospital (282N00000X) |
United | 799 | $93821.71 | 1215903018 - COMMUNITY MEMORIAL HEALTH SYSTEM, COMMUNITY MEMORIAL HOSPITAL OF SAN BUENA VENTURA | 951683892 - COMMUNITY MEMORIAL HEALTH SYSTEM | CA | General Acute Care Hospital (282N00000X) |
United | 799 | $63940.14 | 1083757926 - MUSKOGEE REGIONAL MEDICAL CENTER LLC, MUSKOGEE REGIONAL MEDICAL CENTER REHABILITATION UNIT | 814322087 - (OK) SAINT FRANCIS HOSPITAL MUSKOGEE INC | OK | 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 799 vs. Other Pregnancy, Childbirth & the Puerperium Codes
The MS-DRG 799 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 799 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 |
|---|---|---|
| 798-MS-DRG | High | Vaginal Delivery with Sterilization and/or D&C without CC/MCC |
| 799-MS-DRG | High | Spleenic Procedures with MCC |
| 800-MS-DRG | High | Spleenic Procedures 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 799. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 799 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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