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 | $59509.69 | 1073536553 - DUBOIS REGIONAL MEDICAL CENTER, DRMC SWING BED | 251490707 - DUBOIS REGIONAL MEDICAL CENTER | PA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 799 | $3308.00 | 1902236573 - CREEK NATION HOSPITAL & CLINICS, MUSCOGEE (CREEK) NATION MEDICAL CENTER | 731357965 - MUSCOGEE (CREEK) NATION DEPARTMENT OF HEALTH | OK | General Acute Care Hospital (282N00000X) |
United | 799 | $5761.00 | 1235510090 - HERITAGE PARK SURGICAL HOSPITAL LLC, BAYLOR SCOTT & WHITE SURGICAL HOSPITAL AT SHERMAN | 611762781 | TX | 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 | $100730.43 | 1053301127 - AUGUSTA HEALTH CARE, INC, T/A AUGUSTA HEALTH | 541453954 - AUGUSTA HEALTH CARE INC | VA | General Acute Care Hospital (282N00000X) |
United | 799 | $56410.94 | 1265445506 - WILLIAMSON COUNTY HOSPITAL DISTRICT, WILLIAMSON MEDICAL CENTER | 621501534 | TN | General Acute Care Hospital (282N00000X) |
United | 799 | $51483.32 | 1679679146 - SAINT JOSEPH HEALTH SYSTEM, INC, CHI SAINT JOSEPH MOUNT STERLING | 611334601 - (KY) SAINT JOSEPH HEALTH SYSTEM INC | KY | General Acute Care Hospital (282N00000X) |
United | 799 | $93066.81 | 1316904287 - ALLINA HEALTH SYSTEM, MERCY HOSPITAL | 363261413 - ALLINA HEALTH SYSTEM | MN | General Acute Care Hospital (282N00000X) |
United | 799 | $144122.73 | 1093777492 - MAIMONIDES MEDICAL CENTER | 111635081 - (NY) MAIMONIDES MEDICAL CENTER- | NY | General Acute Care Hospital (282N00000X) |
United | 799 | $58489.05 | 1386802023 - SOUTHEAST HEALTH CENTER OF STODDARD COUNTY, LLC, MERCY HOSPITAL STODDARD | 461481133 - (MO) SOUTHEAST HEALTH CENTER OF STODDARD COUNTY LLC | MO | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 799 | $141693.04 | 1073001715 - PALMETTO HEALTH | 582296052 - (SC) PRISMA HEALTH-MIDLANDS | SC | Hospitalist Physician (208M00000X) |
United | 799 | $80494.00 | 1861435042 - SAINT VINCENT HEALTH CENTER | 250965547 - (PA) HIGHMARK HEALTH | PA | General Acute Care Hospital (282N00000X) |
United | 799 | $107857.88 | 1013534445 - SARASOTA COUNTY PUBLIC HOSPITAL DISTRICT, SARASOTA MEMORIAL HOSPITAL - VENICE | 596012500 - (FL) SARASOTA COUNTY PUBLIC HOSPITAL DISTRICT | FL | 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 | $9314.00 | 1609800432 - THE BROOKLYN HOSPITAL CENTER | 111630755 - (NY) THE BROOKLYN HOSPITAL CENTER | NY | 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 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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