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MS-DRG 799 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.

Spleenic Procedures with MCC
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 799 by major payers:

bcbs

$55,408.97

uhc

$60,570.61

aetna

$74,752.01

cigna

$76,601.43

Preview provider-level rates for...
For billing codeMS-DRG 799
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for MS-DRG 799

United
799$121953.921447227491 - HEALTHALLIANCE MARYS AVENUE CAMPUS, BENEDICTINE HOSPITAL141338470 - (NY) HEALTHALLIANCE HOSPITAL MARYS AVENUE CAMPUSNYRehabilitation Hospital Unit (273Y00000X)
United
799$98609.791063426377 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION, ELMHURST HOSPITAL CENTER132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATIONNYGeneral Acute Care Hospital (282N00000X)
United
799$44452.921891776217 - JEFFERSON COUNTY HMA, LLC, TENNOVA HEALTHCARE-JEFFERSON MEMORIAL HOSPITAL452528414TNMedicare Defined Swing Bed Hospital Unit (275N00000X)
United
799$44452.921891776217 - JEFFERSON COUNTY HMA, LLC, TENNOVA HEALTHCARE-JEFFERSON MEMORIAL HOSPITAL452528414TNMedicare Defined Swing Bed Hospital Unit (275N00000X)
United
799$90515.591881651990 - ALLINA HEALTH SYSTEM, OWATONNA HOSPITAL363261413 - ALLINA HEALTH SYSTEMMNPsychiatric Hospital Unit (273R00000X)
United
799$79714.251568461440 - APPALACHIAN REGIONAL HEALTHCARE, INC, BECKLEY ARH HOSPITAL520795508 - APPALACHIAN REGIONAL HEALTHCARE INCWVGeneral Acute Care Hospital (282N00000X)
United
799$92077.341891904942 - ST JUDE HOSPITAL INC, PROVIDENCE ST. JUDE MEDICAL CENTER951643325 - (CA) ST JUDE HOSPITALCAGeneral Acute Care Hospital (282N00000X)
United
799$141693.041558576280 - PRISMA HEALTH-MIDLANDS582296052 - (SC) PRISMA HEALTH-MIDLANDSSCGeneral Acute Care Hospital (282N00000X)
United
799$79143.641609345685 - MOUNTAIN VISTA MEDICAL CENTER, LP, FLORENCE HOSPITAL, A CAMPUS OF MOUNTAIN VISTA MEDICAL CENTER860181654 - HONORHEALTHAZGeneral Acute Care Hospital (282N00000X)
United
799$9314.001609800432 - THE BROOKLYN HOSPITAL CENTER111630755 - (NY) THE BROOKLYN HOSPITAL CENTERNYGeneral Acute Care Hospital (282N00000X)
United
799$52126.871477101376 - SSM SELECT REHAB ST. LOUIS, LLC, SSM HEALTH PHYSICAL THERAPY263694972MORehabilitation Hospital (283X00000X)
United
799$52126.871477101376 - SSM SELECT REHAB ST. LOUIS, LLC, SSM HEALTH PHYSICAL THERAPY263694972MORehabilitation Hospital (283X00000X)
United
799$99217.101659381895 - BON SECOURS-RICHMOND COMMUNITY HOSPITAL LLC, BON SECOURS RICHMOND COMMUNITY HOSPITAL PRO FEE SERVICE540647482VAGeneral Acute Care Hospital (282N00000X)
United
799$93821.711215903018 - COMMUNITY MEMORIAL HEALTH SYSTEM, COMMUNITY MEMORIAL HOSPITAL OF SAN BUENA VENTURA951683892 - COMMUNITY MEMORIAL HEALTH SYSTEMCAGeneral Acute Care Hospital (282N00000X)
United
799$63940.141083757926 - MUSKOGEE REGIONAL MEDICAL CENTER LLC, MUSKOGEE REGIONAL MEDICAL CENTER REHABILITATION UNIT814322087 - (OK) SAINT FRANCIS HOSPITAL MUSKOGEE INCOKRehabilitation Hospital Unit (273Y00000X)
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 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.

CodeComplexityDescription
798-MS-DRGHighVaginal Delivery with Sterilization and/or D&C without CC/MCC
799-MS-DRGHighSpleenic Procedures with MCC
800-MS-DRGHighSpleenic 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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