MS-DRG 801 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 801 by major payers:
$20,621.75
$21,481.43
$25,965.77
$26,834.21
| 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 801 | ||||||
United | 801 | $7275.00 | 1689782872 - FREEMAN NEOSHO HOSPITAL | 431240629 - (MO) FREEMAN NEOSHO HOSPITAL | MO | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 801 | $18827.01 | 1184057309 - STAR MEDICAL CENTER, LLC, STAR MEDICAL CENTER | 462945429 - (TX) STAR MEDICAL CENTER, LLC | TX | Special Hospital (284300000X) |
United | 801 | $17118.00 | 1801821947 - LESTER E COX MEDICAL CENTERS, COX MEDICAL CENTERS MEYER ORTHOPEDIC AND REHABILITATION HOSPITAL | 440577118 - LESTER E COX MEDICAL CENTER | MO | Rehabilitation Hospital Unit (273Y00000X) |
United | 801 | $14840.96 | 1679880041 - SALINE COUNTY MEDICAL CENTER, SALINE MEMORIAL HOSPITAL | 812816675 | AR | General Acute Care Hospital (282N00000X) |
United | 801 | $47522.16 | 1225081516 - GADSDEN REGIONAL MEDICAL CENTER LLC, GADSDEN REGIONAL MEDICAL CENTER | 631102774 | AL | General Acute Care Hospital (282N00000X) |
United | 801 | $2525.00 | 1679596860 - ST DOMINIC-JACKSON MEMORIAL HOSPITAL | 640303091 - (MS) ST DOMINIC-JACKSON MEMORIAL HOSPITAL | MS | Psychiatric Hospital Unit (273R00000X) |
United | 801 | $24574.66 | 1508049800 - SUMMA BARBERTON CITIZENS HOSPITAL, BARBERTON CITIZENS HOSPITAL PSYCHIATRIC UNIT | 340714755 - SUMMA HEALTH SYSTEM | OH | Psychiatric Hospital Unit (273R00000X) |
United | 801 | $17118.00 | 1760549562 - SKAGGS COMMUNITY HOSPITAL ASSOCIATION, COX MEDICAL CENTER BRANSON | 440577118 - LESTER E COX MEDICAL CENTER | MO | Rehabilitation Hospital Unit (273Y00000X) |
United | 801 | $31255.78 | 1801815576 - MERCY HEALTH-ST CHARLES HOSPITAL LLC, ST CHARLES HOSPITAL OF OREGON, OHIO | 344428250 - MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC | OH | Psychiatric Hospital Unit (273R00000X) |
United | 801 | $67818.63 | 1205605409 - SOUTH CAROLINA COASTAL MEDICAL CENTER LLC | 934580630 | SC | General Acute Care Hospital (282N00000X) |
United | 801 | $48590.78 | 1770626426 - DIGNITY HEALTH, ST. ROSE DOMINICAN HOSPITAL, SIENA CAMPUS | 880455713 - (NV) DIGNITY HEALTH | NV | General Acute Care Hospital (282N00000X) |
United | 801 | $6893.02 | 1427075027 - FLETCHER HOSPITAL INC., PARK RIDGE HEALTH, PARK RIDGE HOSPITAL | 560543246 - FLETCHER HOSPITAL INC | NC | Rural Acute Care Hospital (282NR1301X) |
United | 801 | $35844.10 | 1669461281 - INTERMOUNTAIN FRONT RANGE, INC. | 841103606 - (CO) SCL HEALTH - FRONT RANGE INC | CO | General Acute Care Hospital (282N00000X) |
United | 801 | $67818.63 | 1205605409 - SOUTH CAROLINA COASTAL MEDICAL CENTER LLC | 934580630 | SC | General Acute Care Hospital (282N00000X) |
United | 801 | $6632.00 | 1205089026 - PRIME HEALTHCARE SERVICES | 263487583 | CA | 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 801 vs. Other Pregnancy, Childbirth & the Puerperium Codes
The MS-DRG 801 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 801 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 |
|---|---|---|
| 800-MS-DRG | High | Spleenic Procedures with CC |
| 801-MS-DRG | High | Spleenic Procedures without CC/MCC |
| 802-APR-DRG | Moderate | Acute Major Eye Infections |
| 802-MS-DRG | High | Other O.R. Procedures of the Blood and Blood Forming Organs 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 801. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 801 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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