MS-DRG 802 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 802 by major payers:
$39,331.51
$46,759.32
$56,121.76
$57,624.04
| 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 802 | ||||||
United | 802 | $28527.83 | 1033117635 - GUTHRIE CORTLAND MEDICAL CENTER | 150532079 - (NY) GUTHRIE CORTLAND MEDICAL CENTER | NY | Psychiatric Hospital Unit (273R00000X) |
United | 802 | $66016.21 | 1891870994 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 802 | $77719.06 | 1548357973 - DECATUR MEMORIAL HOSPITAL | 370661199 - DECATUR MEMORIAL HOSPITAL | IL | General Acute Care Hospital (282N00000X) |
United | 802 | $13459.17 | 1225339898 - SCREVEN COUNTY HOSPITAL, LLC, OPTIM MEDICAL CENTER - SCREVEN | 273100946 | GA | Critical Access Hospital (282NC0060X) |
United | 802 | $36278.17 | 1104823178 - MERCY HOSPITAL SCRANTON PENNSYLVANIA | 274564798 | PA | General Acute Care Hospital (282N00000X) |
United | 802 | $78919.84 | 1043397292 - UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER, UHCMC | 341567805 - UNIVERSITY HOSPITALS HEALTH SYSTEM INC | OH | General Acute Care Hospital (282N00000X) |
United | 802 | $35848.00 | 1013379528 - BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION, THE MEDICAL CENTER AT ALBANY | 610920842 - (KY) BOWLING GREEN-WARREN COUNTY COMMUNITY HOSPITAL CORPORATION | KY | Critical Access Hospital (282NC0060X) |
United | 802 | $8787.00 | 1780747097 - FREEMAN-OAK HILL HEALTH SYSTEM | 431704371 - FREEMAN HEALTH SYSTEM | MO | General Acute Care Hospital (282N00000X) |
United | 802 | $31789.78 | 1093744187 - BAPTIST HOSPITALS OF SOUTHEAST TEXAS, MEMORIAL HERMANN BAPTIST BEAUMONT HOSPITAL | 741303720 - BAPTIST HOSPITALS OF SOUTHEAST TEXAS | TX | General Acute Care Hospital (282N00000X) |
United | 802 | $36214.00 | 1295817260 - WHITE RIVER HEALTH SYSTEM, INC, WHITE RIVER MEDICAL CENTER | 710411459 - WHITE RIVER HEALTH SYSTEM INC | AR | Psychiatric Hospital Unit (273R00000X) |
United | 802 | $115893.00 | 1295755536 - ANMED HEALTH, ANMED | 570359174 - ANMED HEALTH | SC | General Acute Care Hospital (282N00000X) |
United | 802 | $54256.19 | 1780600577 - MARY IMOGENE BASSETT HOSPITAL, BASSETT HEALTHCARE | 135596796 - MARY IMOGENE BASSETT HOSPITAL | NY | Rural Acute Care Hospital (282NR1301X) |
United | 802 | $28479.07 | 1033160049 - RUSSELLVILLE HOLDINGS LLC, ST . MARY'S REGIONAL MEDICAL CENTER | 621771866 - (AR) RUSSELLVILLE HOLDINGS LLC | AR | General Acute Care Hospital (282N00000X) |
United | 802 | $85145.59 | 1053382655 - FOLEY HOSPITAL COMPANY LLC, SOUTH BALDWIN REGIONAL MEDICAL CENTER | 621811413 - (AL) FOLEY HOSPITAL CORPORATION | AL | General Acute Care Hospital (282N00000X) |
United | 802 | $86370.39 | 1700553856 - SOUTHERN BAPTIST HOSPITAL OF FLORIDA, INC | 590747311 - SOUTHERN BAPTIST HOSPITAL OF FLORIDA INC | FL | Children's Hospital (282NC2000X) |
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 802 vs. Other Pregnancy, Childbirth & the Puerperium Codes
The MS-DRG 802 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 802 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 |
|---|---|---|
| 801-APR-DRG | Moderate | Acute Major Eye Infections |
| 801-MS-DRG | High | Spleenic Procedures without CC/MCC |
| 802-MS-DRG | High | Other O.R. Procedures of the Blood and Blood Forming Organs with MCC |
| 803-APR-DRG | Moderate | Acute Major Eye Infections |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 802. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 802 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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