MS-DRG 806 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 806 by major payers:
$8,254.74
$8,377.52
$10,948.23
$11,742.51
| 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 806 | ||||||
United | 806 | $3105.00 | 1245284769 - OUACHITA COUNTY MEDICAL CENTER | 710766341 - (AR) OUACHITA COUNTY MEDICAL CENTER | AR | Rural Acute Care Hospital (282NR1301X) |
United | 806 | $2687.00 | 1538522412 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE TRANSMOUNTAIN CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 806 | $14524.05 | 1497119218 - THEDACARE REGIONAL MEDICAL CENTER, APPLETON MEDICAL CENTER, INC. | 350983617 - COMMUNITY HEALTH NETWORK INC | WI | General Acute Care Hospital (282N00000X) |
United | 806 | $3999.00 | 1093708679 - ASCENSION PROVIDENCE | 741109636 - (TX) ASCENSION PROVIDENCE | TX | General Acute Care Hospital (282N00000X) |
United | 806 | $5993.00 | 1265818488 - SMSJ TUCSON HOLDINGS LLC, ST. MARYS HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 806 | $27313.00 | 1083713788 - UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER, UCSF MEDICAL CENTER | 943281657 | CA | General Acute Care Hospital (282N00000X) |
United | 806 | $6187.75 | 1467427674 - HOSPITAL DISTRICT NO 6 OF HARPER COUNTY KANSAS, PATTERSON HEALTH CENTER | 480993940 - (KS) HOSPITAL DISTRICT NO 6 OF HARPER COUNTY KANSAS | KS | Critical Access Hospital (282NC0060X) |
United | 806 | $24311.50 | 1659787554 - BANNER HEALTH, BANNER FORT COLLINS MEDICAL CENTER | 450233470 - BANNER HEALTH | CO | General Acute Care Hospital (282N00000X) |
United | 806 | $19405.50 | 1013389089 - MAIMONIDES MEDICAL CENTER | 111635081 - (NY) MAIMONIDES MEDICAL CENTER- | NY | General Acute Care Hospital (282N00000X) |
United | 806 | $2745.00 | 1538522412 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE TRANSMOUNTAIN CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 806 | $7012.00 | 1548291883 - TEXAS HEALTH PRESBYTERIAN HOSPITAL ALLEN | 752771569 - (TX) MOTHER FRANCES HOSPITAL-WINNSBORO | TX | General Acute Care Hospital (282N00000X) |
United | 806 | $10186.00 | 1548291883 - TEXAS HEALTH PRESBYTERIAN HOSPITAL ALLEN | 752890358 - (TX) TEXAS HEALTH PRESBYTERIAN HOSPITAL ALLEN | TX | General Acute Care Hospital (282N00000X) |
United | 806 | $27313.00 | 1083713788 - UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER, UCSF MEDICAL CENTER | 943281657 | CA | General Acute Care Hospital (282N00000X) |
United | 806 | $17442.38 | 1972139004 - BANNER HEALTH, BANNER OCOTILLO MEDICAL CENTER | 450233470 - BANNER HEALTH | AZ | General Acute Care Hospital (282N00000X) |
United | 806 | $10023.00 | 1568429454 - COMMUNITY MERCY HEALTH PARTNERS, MERCY HEALTH - URBANA HOSPITAL | 310785684 - COMMUNITY MERCY HEALTH PARTNERS | OH | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
MS-DRG 806 vs. Other Pregnancy, Childbirth & the Puerperium Codes
The MS-DRG 806 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 806 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 |
|---|---|---|
| 805-MS-DRG | High | Vaginal Delivery without Sterilization or D&C with MCC |
| 806-MS-DRG | High | Vaginal Delivery without Sterilization or D&C with CC |
| 807-MS-DRG | High | Vaginal Delivery without Sterilization or D&C without CC/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 806. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 806 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like MS-DRG 806) and we'll show you how you compare in 15 minutes or less.