MS-DRG 807 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 807 by major payers:
$7,221.79
$7,933.81
$10,011.27
$10,340.27
| 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 807 | ||||||
United | 807 | $8604.00 | 1841510849 - MERIDIAN HOSPITALS CORPORATION, SOUTHERN OCEAN MEDICAL CENTER | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | General Acute Care Hospital (282N00000X) |
United | 807 | $15199.61 | 1588083745 - GREENVILLE HEALTH SYSTEM, GHS CANCER INST-GREER | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 807 | $4966.45 | 1871884031 - THC-SEATTLE LLC, KINDRED HOSPITAL SEATTLE - FIRST HILL | 911637321 | WA | Long Term Care Hospital (282E00000X) |
United | 807 | $12165.82 | 1053339507 - DAYTON OSTEOPATHIC HOSPITAL, KETTERING HEALTH DAYTON | 310564121 - (OH) DAYTON OSTEOPATHIC HOSPITAL | OH | General Acute Care Hospital (282N00000X) |
United | 807 | $6285.00 | 1700219037 - CHCA CONROE LP, CONROE REGIONAL MEDICAL CENTER | 621801361 - (TX) CHCA CONROE LP | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 807 | $7345.00 | 1740981430 - NORTHEAST GEORGIA MEDICAL CENTER HABERSHAM LLC | 922451946 | GA | General Acute Care Hospital (282N00000X) |
United | 807 | $9871.41 | 1548698723 - ES REHABILITATION LLC, EMORY REHABILITATION HOSPITAL | 463808276 | GA | Rehabilitation Hospital (283X00000X) |
United | 807 | $15199.61 | 1821544925 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH CANCER INST-SENECA | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 807 | $7598.89 | 1942240189 - REFUGIO COUNTY MEMORIAL HOSPITAL DISTRICT | 741915330 - (TX) REFUGIO COUNTY MEMORIAL HOSPITAL DISTRICT | TX | Critical Access Hospital (282NC0060X) |
United | 807 | $7596.00 | 1346230323 - SPRING VALLEY MEDICAL CENTER | 721549752 | NV | General Acute Care Hospital (282N00000X) |
United | 807 | $4355.00 | 1881977593 - DLP PERSON MEMORIAL HOSPITAL LLC, PERSON MEMORIAL HOSPITAL | 452909143 | NC | General Acute Care Hospital (282N00000X) |
United | 807 | $13784.79 | 1881729036 - TAYLORVILLE MEMORIAL CHILDRENS HOSPITAL | 370661250 - (IL) MEMORIAL HEALTH SYSTEM | IL | Children's Hospital (282NC2000X) |
United | 807 | $6080.00 | 1538471800 - VHS CHILDRENS HOSPITAL OF MICHIGAN INC, CHILDRENS HOSPITAL OF MICHIGAN | 272845064 | MI | Children's Hospital (282NC2000X) |
United | 807 | $4980.72 | 1467493551 - MERCY HEALTH, MERCY HEALTH ST VINCENT MEDICAL CENTER | 344428250 - MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC | OH | General Acute Care Hospital (282N00000X) |
United | 807 | $5281.00 | 1871606764 - GLENS FALLS HOSPITAL INC | 141338413 - ALBANY MED HEALTH SYSTEM | 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 807 vs. Other Pregnancy, Childbirth & the Puerperium Codes
The MS-DRG 807 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 807 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 |
|---|---|---|
| 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 |
| 808-MS-DRG | High | Major Hematological and Immunological Diagnoses except Sickle Cell Crisis and Coagulation Disorders 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 807. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 807 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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