MS-DRG 812 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 812 by major payers:
$10,055.38
$12,803.14
$14,558.91
$14,968.04
| 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 812 | ||||||
United | 812 | $8160.27 | 1043505225 - PECOS COUNTY MEMORIAL HOSPITAL | 921628671 | TX | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 812 | $11896.17 | 1104075704 - VIRGINIA HOSPITAL CENTER ARLINGTON | 540505989 - (VA) VIRGINIA HOSPITAL CENTER ARLINGTON HEALTH SYSTEM | VA | Psychiatric Hospital Unit (273R00000X) |
United | 812 | $15795.42 | 1184747883 - INOVA LOUDOUN HOSPITAL | 540620889 - INOVA HEALTH CARE SERVICES | VA | General Acute Care Hospital (282N00000X) |
United | 812 | $30931.91 | 1336206580 - MCKEE MEDICAL CENTER | 840826332 - (CO) MCKEE MEDICAL CENTER | CO | Rehabilitation Hospital Unit (273Y00000X) |
United | 812 | $29478.34 | 1013389089 - MAIMONIDES MEDICAL CENTER | 111635081 - (NY) MAIMONIDES MEDICAL CENTER- | NY | General Acute Care Hospital (282N00000X) |
United | 812 | $17044.11 | 1124463815 - AURORA MEDICAL CENTER GRAFTON | 272953799 - AURORA HEALTH CARE INC | WI | Rehabilitation Hospital Unit (273Y00000X) |
United | 812 | $16825.98 | 1154980118 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 812 | $8622.00 | 1235419144 - STATEN ISLAND UNIVERSITY HOSPITAL | 112868878 - (NY) STATEN ISLAND UNIVERSITY HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 812 | $31240.16 | 1568759991 - VHS HARLINGEN HOSPITAL COMPANY LLC, VALLEY BAPTIST MEDICAL CENTER - REHAB UNIT | 452662980 | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 812 | $16645.33 | 1134223878 - PROVIDENCE EVERETT MEDICAL CENTER, INPATIENT REHABILITATION FACILITY | 352346161 | WA | Rehabilitation Hospital Unit (273Y00000X) |
United | 812 | $15912.63 | 1174977557 - BBH CBMC, LLC, CITIZENS BAPTIST MEDICAL CENTER | 474802869 | AL | General Acute Care Hospital (282N00000X) |
United | 812 | $8899.50 | 1508901448 - ST. JOSEPH HEALTH SERVICES OF RI, PULMONARY GROUP | 464661337 | RI | General Acute Care Hospital (282N00000X) |
United | 812 | $13594.32 | 1982733655 - DIGNITY HEALTH, ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER | 463533638 - (AZ) DIGNITY HEALTH | AZ | General Acute Care Hospital (282N00000X) |
United | 812 | $9972.86 | 1306816426 - ASCENSION MACOMB OAKLAND HOSPITAL, ST. JOHN MACOMB OAKLAND HOSPITAL-WARREN CAMPUS | 383322109 - ASCENSION MACOMB OAKLAND HOSPITAL | MI | Psychiatric Hospital Unit (273R00000X) |
United | 812 | $7239.83 | 1760598692 - PECOS COUNTY MEMORIAL HOSPITAL | 746002963 | TX | Critical Access Hospital (282NC0060X) |
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 812 vs. Other Pregnancy, Childbirth & the Puerperium Codes
The MS-DRG 812 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 812 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 |
|---|---|---|
| 811-APR-DRG | High | ALLERGIC REACTIONS |
| 811-MS-DRG | High | Red Blood Cell Disorders with MCC |
| 812-MS-DRG | High | Red Blood Cell Disorders without MCC |
| 813-APR-DRG | High | OTHER COMPLICATIONS OF TREATMENT |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 812. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 812 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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