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 | $16775.53 | 1477531580 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 812 | $15266.00 | 1366492977 - LUCY WEBB HAYES NATIONAL TRAINING SCHOOL FOR DEACONESSES & MISSIONARIE, SIBLEY MEMORIAL HOSPITAL | 530196602 - (DC) LUCY WEBB HAYNES NATIONAL TRAINING SCHOOL FOR DEACONESSES AND MISSION | DC | General Acute Care Hospital (282N00000X) |
United | 812 | $18582.58 | 1942233028 - GREENE MEMORIAL HOSPITAL | 310809436 - (OH) GREENE MEMORIAL HOSPITAL INC | OH | General Acute Care Hospital (282N00000X) |
United | 812 | $15795.42 | 1184747883 - INOVA LOUDOUN HOSPITAL | 540620889 - INOVA HEALTH CARE SERVICES | VA | General Acute Care Hospital (282N00000X) |
United | 812 | $3191.00 | 1225450588 - PARISH HOSPITAL SERVICE DISTRICT FOR THE PARISH OF ORLEANS, NEW ORLEANS EAST HOSPITAL | 273335876 | LA | General Acute Care Hospital (282N00000X) |
United | 812 | $8160.27 | 1043505225 - PECOS COUNTY MEMORIAL HOSPITAL | 921628671 | TX | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 812 | $12386.54 | 1245353747 - DALLAM-HARTLEY COUNTIES HOSPITAL DISTRICT, COON MEMORIAL HOSPITAL | 751702162 | TX | Critical Access Hospital (282NC0060X) |
United | 812 | $10807.16 | 1962451195 - BROOKDALE HOSPITAL MEDICAL CENTER, BROOKDALE EMERGENCY PHYSICIANS ASSOCIATES | 111631746 - BROOKDALE HOSPITAL MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 812 | $10339.53 | 1932160082 - MARION REGIONAL MEDICAL CENTER, INC., MARION REGIONAL MEDICAL CENTER | 640926753 - (AL) MARION REGIONAL MEDICAL CENTER INC | AL | General Acute Care Hospital (282N00000X) |
United | 812 | $16012.32 | 1366436123 - OUR LADY OF THE LAKE HOSPITAL INC., OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER | 720423651 - (LA) OUR LADY OF THE LAKE HOSPITAL INC | LA | General Acute Care Hospital (282N00000X) |
United | 812 | $16302.11 | 1578648614 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 812 | $3952.00 | 1760443980 - SKAGGS COMMUNITY HOSPITAL ASSOCIATION, COX MEDICAL CENTER BRANSON | 440584290 - (MO) SKAGGS COMMUNITY HOSPITAL ASSOCIATION | MO | General Acute Care Hospital (282N00000X) |
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 | $10339.53 | 1851619241 - BASTROP REHABILITATION HOSPITAL, LLC, RIVERBEND REHABILITATION HOSPITAL | 721460782 - (LA) BASTROP REHABILITATION HOSPITAL LLC | LA | Rehabilitation Hospital (283X00000X) |
United | 812 | $10032.90 | 1922542604 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Rehabilitation Hospital Unit (273Y00000X) |
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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