MS-DRG 817 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 817 by major payers:
$27,894.58
$32,134.90
$39,592.39
$39,941.63
| 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 817 | ||||||
United | 817 | $53417.08 | 1902474430 - FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC, FROEDTERT COMMUNITY HOSPITAL | 843381796 | WI | General Acute Care Hospital (282N00000X) |
United | 817 | $33270.64 | 1780763284 - SSM HEALTH CARE ST. LOUIS, SSM HEALTH ST. MARY'S HOSPITAL - ST. LOUIS | 431343281 - SSM HEALTH CARE ST LOUIS | MO | Psychiatric Hospital Unit (273R00000X) |
United | 817 | $108839.45 | 1053359729 - HARBORVIEW MEDICAL CENTER | 911631806 | WA | General Acute Care Hospital (282N00000X) |
United | 817 | $27032.08 | 1992931109 - CRESTWOOD MEDICAL CENTER | 621647983 | AL | General Acute Care Hospital (282N00000X) |
United | 817 | $27868.34 | 1306212923 - SMSJ TUCSON HOLDINGS LLC, ST. JOSEPHS HOSPITAL | 474131755 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 817 | $59952.57 | 1467764555 - VANDERBILT MEDICAL CENTER | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Critical Access Hospital (282NC0060X) |
United | 817 | $34493.53 | 1295777324 - LONE STAR HMA L P, DALLAS REGIONAL MEDICAL CENTER | 472177648 | TX | General Acute Care Hospital (282N00000X) |
United | 817 | $62718.37 | 1730104217 - DANBURY HOSPITAL, INPATIENT PSYCHIATRY UNIT | 60646597 - DANBURY HOSPITAL | CT | Psychiatric Hospital Unit (273R00000X) |
United | 817 | $51672.94 | 1558028050 - MCHS HOSPITALS INC, MARSHFIELD MEDICAL CENTER - MARSHFIELD SWING BED | 810977948 - MCHS HOSPITALS INC | WI | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 817 | $42731.64 | 1831722586 - PRIME HEALTHCARE SERVICES, ST. MARY'S GENERAL HOSPITAL | 463499370 | NJ | Psychiatric Hospital Unit (273R00000X) |
United | 817 | $35009.73 | 1831868033 - VHS SAN ANTONIO PARTNERS, LLC, NORTH CENTRAL BAPTIST HOSPITAL | 760714523 | TX | General Acute Care Hospital (282N00000X) |
United | 817 | $32910.67 | 1588615033 - THE HEALTH CARE AUTHORITY OF THE CITY OF HUNTSVILLE, HUNTSVILLE HOSPITAL | 630845288 | AL | Psychiatric Hospital Unit (273R00000X) |
United | 817 | $23088.43 | 1679560866 - MARTIN COUNTY HOSPITAL DISTRICT | 751300105 | TX | Critical Access Hospital (282NC0060X) |
United | 817 | $35491.39 | 1649337908 - BUTLER HEALTH CARE PROVIDERS, BUTLER MEMORIAL HOSPITAL | 250965274 - (PA) BUTLER HEALTHCARE PROVIDERS | PA | General Acute Care Hospital (282N00000X) |
United | 817 | $46519.08 | 1841277704 - SCRIPPS HEALTH, SCRIPPS MEMORIAL HOSPITAL LA JOLLA | 951684089 - SCRIPPS HEALTH | CA | 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 817 vs. Other Pregnancy, Childbirth & the Puerperium Codes
The MS-DRG 817 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 817 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 |
|---|---|---|
| 816-APR-DRG | High | TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES |
| 816-MS-DRG | High | Reticuloendothelial and Immunity Disorders without CC/MCC |
| 817-MS-DRG | High | Other Antepartum Diagnoses with O.R. Procedures with MCC |
| 818-MS-DRG | High | Other Antepartum Diagnoses with O.R. Procedures with CC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 817. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 817 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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