MS-DRG 818 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 818 by major payers:
$15,360.94
$17,310.59
$20,316.78
$20,581.13
| 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 818 | ||||||
United | 818 | $34363.64 | 1659456994 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 818 | $13377.16 | 1275703910 - UCHEALTH PIKES PEAK REGIONAL HOSPITAL | 824191576 - (CO) UCHEALTH PIKES PEAK REGIONAL HOSPITAL | CO | Critical Access Hospital (282NC0060X) |
United | 818 | $25354.27 | 1194889147 - ST. JOSEPH REGIONAL HEALTH NETWORK, ST. JOSEPH MEDICAL CENTER - SPU | 231352211 - (PA) ST JOSEPH REGIONAL HEALTH NETWORK | PA | General Acute Care Hospital (282N00000X) |
United | 818 | $5507.20 | 1285635425 - HANOVER HOSPITAL | 480734138 - (KS) HANOVER HOSPITAL | KS | Critical Access Hospital (282NC0060X) |
United | 818 | $22528.41 | 1801284617 - BANNER | 901074558 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 818 | $74056.56 | 1396818209 - COASTAL CAROLINA MEDICAL CENTER, INC., COASTAL CAROLINA HOSPITAL- REHABILITATION UNIT | 300151925 - (SC) COASTAL CAROLINA MEDICAL CENTER INC | SC | Rehabilitation Hospital Unit (273Y00000X) |
United | 818 | $15651.34 | 1518957174 - ROANE MEDICAL CENTER | 680673354 - (TN) ROANE COUNTY MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | 818 | $3558.00 | 1669513941 - SHRINERS HOSPITALS FOR CHILDREN | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | TX | Children's Hospital (282NC2000X) |
United | 818 | $22153.42 | 1083612881 - ENGLEWOOD HOSPITAL AND MEDICAL CENTER | 221487173 - (NJ) ENGLEWOOD HOSPITAL AND MEDICAL CENTER A NEW JERSEY NONPROFIT CORP | NJ | General Acute Care Hospital (282N00000X) |
United | 818 | $34363.64 | 1659456994 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 818 | $41579.51 | 1740772268 - FLORIDA HOSPITAL OCALA INC, ADVENT HEALTH OCALA | 824372339 - (FL) FLORIDA HOSPITAL OCALA INC | FL | General Acute Care Hospital (282N00000X) |
United | 818 | $8956.59 | 1427051002 - CLAYTON HEALTH SYSTEMS INC, UNION COUNTY GENERAL HOSPITAL | 850442957 - (NM) CLAYTON HEALTH SYSTEMS INC | NM | Critical Access Hospital (282NC0060X) |
United | 818 | $34441.57 | 1386940823 - HOLMES REGIONAL MEDICAL CENTER, INC, PALM BAY HOSPITAL | 590624371 - (FL) HOLMES REGIONAL MEDICAL CENTER | FL | General Acute Care Hospital (282N00000X) |
United | 818 | $29071.36 | 1891117966 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE MEMORIAL CAMPUS | 954537720 | TX | Psychiatric Hospital Unit (273R00000X) |
United | 818 | $36937.26 | 1770626426 - DIGNITY HEALTH, ST. ROSE DOMINICAN HOSPITAL, SIENA CAMPUS | 880455713 - (NV) DIGNITY HEALTH | NV | 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 818 vs. Other Pregnancy, Childbirth & the Puerperium Codes
The MS-DRG 818 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 818 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 |
|---|---|---|
| 817-APR-DRG | High | INTENTIONAL SELF-HARM & ATTEMPTED SUICIDE |
| 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 |
| 819-MS-DRG | High | Other Antepartum Diagnoses with O.R. Procedures 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 818. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 818 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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