MS-DRG 819 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 819 by major payers:
$10,333.53
$11,657.25
$13,078.47
$13,292.34
| 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 819 | ||||||
United | 819 | $6893.02 | 1306843826 - WEST CARROLL HEALTH SYSTEMS LLC, WEST CARROLL MEMORIAL HOSPITAL | 562300247 - WEST CARROLL HEALTH SYSTEMS L.L.C. | LA | General Acute Care Hospital (282N00000X) |
United | 819 | $17660.90 | 1245597418 - SOUTHCOAST HOSPITALS GROUP | 222592333 - SOUTHCOAST HOSPITALS GROUP INC | MA | General Acute Care Hospital (282N00000X) |
United | 819 | $7538.10 | 1932213600 - RUSH UNIVERSITY MEDICAL CENTER | 362174823 - (IL) RUSH UNIVERSITY MEDICAL CENTER | IL | General Acute Care Hospital (282N00000X) |
United | 819 | $10492.03 | 1972655629 - CORNING HOSPITAL | 160393490 - (NY) CORNING HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 819 | $9350.55 | 1093876997 - PHC-MORGAN CITY LP, TECHE REGIONAL MEDICAL CENTER | 842237042 | LA | Rural Acute Care Hospital (282NR1301X) |
United | 819 | $24005.09 | 1649304221 - TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH | 752678857 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH | TX | Chronic Disease Hospital (281P00000X) |
United | 819 | $8088.25 | 1235344409 - DARDANELLE COMMUNITY HOSPITAL LLC, RIVER VALLEY MEDICAL CENTER | 834538290 - (AR) DARDANELLE REGIONAL LLC | AR | Critical Access Hospital (282NC0060X) |
United | 819 | $20788.08 | 1417907924 - GREENVILLE HEALTH SYSTEM, GHS GREENVILLE MEM SUBACUTE | 811723202 - PRISMA HEALTH - UPSTATE | SC | Special Hospital (284300000X) |
United | 819 | $9303.20 | 1891338554 - UOFL HEALTH-LOUISVILLE INC | 843178470 - UOFL HEALTH-LOUISVILLE INC | KY | Rehabilitation Hospital Unit (273Y00000X) |
United | 819 | $10450.37 | 1710442801 - ST VINCENT INFIRMARY MEDICAL CENTER | 710236917 - (AR) ST VINCENT INFIRMARY MEDICAL CENTER | AR | Psychiatric Hospital Unit (273R00000X) |
United | 819 | $6450.35 | 1912118134 - SPECIALISTS HOSPITAL SHREVEPORT, LLC | 208810573 - (LA) SPECIALISTS HOSPITAL SHREVEPORT, L.L.C. | LA | General Acute Care Hospital (282N00000X) |
United | 819 | $9350.55 | 1093876997 - PHC-MORGAN CITY LP, TECHE REGIONAL MEDICAL CENTER | 842237042 | LA | Rural Acute Care Hospital (282NR1301X) |
United | 819 | $11920.90 | 1467433763 - FAIRFIELD MEDICAL CENTER | 310645626 - (OH) FAIRFIELD MEDICAL CENTER | OH | General Acute Care Hospital (282N00000X) |
United | 819 | $16542.28 | 1568785137 - STATEN ISLAND UNIVERSITY HOSPITAL | 112868878 - (NY) STATEN ISLAND UNIVERSITY HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 819 | $22973.03 | 1205181120 - HOSPITAL FOR SPECIAL SURGERY- NP | 131624135 - NEW YORK SOCIETY FOR THE RELIEF OF RUPTURED & CRIPPLED MAINTAINING | NY | Special Hospital (284300000X) |
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 819 vs. Other Pregnancy, Childbirth & the Puerperium Codes
The MS-DRG 819 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 819 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 |
|---|---|---|
| 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 |
| 820-MS-DRG | High | Lymphoma and Leukemia with Major O.R. Procedures 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 819. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 819 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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