MS-DRG 820 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 820 by major payers:
$63,853.72
$75,155.26
$91,158.21
$93,692.20
| 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 820 | ||||||
United | 820 | $49643.41 | 1144205360 - MEMORIAL HOSPITAL OF TEXAS COUNTY AUTHORITY | 730725208 | OK | Critical Access Hospital (282NC0060X) |
United | 820 | $117179.60 | 1225289895 - PROVIDENCE HEALTH & SERVICES, PROVIDENCE HOLY FAMILY HOSPITAL | 352345508 | WA | General Acute Care Hospital (282N00000X) |
United | 820 | $62299.60 | 1942265327 - LINCOLN COUNTY HOSPITAL | 480896979 - (KS) LINCOLN COUNTY HOSPITAL | KS | Critical Access Hospital (282NC0060X) |
United | 820 | $19346.00 | 1316599541 - HMH HOSPITALS CORPORATION | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | Rehabilitation Hospital Unit (273Y00000X) |
United | 820 | $47948.80 | 1083903744 - HOSPITAL SERVICE DISTRICT OF THE PARISH OF ST. BERNARD, STATE OF LOUIS, ST. BERNARD PARISH HOSPITAL | 261576974 - (LA) HOSPITAL SERVICE DISTRICT OF THE PARISH OF ST BERNARD STATE OF LOUIS | LA | Rural Acute Care Hospital (282NR1301X) |
United | 820 | $34472.57 | 1477541183 - EAST CAROLINA HEALTH, VIDANT CHOWAN HOSPITAL | 562101090 - (NC) EAST CAROLINA HEALTH | NC | Critical Access Hospital (282NC0060X) |
United | 820 | $151001.34 | 1376540138 - SENTARA HOSPITALS, SENTARA OBICI HOSPITAL | 541547408 - SENTARA HOSPITALS | VA | General Acute Care Hospital (282N00000X) |
United | 820 | $230246.76 | 1740215219 - JOHN MUIR HEALTH, JOHN MUIR HEALTH, WALNUT CREEK MEDICAL CENTER | 941461843 - (CA) JOHN MUIR HEALTH | CA | General Acute Care Hospital (282N00000X) |
United | 820 | $107594.97 | 1689672693 - SAINT CLARE HOSPITAL, ST. CLARE HOSPITAL | 911487485 | WA | General Acute Care Hospital (282N00000X) |
United | 820 | $63829.87 | 1851496152 - SSM HEALTH CARE ST. LOUIS, SSM HEALTH ST. CLARE HOSPITAL - FENTON | 431343281 - SSM HEALTH CARE ST LOUIS | MO | General Acute Care Hospital (282N00000X) |
United | 820 | $37911.60 | 1356318968 - ALLEGHANY COUNTY MEMORIAL HOSPITAL INC, ALLEGHANY HEALTH | 560525657 - (NC) ALLEGHANY COUNTY MEMORIAL HOSPITAL INC | NC | Critical Access Hospital (282NC0060X) |
United | 820 | $2786.00 | 1699444976 - HH HEALTH SYSTEM | 872027148 | AL | General Acute Care Hospital (282N00000X) |
United | 820 | $2786.00 | 1699444976 - HH HEALTH SYSTEM | 872027148 | AL | General Acute Care Hospital (282N00000X) |
United | 820 | $32212.40 | 1932211851 - SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER, LAWRENCE COUNTY HOSPITAL | 640468873 | MS | Critical Access Hospital (282NC0060X) |
United | 820 | $49643.41 | 1144205360 - MEMORIAL HOSPITAL OF TEXAS COUNTY AUTHORITY | 730725208 | OK | 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 820 vs. Other Pregnancy, Childbirth & the Puerperium Codes
The MS-DRG 820 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 820 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 |
|---|---|---|
| 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 |
| 821-APR-DRG | Moderate | Eye Infections And Other Eye Disorders |
| 821-MS-DRG | High | Lymphoma and Leukemia with Major 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 820. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 820 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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