MS-DRG 825 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 825 by major payers:
$15,600.25
$17,039.71
$19,577.51
$20,271.54
| 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 825 | ||||||
United | 825 | $22172.85 | 1851568687 - DIGNITY HEALTH, ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER | 463533638 - (AZ) DIGNITY HEALTH | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 825 | $12052.63 | 1568481984 - MERCY HOSPITAL SOUTH | 430980256 - (MO) MERCY HOSPITAL SOUTH | MO | General Acute Care Hospital (282N00000X) |
United | 825 | $31035.84 | 1902466840 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 825 | $14851.09 | 1902800352 - UNITED MEMORIAL MEDICAL CENTER | 160743029 - (NY) UNITED MEMORIAL MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 825 | $9846.44 | 1336103738 - COMMUNITY MEMORIAL HOSPITAL | 540551711 - (VA) COMMUNITY MEMORIAL HOSPITAL | VA | General Acute Care Hospital (282N00000X) |
United | 825 | $11025.29 | 1972557064 - BILOXI HMA LLC, MERIT HEALTH BILOXI | 592754033 | MS | General Acute Care Hospital (282N00000X) |
United | 825 | $13930.33 | 1396786307 - SARTORI MEMORIAL HOSPITAL INC, MERCYONE CEDAR FALLS MEDICAL CENTER | 420758901 - (IA) SARTORI MEMORIAL HOSPITAL INC | IA | Psychiatric Hospital Unit (273R00000X) |
United | 825 | $11025.29 | 1972557064 - BILOXI HMA LLC, MERIT HEALTH BILOXI | 592754033 | MS | General Acute Care Hospital (282N00000X) |
United | 825 | $29420.74 | 1629122171 - BANNER | 270036499 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 825 | $19841.16 | 1114972007 - CANNON COUNTY HOSPITAL LLC, STONES RIVER HOSPITAL | 474063232 | TN | General Acute Care Hospital (282N00000X) |
United | 825 | $29208.76 | 1548817117 - MEMORIAL HOSPITAL AT GULFPORT, MEMORIAL HOSPITAL AT STONE COUNTY | 646010232 - GULFPORT SURGERY CLINIC, LLC | MS | General Acute Care Hospital (282N00000X) |
United | 825 | $18903.74 | 1538201488 - JOHNSTON MEMORIAL HOSPITAL | 463176429 - (NC) JOHNSTON HEALTH SERVICES CORPORATION | NC | General Acute Care Hospital (282N00000X) |
United | 825 | $15571.42 | 1538110556 - DUPONT HOSPITAL LLC, DUPONT HOSPITAL | 621801445 - (IN) DUPONT HOSPITAL LLC | IN | General Acute Care Hospital (282N00000X) |
United | 825 | $28847.49 | 1841231461 - MULTICARE HEALTH SYSTEM, MULTICARE GOOD SAMARITAN HOSPITAL | 911352172 - MULTICARE HEALTH SYSTEM | WA | General Acute Care Hospital (282N00000X) |
United | 825 | $10339.53 | 1023055191 - UNIVERSITY OF SOUTH ALABAMA, USA HEALTH CHILDREN'S & WOMEN'S HOSPITAL | 630477348 - UNIVERSITY OF SOUTH ALABAMA | AL | Children's Hospital (282NC2000X) |
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 825 vs. Other Pregnancy, Childbirth & the Puerperium Codes
The MS-DRG 825 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 825 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 |
|---|---|---|
| 824-APR-DRG | Moderate | Eye Infections And Other Eye Disorders |
| 824-MS-DRG | High | Lymphoma and Non-acute Leukemia with Other Procedures with CC |
| 825-MS-DRG | High | Lymphoma and Non-acute Leukemia with Other Procedures without CC/MCC |
| 826-APR-DRG | Moderate | Eye Infections And Other Eye Disorders |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 825. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 825 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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