MS-DRG 826 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 826 by major payers:
$56,357.08
$62,298.82
$74,733.62
$76,909.07
| 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 826 | ||||||
United | 826 | $90896.86 | 1912527193 - ASCENSION NE WISCONSIN, INC, ASCENSION NE WISCONSIN-MERCY CAMPUS | 390816818 - ASCENSION NE WISCONSIN INC | WI | General Acute Care Hospital (282N00000X) |
United | 826 | $12990.00 | 1225133473 - MONMOUTH MEDICAL CENTER INC, MONMOUTH MEDICAL CENTER SOUTHERN CAMPUS | 223452412 | NJ | General Acute Care Hospital (282N00000X) |
United | 826 | $56000.42 | 1477537363 - VHS OF PHOENIX INC, ABRAZO CENTRAL CAMPUS | 621809851 | AZ | General Acute Care Hospital (282N00000X) |
United | 826 | $12990.00 | 1225133473 - MONMOUTH MEDICAL CENTER INC, MONMOUTH MEDICAL CENTER SOUTHERN CAMPUS | 223452412 | NJ | General Acute Care Hospital (282N00000X) |
United | 826 | $74669.71 | 1417961137 - BRONSON METHODIST HOSPITAL, BRONSON MEDICAL GROUP | 381359087 - (MI) BRONSON METHODIST HOSPITAL | MI | Hospitalist Physician (208M00000X) |
United | 826 | $30851.40 | 1306897681 - PROSSER PUBLIC HOSPITAL DISTRICT OF BENTON COUNTY, PROSSER MEMORIAL HOSPITAL | 916013490 - PROSSER PUBLIC HOSPITAL DISTRICT OF BENTON COUNTY | WA | Critical Access Hospital (282NC0060X) |
United | 826 | $56000.42 | 1477537363 - VHS OF PHOENIX INC, ABRAZO CENTRAL CAMPUS | 621809851 | AZ | General Acute Care Hospital (282N00000X) |
United | 826 | $48729.78 | 1447747316 - ST JOSEPHS HOSPITAL BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDE | 371208459 - (IL) ST JOSEPHS HOSP OF THE HOSP SISTERS OF THE 3RD ORDER OF ST FRANCIS | IL | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 826 | $71355.52 | 1932125911 - NASSAU HEALTH CARE CORPORATION, NUMC DEPARTMENT OF OB/GYN, FPP | 113465690 | NY | General Acute Care Hospital (282N00000X) |
United | 826 | $109759.78 | 1811957681 - SENTARA HOSPITALS, SENTARA LEIGH HOSPITAL | 541547408 - SENTARA HOSPITALS | VA | General Acute Care Hospital (282N00000X) |
United | 826 | $101192.85 | 1568664613 - ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH, LLC | 260143823 | IN | Special Hospital (284300000X) |
United | 826 | $85959.00 | 1609824010 - OREGON HEALTH & SCIENCE UNIVERSITY | 262998832 | OR | General Acute Care Hospital (282N00000X) |
United | 826 | $147071.06 | 1629068531 - BEAUFORT COUNTY MEMORIAL HOSPITAL, BMH INPATIENT PSYCHIATRIC UNIT | 576000094 - BEAUFORT COUNTY MEMORIAL HOSPITAL | SC | Psychiatric Hospital Unit (273R00000X) |
United | 826 | $80524.47 | 1902891682 - STATE OF CONNECTICUT, JOHN DEMPSEY HOSPITAL- SUBPROVIDER | 66000798 | CT | Psychiatric Hospital Unit (273R00000X) |
United | 826 | $80524.47 | 1902891682 - STATE OF CONNECTICUT, JOHN DEMPSEY HOSPITAL- SUBPROVIDER | 66000798 | CT | Psychiatric Hospital Unit (273R00000X) |
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 826 vs. Other Pregnancy, Childbirth & the Puerperium Codes
The MS-DRG 826 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 826 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 |
|---|---|---|
| 825-MS-DRG | High | Lymphoma and Non-acute Leukemia with Other Procedures without CC/MCC |
| 826-MS-DRG | High | Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures with MCC |
| 827-APR-DRG | Moderate | Eye Infections And Other Eye Disorders |
| 827-MS-DRG | High | Myeloproliferative Disorders or Poorly Differentiated Neoplasms 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 826. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 826 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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