MS-DRG 828 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 828 by major payers:
$19,722.80
$21,419.14
$25,239.31
$26,162.67
| 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 828 | ||||||
United | 828 | $39383.66 | 1346441953 - NORWALK HOSPITAL ASSOCIATION | 66068853 - (CT) NORWALK HOSPITAL ASSOCIATION | CT | General Acute Care Hospital (282N00000X) |
United | 828 | $3862.00 | 1255327920 - UHS CORONA INC, CORONA REGIONAL MEDICAL CENTER | 432035443 | CA | Rehabilitation Hospital Unit (273Y00000X) |
United | 828 | $33643.26 | 1326020447 - OHIOHEALTH BERGER HOSPITAL LLC, BERGER HOSPITAL | 384105653 | OH | General Acute Care Hospital (282N00000X) |
United | 828 | $25147.90 | 1003832098 - NASSAU HEALTH CARE CORPORATION, NUMC -DEPARTMENT OF PM&R, FPP | 113465690 | NY | General Acute Care Hospital (282N00000X) |
United | 828 | $25147.90 | 1003832098 - NASSAU HEALTH CARE CORPORATION, NUMC -DEPARTMENT OF PM&R, FPP | 113465690 | NY | General Acute Care Hospital (282N00000X) |
United | 828 | $3862.00 | 1255327920 - UHS CORONA INC, CORONA REGIONAL MEDICAL CENTER | 432035443 | CA | Rehabilitation Hospital Unit (273Y00000X) |
United | 828 | $10434.59 | 1023237674 - PROSSER PUBLIC HOSPITAL DISTRICT OF BENTON COUNTY | 916013490 - PROSSER PUBLIC HOSPITAL DISTRICT OF BENTON COUNTY | WA | Critical Access Hospital (282NC0060X) |
United | 828 | $19758.61 | 1780837435 - ROANE COUNTY MEDICAL CENTER, ROANE MEDICAL CENTER | 680673354 - (TN) ROANE COUNTY MEDICAL CENTER | TN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 828 | $10519.25 | 1629039193 - RIVERSIDE HOSPITAL OF LOUISIANA, INC., RIVERSIDE HOSPITAL OF LOUISIANA | 481266084 - (LA) RIVERSIDE HOSPITAL OF LOUISIANA, INC. | LA | Long Term Care Hospital (282E00000X) |
United | 828 | $25423.59 | 1710939459 - ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC., ASPIRUS TOMAHAWK HOSPITAL | 362338884 - NORTHWESTERN MEMORIAL HEALTHCARE | WI | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 828 | $35456.76 | 1255317590 - MEMORIAL MEDICAL CENTER | 370661220 - (IL) MEMORIAL HEALTH SYSTEM | IL | General Acute Care Hospital (282N00000X) |
United | 828 | $14105.51 | 1144776329 - BAPTIST MEMORIAL HOSPITAL-CALHOUN INC | 813257997 - (MS) BAPTIST MEMORIAL HOSPITAL - CALHOUN INC | MS | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 828 | $17831.15 | 1871665380 - SSM HEALTH CARE ST. LOUIS, SSM HEALTH ST JOSEPH HOSPITAL - LAKE SAINT LOUIS | 431343281 - SSM HEALTH CARE ST LOUIS | MO | General Acute Care Hospital (282N00000X) |
United | 828 | $23342.89 | 1215135785 - NASSAU HEALTH CARE CORPORATION, NASSAU UNIVERSITTY MEDICAL CENTER - | 113465690 | NY | Substance Use Disorder Rehabilitation Hospital Unit (276400000X) |
United | 828 | $12941.80 | 1689857385 - PHYSICIANS MEDICAL CENTER LLC | 205071967 - PHYSICIANS MEDICAL CENTER, LLC | IN | 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 828 vs. Other Pregnancy, Childbirth & the Puerperium Codes
The MS-DRG 828 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 828 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 |
|---|---|---|
| 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 |
| 828-MS-DRG | High | Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures without CC/MCC |
| 829-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 828. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 828 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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