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 | $29463.22 | 1639320484 - PROVIDENCE HEALTH & SERVICES, PROV SCRED HRT MED CTR & CHLDS HOS | 364640211 | WA | Psychiatric Hospital Unit (273R00000X) |
United | 828 | $16758.32 | 1720166002 - PRAIRIE LAKES HEALTH CARE SYSTEM INC | 460391067 - PRAIRIE LAKES HEALTH CARE SYSTEM INC | SD | Rural Acute Care Hospital (282NR1301X) |
United | 828 | $72864.63 | 1184654923 - DOCTORS MEDICAL CENTER OF MODESTO, INC., DOCTORS MEDICAL CENTER OF MODESTO | 952588614 | CA | General Acute Care Hospital (282N00000X) |
United | 828 | $29313.83 | 1437172350 - MERCY HEALTH-ST CHARLES HOSPITAL LLC | 344428250 - MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC | OH | Rehabilitation Hospital Unit (273Y00000X) |
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 | $16184.48 | 1881654259 - BAPTIST HEALTHCARE SYSTEM INC, BAPTIST HEALTH CORBIN | 610444707 - BAPTIST HEALTHCARE SYSTEM INC | KY | Psychiatric Hospital Unit (273R00000X) |
United | 828 | $33643.26 | 1326020447 - OHIOHEALTH BERGER HOSPITAL LLC, BERGER HOSPITAL | 384105653 | OH | General Acute Care Hospital (282N00000X) |
United | 828 | $18474.46 | 1912366238 - JEWISH HOSPITAL & ST. MARY'S HEALTHCARE, INC., JEWISH HOSPITAL MEDICAL CENTER NORTHEAST | 843178470 - UOFL HEALTH-LOUISVILLE INC | KY | General Acute Care Hospital (282N00000X) |
United | 828 | $14772.33 | 1073598439 - VALLEY MEDICAL FACILITIES, INC., HERITAGE VALLEY KENNEDY | 251801532 - (PA) HERITAGE VALLEY HEALTH SYSTEM | PA | General Acute Care Hospital (282N00000X) |
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 | $13336.00 | 1346243375 - ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL, INC | 221487243 - (NJ) ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL | NJ | General Acute Care Hospital (282N00000X) |
United | 828 | $16805.90 | 1316190069 - ROANE COUNTY MEDICAL CENTER, EMORY RIVER GERIATRIC CENTER | 680673354 - (TN) ROANE COUNTY MEDICAL CENTER | TN | Psychiatric Hospital Unit (273R00000X) |
United | 828 | $33534.26 | 1598860108 - MEMORIAL HEALTH SYSTEMS INC, ADVENTHEALTH DAYTONA BEACH | 590973502 - MEMORIAL HEALTH SYSTEMS INC | FL | Rehabilitation Hospital Unit (273Y00000X) |
United | 828 | $33643.26 | 1326020447 - OHIOHEALTH BERGER HOSPITAL LLC, BERGER HOSPITAL | 384105653 | OH | General Acute Care Hospital (282N00000X) |
United | 828 | $13410.53 | 1063466035 - CHCA CLEAR LAKE LP, HCA HOUSTON HEALTHCARE CLEAR LAKE | 621801360 | TX | 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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