MS-DRG 831 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 831 by major payers:
$12,335.00
$15,398.54
$17,889.18
$18,224.06
| 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 831 | ||||||
United | 831 | $18622.05 | 1790860856 - CARONDELET HEALTH NETWORK, ST JOSEPH'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 831 | $10967.87 | 1740876382 - DELTA HEALTH SYSTEM, DELTA HEALTH-NORTHWEST REGIONAL | 853959101 | MS | General Acute Care Hospital (282N00000X) |
United | 831 | $10345.00 | 1447597240 - BAYLOR UNIVERSITY MEDICAL CENTER | 751837454 - (TX) BAYLOR UNIVERSITY MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 831 | $10173.69 | 1356692297 - H H HEALTH SYSTEM-MORGAN LLC, DECATUR MORGAN HOSPITAL-DECATUR CAMPUS | 460928982 | AL | General Acute Care Hospital (282N00000X) |
United | 831 | $12518.28 | 1609603877 - LIFESPAN OF MASSACHUSETTS | 994836263 | MA | General Acute Care Hospital (282N00000X) |
United | 831 | $15020.87 | 1821186313 - SHANDS JACKSONVILLE MEDICAL CENTER INC, SHANDS JACKSONVILLE | 592142859 - SHANDS JACKSONVILLE MEDICAL CENTER INC | FL | General Acute Care Hospital (282N00000X) |
United | 831 | $13290.70 | 1598717480 - HURLEY MEDICAL CENTER | 386005601 | MI | General Acute Care Hospital (282N00000X) |
United | 831 | $20494.71 | 1659456994 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 831 | $34234.19 | 1851787295 - HDMC HOLDINGS, LLC, HI-DESERT MEDICAL CENTER | 473550779 | CA | General Acute Care Hospital (282N00000X) |
United | 831 | $15340.53 | 1063457901 - ROBINSON MEMORIAL PORTAGE COUNTY HOSPITAL | 461382538 - (OH) UNIVERSITY HOSPITALS HEALTH SYSTEM INC | OH | General Acute Care Hospital (282N00000X) |
United | 831 | $12876.36 | 1285719328 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 831 | $18153.57 | 1720814072 - BMC COMMUNITY HOSPITAL CORPORATION II | 994793550 | MA | General Acute Care Hospital (282N00000X) |
United | 831 | $12725.80 | 1649490871 - WASHINGTON HOSPITAL | 250965600 - (PA) WASHINGTON HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 831 | $18174.09 | 1780624049 - JAMAICA HOSPITAL, JAMAICA HOSPITAL PATHOLOGY DEPARTMENT | 111631788 - (NY) JAMAICA HOSPITAL MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 831 | $39735.96 | 1518061928 - THE NEW YORK AND PRESBYTERIAN HOSPITAL, NEW YORK - PRESBYTERIAN HOSPITAL | 133957095 - (NY) THE NEW YORK AND PRESBYTERIAN HOSPITAL | NY | Rehabilitation Hospital (283X00000X) |
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 831 vs. Other Pregnancy, Childbirth & the Puerperium Codes
The MS-DRG 831 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 831 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 |
|---|---|---|
| 830-MS-DRG | High | Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Other Procedures without CC/MCC |
| 831-MS-DRG | High | Other Antepartum Diagnoses without O.R. Procedures with MCC |
| 832-MS-DRG | High | Other Antepartum Diagnoses without 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 831. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 831 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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