MS-DRG 838 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 | • Myeloproliferative Diseases & Disorders, Poorly Differentiated Neoplasms |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 838 by major payers:
$26,537.28
$25,824.48
$32,082.85
$32,557.72
| 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 838 | ||||||
United | 838 | $38959.55 | 1891148821 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH MARSHALL I PICKENS HOSPITAL | 811723202 - PRISMA HEALTH - UPSTATE | SC | Psychiatric Hospital (283Q00000X) |
United | 838 | $98097.95 | 1801821376 - JOHN MUIR HEALTH, JOHN MUIR HEALTH MEDICAL CENTER, CONCORD CAMPUS | 680396600 | CA | General Acute Care Hospital (282N00000X) |
United | 838 | $24115.30 | 1154571180 - PORTER HOSPITAL LLC, NORTHWEST HEALTH-PORTER | 208473972 | IN | Rehabilitation Hospital Unit (273Y00000X) |
United | 838 | $39969.73 | 1326296211 - INDIANA UNIVERSITY HEALTH ARNETT INC, IU HEALTH ARNETT HOSPITAL | 263162145 - (IN) INDIANA UNIVERSITY HEALTH ARNETT INC | IN | General Acute Care Hospital (282N00000X) |
United | 838 | $8161.00 | 1326349986 - MID COAST MEDICAL CENTER, MID COAST MEDICAL CENTER - CENTRAL | 464007700 - (TX) SCOTT & WHITE HOSPITAL | TX | Critical Access Hospital (282NC0060X) |
United | 838 | $45151.78 | 1164507133 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 838 | $35742.96 | 1497764526 - NORTHERN ILLINOIS MEDICAL CENTER, NORTHWESTERN MEDICINE MCHENRY HOSPITAL | 362338884 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 838 | $18334.92 | 1235111071 - SALINE HOSPITAL LLC, SALINE MEMORIAL HOSPITAL | 812816675 | AR | General Acute Care Hospital (282N00000X) |
United | 838 | $31112.58 | 1598971855 - OVERLAKE HOSPITAL MEDICAL CENTER LAB | 910652651 - (WA) OVERLAKE HOSPITAL MEDICAL CENTER | WA | General Acute Care Hospital (282N00000X) |
United | 838 | $45602.05 | 1467537506 - CARONDELET HEALTH NETWORK, ST. MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 838 | $5392.00 | 1225484751 - PROSPECT MANCHESTER HOSPITAL, INC., INPATIENT PSYCH UNIT | 812216981 | CT | Psychiatric Hospital Unit (273R00000X) |
United | 838 | $43342.62 | 1407116759 - FAUQUIER HEALTH | 463107896 | VA | General Acute Care Hospital (282N00000X) |
United | 838 | $32613.46 | 1992733513 - EMANATE HEALTH FOOTHILL PRESBYTERIAN HOSPITAL, FOOTHILL PRESBYTERIAN HOSPITAL | 952413054 - (CA) EMANATE HEALTH FOOTHILL PRESBYTERIAN HOSPITAL | CA | General Acute Care Hospital (282N00000X) |
United | 838 | $30025.47 | 1780837435 - ROANE COUNTY MEDICAL CENTER, ROANE MEDICAL CENTER | 680673354 - (TN) ROANE COUNTY MEDICAL CENTER | TN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 838 | $18618.88 | 1467447508 - BROADLAWNS MEDICAL CENTER, BROADLAWNS MEDICAL CENTER | 426005830 - (IA) BROADLAWNS MEDICAL CENTER | IA | 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 838 vs. Other Myeloproliferative Diseases & Disorders, Poorly Differentiated Neoplasms Codes
The MS-DRG 838 code is part of the Myeloproliferative Diseases & Disorders, Poorly Differentiated Neoplasms 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 838 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 |
|---|---|---|
| 837-MS-DRG | High | Chemotherapy with Acute Leukemia as Secondary Diagnosis or with High Dose Chemotherapy Agent with MCC |
| 838-MS-DRG | High | Chemotherapy with Acute Leukemia as Secondary Diagnosis with CC or High Dose Chemotherapy Agent |
| 839-MS-DRG | High | Chemotherapy with Acute Leukemia as Secondary Diagnosis without CC/MCC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 838. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 838 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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