MS-DRG 842 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 842 by major payers:
$13,301.43
$14,771.21
$16,937.05
$17,154.11
| 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 842 | ||||||
United | 842 | $26841.33 | 1780927277 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS | 954537720 | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 842 | $16259.70 | 1679508022 - MARIAN HEALTH CENTER -SMHC, MERCYONE SIOUXLAND MEDICAL CENTER | 311407377 | IA | Psychiatric Hospital Unit (273R00000X) |
United | 842 | $13848.25 | 1346377413 - J. ARTHUR DOSHER MEMORIAL HOSPITAL | 560845824 - (NC) J ARTHUR DOSHER MEMORIAL HOSPITAL | NC | General Acute Care Hospital (282N00000X) |
United | 842 | $27640.77 | 1477531580 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 842 | $17566.81 | 1659347920 - CAMDEN GENERAL HOSPITAL, INC., WEST TENNESSEE HEALTHCARE CAMDEN HOSPITAL | 581884314 - (TN) CAMDEN GENERAL HOSPITAL | TN | Critical Access Hospital (282NC0060X) |
United | 842 | $20428.38 | 1285732933 - ST MARYS HEALTH, INC., ASCENSION ST. VINCENT EVANSVILLE | 350869065 - (IN) UNITED STATES CATHOLIC CONFERENCE | IN | Psychiatric Hospital Unit (273R00000X) |
United | 842 | $11527.71 | 1639555865 - HCH TUCSON HOLDINGS LLC, HOLY CROSS HOSPITAL | 474132507 | AZ | Critical Access Hospital (282NC0060X) |
United | 842 | $13786.04 | 1043904949 - REUNION REHABILITATION HOSPITAL JACKSONVILLE, LLC | 880596358 - (FL) REUNION REHABILITATION HOSPITAL JACKSONVILLE LLC | FL | Rehabilitation Hospital (283X00000X) |
United | 842 | $11052.00 | 1679934277 - CHILDREN'S HOSPITAL COLORADO, CHILDREN'S HOSPITAL COLORADO THERAPY CARE BROOMFIELD | 840166760 - CHILDRENS HOSPITAL COLORADO | CO | Children's Hospital (282NC2000X) |
United | 842 | $26524.71 | 1639669435 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY, UCHEALTH EMERGENCY ROOM - GREEN VALLEY RANCH | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 842 | $13562.15 | 1427616002 - NYU LANGONE HOSPITALS, NYU LANGONE HOSPITAL LONG ISLAND | 133971298 - NYU LANGONE HOSPITALS | NY | General Acute Care Hospital (282N00000X) |
United | 842 | $9667.98 | 1487616470 - CHARLES COLE MEMORIAL HOSPITAL, SWING BED PROGRAM | 240802108 - UPMC | PA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 842 | $22487.17 | 1659330173 - MERCY MEDICAL CENTER | 111635088 - (NY) MERCY MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 842 | $11107.00 | 1710348214 - CHILDREN'S HOSPITAL COLORADO, CHILDREN'S HOSPITAL COLORADO NORTH CAMPUS | 840166760 - CHILDRENS HOSPITAL COLORADO | CO | Children's Hospital (282NC2000X) |
United | 842 | $13679.71 | 1871695973 - STANTON COUNTY HOSPITAL | 480680477 | KS | Critical Access Hospital (282NC0060X) |
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 842 vs. Other Myeloproliferative Diseases & Disorders, Poorly Differentiated Neoplasms Codes
The MS-DRG 842 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 842 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 |
|---|---|---|
| 841-APR-DRG | High | EXTENSIVE 3RD DEGREE BURNS W SKIN GRAFT |
| 841-MS-DRG | High | Lymphoma and Non-acute Leukemia with CC |
| 842-MS-DRG | High | Lymphoma and Non-acute Leukemia without CC/MCC |
| 843-APR-DRG | High | EXTENSIVE 3RD DEGREE BURNS W/O SKIN GRAFT |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 842. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 842 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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