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MS-DRG 904 Fee Schedule

Last Verified: October 2026

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.

SKIN GRAFTS FOR INJURIES WITH CC/MCC
Key FactDetail
Service Type

Injuries, Poisonings & Toxic Effects of Drugs

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Complexity LevelHigh

National average reimbursement for MS-DRG 904 by major payers:

bcbs

$39,860.99

uhc

$49,222.88

aetna

$59,812.34

cigna

$61,824.32

Compare published rates across providers.

Choose a payer to see a sample of rates for MS-DRG 904.

MS-DRG 904
5 of 25 sample ratesHigher to lower in this preview
  1. Jfk Memorial Hospital, Inc., John F. Kennedy Memorial Hospital

    CAGeneral Acute Care HospitalNPI 1477584993Tax ID 75-2919774

    $167,946.26Published rate
  2. Lake Wales Hospital Corporation, Lake Wales Medical Center

    FLPsychiatric Hospital UnitNPI 1841696762Tax ID 83-4672945

    $80,264.54Published rate
  3. The Brookdale Hospital Medical Center

    Brookdale Hospital Medical Center

    NYGeneral Acute Care HospitalNPI 1649474990Tax ID 11-1631746

    $46,348.73Published rate
  4. Marion Regional Medical Center, Inc., Marion Regional Medical Center - Swing Bed

    Monroe Health Services Inc

    ALMedicare Defined Swing Bed Hospital UnitNPI 1801842067Tax ID 32-0583236

    $34,753.76Published rate
  5. Houston County Community Hospital

    TNMedicare Defined Swing Bed Hospital UnitNPI 1457694804Tax ID 46-2490116

    $500.00Published rate

National sample. Rates vary by location, specialty, and contract.

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MS-DRG 904 vs. Other Injuries, Poisonings & Toxic Effects of Drugs Codes

The MS-DRG 904 code is part of the Injuries, Poisonings & Toxic Effects of Drugs 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 904 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.

CodeComplexityDescription
903-APR-DRGModerateMajor Larynx & Trachea Procedures
903-MS-DRGHighWOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC
904-MS-DRGHighSKIN GRAFTS FOR INJURIES WITH CC/MCC
905-MS-DRGHighSKIN GRAFTS FOR INJURIES 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 904. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 904 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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