MS-DRG 905 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 | • Injuries, Poisonings & Toxic Effects of Drugs |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 905 by major payers:
$19,421.94
$21,340.63
$25,812.42
$26,773.05
| 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 905 | ||||||
United | 905 | $21696.90 | 1467595793 - TRUMAN MEDICAL CENTER, INCORPORATED, UNIVERSITY HEALTH TRUMAN MEDICAL CENTER | 440661018 - (MO) TRUMAN MEDICAL CENTER INCORPORATED | MO | General Acute Care Hospital (282N00000X) |
United | 905 | $23958.24 | 1700979465 - BAPTIST HEALTH CARE, INC | 590657322 - BAPTIST HEALTH CARE INC | FL | General Acute Care Hospital (282N00000X) |
United | 905 | $6098.00 | 1821101239 - IJKG OPCO LLC, BAYONNE MEDICAL CENTER | 261442063 - (NJ) CAREPOINT HEALTH BAYONNE MEDICAL CENTER | NJ | General Acute Care Hospital (282N00000X) |
United | 905 | $17067.52 | 1518042605 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 905 | $49958.58 | 1124318050 - MAIMONIDES MEDICAL CENTER | 111635081 - (NY) MAIMONIDES MEDICAL CENTER- | NY | General Acute Care Hospital (282N00000X) |
United | 905 | $28372.10 | 1588795462 - INOVA HEALTH CARE SERVICES, INOVA FAIRFAX HOSPITAL REHAB UNIT | 540620889 - INOVA HEALTH CARE SERVICES | VA | Rehabilitation Hospital Unit (273Y00000X) |
United | 905 | $24824.25 | 1164400131 - LEHIGH VALLEY HOSPITAL, LEHIGH VALLEY HOSPITAL | 231689692 - LEHIGH VALLEY HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 905 | $20353.61 | 1912997024 - MORRISTOWN HAMBLEN HOSPITAL ASSOCIATION, MORRISTOWN HAMBLEN HEALTHCARE SYSTEM | 620545814 - (TN) MORRISTOWN HAMBLEN HOSP | TN | General Acute Care Hospital (282N00000X) |
United | 905 | $39309.57 | 1952163339 - PRISMA HEALTH-UPSTATE | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 905 | $34218.28 | 1891117966 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE MEMORIAL CAMPUS | 954537720 | TX | Psychiatric Hospital Unit (273R00000X) |
United | 905 | $27898.81 | 1952512469 - VALLEY BAPTIST MEDICAL CENTER, VALLEY BAPTIST MEDICAL FACILITY BROWNSVILLE | 452663071 | TX | Psychiatric Hospital Unit (273R00000X) |
United | 905 | $27507.27 | 1538236385 - ST VINCENT JENNINGS HOSPITAL INC, SWING BED | 743107055 - (IN) ST VINCENT CARMEL HOSPITAL INC | IN | Critical Access Hospital (282NC0060X) |
United | 905 | $28142.16 | 1417944224 - IREDELL MEMORIAL HOSPITAL, INCORPORATED | 560591303 - (NC) IREDELL MEMORIAL HOSPITAL INCORPORATED | NC | General Acute Care Hospital (282N00000X) |
United | 905 | $48457.07 | 1033120423 - TEXAS HEALTH HUGULEY, INC., TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH | 452694620 - (TX) TEXAS HEALTH HUGULEY INC | TX | General Acute Care Hospital (282N00000X) |
United | 905 | $30244.47 | 1700829199 - SCRIPPS HEALTH, SCRIPPS MEMORIAL HOSPITAL ENCINITAS | 951684089 - SCRIPPS HEALTH | CA | 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 905 vs. Other Injuries, Poisonings & Toxic Effects of Drugs Codes
The MS-DRG 905 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 905 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 |
|---|---|---|
| 904-APR-DRG | Moderate | Major Larynx & Trachea Procedures |
| 904-MS-DRG | High | Skin Grafts for Injuries with CC/MCC |
| 905-MS-DRG | High | Skin Grafts for Injuries without CC/MCC |
| 906-MS-DRG | High | Hand Procedures for Injuries |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 905. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 905 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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