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See a sample rate comparisonMS-DRG 919 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.
COMPLICATIONS OF TREATMENT WITH MCC
| 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 919 by major payers:
$20,650.62
$23,279.62
$28,598.41
$29,077.17
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MS-DRG 919
5 of 25 sample ratesHigher to lower in this preview
Children'S Hospital
Childrens Hospital
$52,787.75Published rateVanderbilt University Medical Center
$33,324.46Published rateSsm Select Rehab St Louis LLC, Ssm Physical Therapy
$22,869.76Published rateBaptist Memorial Hospital-Calhoun Inc
Baptist Memorial Hospital - Calhoun Inc
$16,047.67Published rateHospital Service District No. 1 Of Iberia Parish, Iberia Medical Center
$3,693.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 919 vs. Other Injuries, Poisonings & Toxic Effects of Drugs Codes
The MS-DRG 919 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 919 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 |
|---|---|---|
| 918-APR-DRG | Moderate | Other Major Head And Neck Procedures |
| 918-MS-DRG | High | POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC |
| 919-MS-DRG | High | COMPLICATIONS OF TREATMENT WITH MCC |
| 920-APR-DRG | Moderate | Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 919. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 919 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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