MS-DRG 919 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 919 by major payers:
$20,650.62
$23,279.62
$28,598.41
$29,077.17
| 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 919 | ||||||
United | 919 | $18837.78 | 1679617963 - CHESTNUT HILL REHAB HOSPITAL, LLC, MONTGOMERY REHAB HOSPITAL OF CHESTNUT HILL | 883577015 | PA | Rehabilitation Hospital (283X00000X) |
United | 919 | $9416.40 | 1609811538 - D. W. MCMILLAN MEMORIAL HOSPITAL | 636000288 - (AL) D.W. MCMILLAN MEMORIAL HOSPITAL | AL | General Acute Care Hospital (282N00000X) |
United | 919 | $27543.84 | 1801813399 - ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS, ST VINCENT HOSPITAL REHABILITATION UNIT | 390817529 - ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS | WI | Rehabilitation Hospital Unit (273Y00000X) |
United | 919 | $13694.76 | 1033102942 - CARILION MEDICAL CENTER, CARILION ROANOKE MEMORIAL HOSPITAL | 540506332 - CARILION MEDICAL CENTER | VA | General Acute Care Hospital (282N00000X) |
United | 919 | $23274.60 | 1003976713 - PRESENCE CENTRAL AND SUBURBAN HOSPITALS NETWORK, PRESENCE ST. JOSEPH MEDICAL CENTER - PSYCHIATRIC UNIT | 992141118 | IL | Psychiatric Hospital Unit (273R00000X) |
United | 919 | $3693.00 | 1285601088 - HOSPITAL SERVICE DISTRICT NO. 1 OF IBERIA PARISH, IBERIA MEDICAL CENTER | 726014963 | LA | General Acute Care Hospital (282N00000X) |
United | 919 | $23373.08 | 1669991675 - TOPEKA HOSPITAL, LLC, THE UNIVERSITY OF KANSAS HEALTH SYSTEM, ST. FRANCIS CAMPUS | 822034009 | KS | Rehabilitation Hospital Unit (273Y00000X) |
United | 919 | $22727.52 | 1124495239 - PRIME HEALTHCARE SERVICES-SUBURBAN HOSPITAL LLC, SUBURBAN COMMUNITY HOSPITAL | 472819044 | PA | General Acute Care Hospital (282N00000X) |
United | 919 | $23478.84 | 1760421713 - THE UNITY HOSPITAL OF ROCHESTER, PARK RIDGE HOSPITAL | 237221763 - THE UNITY HOSPITAL OF ROCHESTER | NY | General Acute Care Hospital (282N00000X) |
United | 919 | $33324.46 | 1396882205 - VANDERBILT UNIVERSITY MEDICAL CENTER | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | 919 | $16047.67 | 1881142461 - BAPTIST MEMORIAL HOSPITAL-CALHOUN INC | 813257997 - (MS) BAPTIST MEMORIAL HOSPITAL - CALHOUN INC | MS | Critical Access Hospital (282NC0060X) |
United | 919 | $13623.83 | 1942288527 - MARY WASHINGTON HOSPITAL INC. | 540519577 - (VA) MARY WASHINGTON HOSPITAL INC | VA | General Acute Care Hospital (282N00000X) |
United | 919 | $26259.83 | 1952326977 - AMISUB (SFH), INC., ST. FRANCIS HOSPITAL | 752522262 | TN | General Acute Care Hospital (282N00000X) |
United | 919 | $48710.17 | 1619997079 - WELLSTAR SYLVAN GROVE HOSPITAL, INC, WELLSTAR SYLVAN GROVE HOSPITAL | 810875069 - (GA) WELLSTAR SYLVAN GROVE HOSPITAL INC | GA | Critical Access Hospital (282NC0060X) |
United | 919 | $13073.00 | 1184993727 - RUSH HOSPITAL/BUTLER, INC, OCHSNER CHOCTAW GENERAL | 640655993 - RUSH HOSPITAL-BUTLER INC | AL | 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 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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