MS-DRG 920 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 920 by major payers:
$12,271.11
$13,870.43
$16,113.37
$16,454.20
| 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 920 | ||||||
United | 920 | $24896.66 | 1730132515 - TUFTS MEDICAL CENTER, INC., TUFTS MEDICAL CENTER | 43400617 - TUFTS MEDICAL CENTER PARENT INC | MA | General Acute Care Hospital (282N00000X) |
United | 920 | $3693.00 | 1780690180 - HOSPITAL SERVICE DISTRICT NO. 1 OF IBERIA PARISH, IBERIA MEDICAL CENTER | 726014963 | LA | General Acute Care Hospital (282N00000X) |
United | 920 | $10964.00 | 1902366305 - BAYLOR SCOTT & WHITE MEDICAL CENTERS, BAYLOR SCOTT & WHITE MEDICAL CENTER - AUSTIN | 813040663 - (TX) BAYLOR SCOTT & WHITE MEDICAL CENTERS-CAPITOL AREA | TX | General Acute Care Hospital (282N00000X) |
United | 920 | $2893.00 | 1144557927 - SAVOY MEDICAL MANAGEMENT GROUP, INC., SAVOY MEDICAL CENTER-REHAB UNIT | 800202027 - (LA) SAVOY MEDICAL MANAGEMENT GROUP INC | LA | Rehabilitation Hospital Unit (273Y00000X) |
United | 920 | $13006.57 | 1538163886 - DAMERON HOSPITAL ASSOCIATION | 941201197 - (CA) DAMERON HOSPITAL ASSOCIATION | CA | General Acute Care Hospital (282N00000X) |
United | 920 | $16113.19 | 1962726067 - NORTHWESSTERN LAKE FOREST HOSPITA | 362179779 - (IL) NORTHWESTERN MEMORIAL HEALTHCARE | IL | General Acute Care Hospital (282N00000X) |
United | 920 | $10468.25 | 1487607784 - NORTHWEST HOSPITAL LLC, NORTHWEST MEDICAL CENTER | 522379881 | AZ | General Acute Care Hospital (282N00000X) |
United | 920 | $15938.45 | 1811912405 - NASSAU HEALTH CARE CORPORATION, NUMC DEPARTMENT OF NEUROLOGY, FPP | 113465690 | NY | General Acute Care Hospital (282N00000X) |
United | 920 | $13283.40 | 1154353993 - SOUTHWEST GENERAL HEALTH CENTER | 340753531 - (OH) SOUTHWEST GENERAL HEALTH CENTER | OH | General Acute Care Hospital (282N00000X) |
United | 920 | $17189.33 | 1487639175 - KNOX COUNTY HOSPITAL DISTRICT, KNOX COUNTY HOSPITAL DISTRICT | 750808798 | TX | General Acute Care Hospital (282N00000X) |
United | 920 | $9392.07 | 1063639268 - ANDERSON REGIONAL MEDICAL CENTER, PROFESSIONAL FEES-HOSPITALIST/CVSURG | 640362400 - (MS) ANDERSON REGIONAL MEDICAL CENTER | MS | General Acute Care Hospital (282N00000X) |
United | 920 | $15359.70 | 1245409309 - EASTON HOSPITAL | 844475996 - (PA) ST LUKES HOSPITAL-EASTON CAMPUS | PA | General Acute Care Hospital (282N00000X) |
United | 920 | $8918.57 | 1972557064 - BILOXI HMA LLC, MERIT HEALTH BILOXI | 592754033 | MS | General Acute Care Hospital (282N00000X) |
United | 920 | $11167.79 | 1669558771 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 920 | $11885.00 | 1730166224 - INSIGHT CHICAGO, INC., INSIGHT HOSPITAL & MEDICAL CENTER CHICAGO | 862358048 - INSIGHT CHICAGO INC | IL | 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 920 vs. Other Injuries, Poisonings & Toxic Effects of Drugs Codes
The MS-DRG 920 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 920 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 |
|---|---|---|
| 919-APR-DRG | Moderate | Other Major Head And Neck Procedures |
| 919-MS-DRG | High | Complications of Treatment with MCC |
| 920-MS-DRG | High | Complications of Treatment with CC |
| 921-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 920. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 920 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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