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See a sample rate comparisonMS-DRG 921 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 WITHOUT CC/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 921 by major payers:
$8,561.97
$9,765.88
$10,971.97
$11,319.61
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MS-DRG 921
5 of 25 sample ratesHigher to lower in this preview
Swedish Health Services, Swedish Medical Center, Cherry Hill
Swedish Health Services
$17,252.68Published rateBaylor University Medical Center
$11,494.00Published rateOrlando Health
Orlando Health Inc
$9,240.00Published rateAscension St John Hospital, St John Hospital And Medical Center
Ascension St John Hospital
$7,431.29Published rateUhs-Corona Inc, Corona Regional Medical Center
$3,288.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 921 vs. Other Injuries, Poisonings & Toxic Effects of Drugs Codes
The MS-DRG 921 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 921 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 |
|---|---|---|
| 920-APR-DRG | Moderate | Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures |
| 920-MS-DRG | High | COMPLICATIONS OF TREATMENT WITH CC |
| 921-MS-DRG | High | COMPLICATIONS OF TREATMENT WITHOUT CC/MCC |
| 922-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 921. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 921 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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