MS-DRG 921 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 921 by major payers:
$8,561.97
$9,765.88
$10,971.97
$11,319.61
| 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 921 | ||||||
United | 921 | $3288.00 | 1346236015 - UHS-CORONA INC, CORONA REGIONAL MEDICAL CENTER | 432035443 | CA | Psychiatric Hospital Unit (273R00000X) |
United | 921 | $8564.62 | 1811059595 - THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY, ESKENAZI HEALTH | 356005697 | IN | Psychiatric Hospital Unit (273R00000X) |
United | 921 | $9510.88 | 1215572045 - OSF HEALTHCARE SYSTEM, OSF LITTLE COMPANY OF MARY MEDICAL CENTER | 370813229 - (IL) OSF HEALTHCARE SYSTEM | IL | General Acute Care Hospital (282N00000X) |
United | 921 | $7520.18 | 1700961869 - CARONDELET HEALTH NETWORK, ST. MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 921 | $14412.00 | 1245262757 - ATLANTICARE REGIONAL MEDICAL CENTER | 210634549 - (NJ) ATLANTICARE HEALTH SYSTEM INC | NJ | Special Hospital (284300000X) |
United | 921 | $9391.91 | 1386868289 - NICHOLAS H. NOYES MEMORIAL HOSPITAL | 160743979 - (NY) NICHOLAS H NOYES MEMORIAL HOSPITAL | NY | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 921 | $11595.00 | 1730620428 - JERSEY CITY MEDICAL CENTER-RWJ BARNABAS HEALTH | 222783298 - (NJ) JERSEY CITY MEDICAL CENTER | NJ | General Acute Care Hospital (282N00000X) |
United | 921 | $10450.29 | 1437107208 - CASA GRANDE COMMUNITY HOSPITAL, CASA GRANDE REGIONAL MEDICAL CENTER | 450233470 - BANNER HEALTH | AZ | General Acute Care Hospital (282N00000X) |
United | 921 | $5328.00 | 1235510090 - HERITAGE PARK SURGICAL HOSPITAL LLC, BAYLOR SCOTT & WHITE SURGICAL HOSPITAL AT SHERMAN | 611762781 | TX | General Acute Care Hospital (282N00000X) |
United | 921 | $13261.61 | 1518382944 - UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER, RBC AT AMC | 341567805 - UNIVERSITY HOSPITALS HEALTH SYSTEM INC | OH | Children's Hospital (282NC2000X) |
United | 921 | $9859.00 | 1730540238 - CHILDREN'S HOSPITAL COLORADO, CHILDREN'S HOSPITAL COLORADO SOUTH CAMPUS | 840166760 - CHILDRENS HOSPITAL COLORADO | CO | Children's Hospital (282NC2000X) |
United | 921 | $8242.76 | 1942294939 - ST JOSEPH REGIONAL HEALTH CENTER, ST JOSEPH AMBULATORY SURGERY | 741282696 - ST JOSEPH REGIONAL HEALTH CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 921 | $10789.33 | 1538186143 - NASSAU HEALTH CARE CORPORATION, NASSAU UNIV MED CENTER-PSYCH | 113465690 | NY | Psychiatric Hospital Unit (273R00000X) |
United | 921 | $12245.19 | 1487218509 - SMSJ TUCSON HOLDINGS, LLC, CARONDELET MARANA HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 921 | $5296.66 | 1730128836 - MIDWEST REGIONAL MEDICAL CENTER, LLC, ALLIANCEHEALTH MIDWEST | 730657693 - SSM HEALTH CARE OF OKLAHOMA INC | OK | 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 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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