MS-DRG 940 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 | • Factors Influencing Health Status & Other Contacts with Health Services |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 940 by major payers:
$25,070.10
$27,515.40
$33,094.65
$34,233.28
| 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 940 | ||||||
United | 940 | $40602.41 | 1730330838 - PROVIDENCE HEALTH & SERVICES-WA | 352346161 | WA | Rehabilitation Hospital Unit (273Y00000X) |
United | 940 | $33686.30 | 1821091851 - CUMBERLAND COUNTY HOSPITAL SYSTEM INC, SOUTHEASTERN REGIONAL REHABILITATION CENTER | 560845796 - CUMBERLAND COUNTY HOSPITAL SYSTEM INC | NC | Rehabilitation Hospital Unit (273Y00000X) |
United | 940 | $34545.53 | 1346218294 - BOSTON MEDICAL CENTER CORPORATION | 43314093 - (MA) BOSTON MEDICAL CENTER CORPORATION | MA | General Acute Care Hospital (282N00000X) |
United | 940 | $23117.72 | 1033163407 - ST JOSEPH HEALTH SYSTEM LLC, LUTHERAN DOWNTOWN HOSPITAL | 510382045 | IN | Rehabilitation Hospital Unit (273Y00000X) |
United | 940 | $39888.57 | 1780638833 - CARTERSVILLE MEDICAL CENTER LLC, CARTERSVILLE MEDICAL CENTER | 582433438 - (GA) CARTERSVILLE MEDICAL CENTER LLC | GA | General Acute Care Hospital (282N00000X) |
United | 940 | $29201.42 | 1811059595 - THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY, ESKENAZI HEALTH | 356005697 | IN | Psychiatric Hospital Unit (273R00000X) |
United | 940 | $14967.62 | 1477594299 - PREFERRED HOSPITAL LEASING INC., COLLINGSWORTH GENERAL HOSPITAL | 200929321 | TX | Critical Access Hospital (282NC0060X) |
United | 940 | $4346.00 | 1215021225 - IRA DAVENPORT MEMORIAL HOSPITAL, INC. | 160835446 - (NY) IRA DAVENPORT MEMORIAL HOSPITAL INC | NY | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 940 | $18440.28 | 1992738959 - FISHER-TITUS MEDICAL CENTER | 344430716 - (OH) FISHER TITUS MEDICAL CENTER | OH | General Acute Care Hospital (282N00000X) |
United | 940 | $8959.00 | 1760580757 - VCU HEALTH TAPPAHANNOCK HOSPITAL | 541489410 - (VA) VCU HEALTH TAPPAHANNOCK HOSPITAL | VA | Rural Acute Care Hospital (282NR1301X) |
United | 940 | $53010.92 | 1235764622 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | General Acute Care Hospital (282N00000X) |
United | 940 | $27777.58 | 1376512988 - INDIAN RIVER MEMORIAL HOSPITAL INC, CLEVELAND CLINIC INDIAN RIVER HOSPITAL | 592496294 - INDIAN RIVER MEMORIAL HOSPITAL INC | FL | General Acute Care Hospital (282N00000X) |
United | 940 | $14104.25 | 1023000296 - GROVE CITY MEDICAL CENTER | 251340370 - GROVE CITY MEDICAL CENTER | PA | General Acute Care Hospital (282N00000X) |
United | 940 | $32705.78 | 1821187758 - EAST BATON ROUGE MEDICAL CENTER REHAB, OCHSNER MEDICAL CENTER BATON ROUGE REHAB | 201729674 | LA | Rehabilitation Hospital Unit (273Y00000X) |
United | 940 | $6141.00 | 1356410351 - PRIME HEALTHCARE PARADISE VALLEY LLC, PARADISE VALLEY HOSPITAL | 205837239 | CA | 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 940 vs. Other Factors Influencing Health Status & Other Contacts with Health Services Codes
The MS-DRG 940 code is part of the Factors Influencing Health Status & Other Contacts with Health Services 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 940 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 |
|---|---|---|
| 939-MS-DRG | High | O.R. Procedures with Diagnoses of Other Contact with Health Services with MCC |
| 940-MS-DRG | High | O.R. Procedures with Diagnoses of Other Contact with Health Services with CC |
| 941-MS-DRG | High | O.R. Procedures with Diagnoses of Other Contact with Health Services without CC/MCC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 940. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 940 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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