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MS-DRG 946 Fee Schedule

Last Verified: March 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.

Rehabilitation without CC/MCC
Key FactDetail
Service Type

Factors Influencing Health Status & Other Contacts with Health Services

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Complexity LevelHigh

National average reimbursement for MS-DRG 946 by major payers:

bcbs

$11,580.49

uhc

$16,940.81

aetna

$17,613.96

cigna

$17,023.05

Preview provider-level rates for...
For billing codeMS-DRG 946
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for MS-DRG 946

United
946$23361.981669440327 - MOUNT SINAI HOSPITAL131624096 - MOUNT SINAI HOSPITALNYRehabilitation Hospital (283X00000X)
United
946$7993.241477509859 - PHYSICIANS MEDICAL CENTER, LLC721275428 - (LA) PHYSICIANS MEDICAL CENTER, LLCLAGeneral Acute Care Hospital (282N00000X)
United
946$17517.891265460232 - NORTH BROWARD HOSPITAL DISTRICT, BROWARD HEALTH IMPERIAL POINT596012065 - NORTH BROWARD HOSPITAL DISTRICTFLGeneral Acute Care Hospital (282N00000X)
United
946$37754.441538522412 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE TRANSMOUNTAIN CAMPUS954537720TXGeneral Acute Care Hospital (282N00000X)
United
946$8305.661467493551 - MERCY HEALTH, MERCY HEALTH ST VINCENT MEDICAL CENTER344428250 - MERCY HEALTH - ST VINCENT MEDICAL CENTER LLCOHGeneral Acute Care Hospital (282N00000X)
United
946$19868.901922053107 - AURORA HEALTH CARE CENTRAL, INC., AURORA MEDICAL CENTER SHEBOYGAN COUNTY390930748 - AURORA HEALTH CARE CENTRAL INCWIGeneral Acute Care Hospital (282N00000X)
United
946$15716.401629017793 - ST. LUKE'S HOSPITAL OF DULUTH, ASPIRUS ST LUKES SUPERIOR SURGERY CENTER410714079 - ST LUKES HOSPITAL OF DULUTHWIGeneral Acute Care Hospital (282N00000X)
United
946$24717.981083274930 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITYCOGeneral Acute Care Hospital (282N00000X)
United
946$8812.371831103654 - INTEGRIS BAPTIST MEDICAL CENTER INC731034824 - (OK) INTEGRIS BAPTIST MEDICAL CENTER INCOKGeneral Acute Care Hospital (282N00000X)
United
946$1800.001669403192 - NACOGDOCHES COUNTY HOSPITAL DISTRICT, NACOGDOCHES MEMORIAL HOSPITAL871142127 - (TX) LION STAR NACOGDOCHES HOSPITAL, LLC DBA NACOGDOCHES MEMORIAL HOSPITALTXRural Acute Care Hospital (282NR1301X)
United
946$7019.001194194720 - PRIME HEALTHCARE SERVICES-LEHIGH ACRES LLC871999484FLGeneral Acute Care Hospital (282N00000X)
United
946$18230.631407845035 - GOOD SAMARITAN MEDICAL CENTER, LLC, GOOD SAMARITAN MEDICAL CENTER431982139 - (CO) GOOD SAMARITAN MEDICAL CENTER LLCCOGeneral Acute Care Hospital (282N00000X)
United
946$15930.821942241799 - SAINT LUKE'S NORTH HOSPITAL, SAINT LUKE'S NORLAND HOSPITAL-SMITHVILLE440565393 - (MO) SAINT LUKES NORTH HOSPITALMOGeneral Acute Care Hospital (282N00000X)
United
946$11390.511841335783 - ST. JOSEPH HEALTH SERVICES OF RI, EEG GROUP464661337RIGeneral Acute Care Hospital (282N00000X)
United
946$16262.951013998426 - WSNCHS NORTH, INC., ST. JOSEPH HOSPITAL113438973 - ST JOSEPH HOSPITALNYGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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MS-DRG 946 vs. Other Factors Influencing Health Status & Other Contacts with Health Services Codes

The MS-DRG 946 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 946 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.

CodeComplexityDescription
945-MS-DRGHighRehabilitation with CC/MCC
946-MS-DRGHighRehabilitation without CC/MCC
947-MS-DRGHighSigns and Symptoms with 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 946. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 946 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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