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MS-DRG 949 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.

Aftercare with 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 949 by major payers:

bcbs

$13,489.54

uhc

$19,704.62

aetna

$17,056.22

cigna

$17,367.09

Preview provider-level rates for...
For billing codeMS-DRG 949
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for MS-DRG 949

United
949$27208.061912567892 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITYCOGeneral Acute Care Hospital (282N00000X)
United
949$18140.151043600026 - PALOS COMMUNITY HOSPITAL362169179 - (IL) NORTHWESTERN MEMORIAL HEALTHCAREILGeneral Acute Care Hospital (282N00000X)
United
949$48251.141336220839 - GILA REGIONAL MEDICAL CENTER856000321 - (NM) GILA REGIONAL MEDICAL CENTERNMCritical Access Hospital (282NC0060X)
United
949$17438.351548296106 - MERCY HEALTH YOUNGSTOWN LLC, MERCY HEALTH ST ELIZABETH YOUNGSTOWN HOSPITAL340505560 - HUMILITY OF MARY HEALTH PARTNERSOHGeneral Acute Care Hospital (282N00000X)
United
949$15619.591306176839 - ORTHOCOLORADO, LLC, ORTHO COLORADO HOSPITAL AT ST ANTHONY MEDI371577105 - (CO) ORTHOCOLORADO HOSPITALCOSpecial Hospital (284300000X)
United
949$13978.211073580726 - METHODIST HOSPITAL PLAINVIEW TEXAS, COVENANT HOSPITAL PLAINVIEW752426010 - (TX) METHODIST HOSPITAL PLAINVIEW TEXASTXGeneral Acute Care Hospital (282N00000X)
United
949$7177.491780633289 - CHRIST HOSPITAL, THE CHRIST HOSPITAL310538525 - CHRIST HOSPITALOHGeneral Acute Care Hospital (282N00000X)
United
949$17045.591689737223 - SWAIN COUNTY HOSPITAL, INC.320441929NCCritical Access Hospital (282NC0060X)
United
949$17613.591205877172 - MVHS INC, WYNN HOSPITAL161576637 - FAXTON-ST LUKES HEALTHCARENYGeneral Acute Care Hospital (282N00000X)
United
949$7850.001336167550 - REEDLEY COMMUNITY HOSPITAL, ADVENTIST HEALTH REEDLEY453220509 - (CA) REEDLEY COMMUNITY HOSPITALCAGeneral Acute Care Hospital (282N00000X)
United
949$17619.661508273814 - FLOWER HOSPITAL, FLOWER HOSPITAL RADIOLOGY344428256 - (OH) TOLEDO HOSPITALOHGeneral Acute Care Hospital (282N00000X)
United
949$39214.421801212410 - WESTCHESTER COUNTY HEALTH CARE CORPORATION, MID-HUDSON VALLEY DIVISION OF WESTCHESTER MEDICAL CENTER133964321 - (NY) PEO MID-HUDSON VALLEY STAFFCONYRehabilitation Hospital Unit (273Y00000X)
United
949$46715.281740215219 - JOHN MUIR HEALTH, JOHN MUIR HEALTH, WALNUT CREEK MEDICAL CENTER941461843 - (CA) JOHN MUIR HEALTHCAGeneral Acute Care Hospital (282N00000X)
United
949$22032.921679592380 - WEST PENN ALLEGHENY HEALTH SYSTEM INC., FORBES REGIONAL HOSPITAL250969492 - (PA) HIGHMARK HEALTHPAGeneral Acute Care Hospital (282N00000X)
United
949$34953.101942326970 - PANA COMMUNITY HOSPITAL ASSOCIATION376062326 - (IL) PANA COMMUNITY HOSPITAL ASSOCIATIONILCritical Access Hospital (282NC0060X)
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 949 vs. Other Factors Influencing Health Status & Other Contacts with Health Services Codes

The MS-DRG 949 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 949 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
948-MS-DRGHighSigns and Symptoms without MCC
949-MS-DRGHighAftercare with CC/MCC
950-APR-DRGHighEXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS
950-MS-DRGHighAftercare 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 949. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 949 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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