MS-DRG 949 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 949 by major payers:

$13,489.54

$19,704.62

$17,056.22

$17,367.09
| 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 949 | ||||||
United | 949 | $27208.06 | 1912567892 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 949 | $18140.15 | 1043600026 - PALOS COMMUNITY HOSPITAL | 362169179 - (IL) NORTHWESTERN MEMORIAL HEALTHCARE | IL | General Acute Care Hospital (282N00000X) |
United | 949 | $48251.14 | 1336220839 - GILA REGIONAL MEDICAL CENTER | 856000321 - (NM) GILA REGIONAL MEDICAL CENTER | NM | Critical Access Hospital (282NC0060X) |
United | 949 | $17438.35 | 1548296106 - MERCY HEALTH YOUNGSTOWN LLC, MERCY HEALTH ST ELIZABETH YOUNGSTOWN HOSPITAL | 340505560 - HUMILITY OF MARY HEALTH PARTNERS | OH | General Acute Care Hospital (282N00000X) |
United | 949 | $15619.59 | 1306176839 - ORTHOCOLORADO, LLC, ORTHO COLORADO HOSPITAL AT ST ANTHONY MEDI | 371577105 - (CO) ORTHOCOLORADO HOSPITAL | CO | Special Hospital (284300000X) |
United | 949 | $13978.21 | 1073580726 - METHODIST HOSPITAL PLAINVIEW TEXAS, COVENANT HOSPITAL PLAINVIEW | 752426010 - (TX) METHODIST HOSPITAL PLAINVIEW TEXAS | TX | General Acute Care Hospital (282N00000X) |
United | 949 | $7177.49 | 1780633289 - CHRIST HOSPITAL, THE CHRIST HOSPITAL | 310538525 - CHRIST HOSPITAL | OH | General Acute Care Hospital (282N00000X) |
United | 949 | $17045.59 | 1689737223 - SWAIN COUNTY HOSPITAL, INC. | 320441929 | NC | Critical Access Hospital (282NC0060X) |
United | 949 | $17613.59 | 1205877172 - MVHS INC, WYNN HOSPITAL | 161576637 - FAXTON-ST LUKES HEALTHCARE | NY | General Acute Care Hospital (282N00000X) |
United | 949 | $7850.00 | 1336167550 - REEDLEY COMMUNITY HOSPITAL, ADVENTIST HEALTH REEDLEY | 453220509 - (CA) REEDLEY COMMUNITY HOSPITAL | CA | General Acute Care Hospital (282N00000X) |
United | 949 | $17619.66 | 1508273814 - FLOWER HOSPITAL, FLOWER HOSPITAL RADIOLOGY | 344428256 - (OH) TOLEDO HOSPITAL | OH | General Acute Care Hospital (282N00000X) |
United | 949 | $39214.42 | 1801212410 - WESTCHESTER COUNTY HEALTH CARE CORPORATION, MID-HUDSON VALLEY DIVISION OF WESTCHESTER MEDICAL CENTER | 133964321 - (NY) PEO MID-HUDSON VALLEY STAFFCO | NY | Rehabilitation Hospital Unit (273Y00000X) |
United | 949 | $46715.28 | 1740215219 - JOHN MUIR HEALTH, JOHN MUIR HEALTH, WALNUT CREEK MEDICAL CENTER | 941461843 - (CA) JOHN MUIR HEALTH | CA | General Acute Care Hospital (282N00000X) |
United | 949 | $22032.92 | 1679592380 - WEST PENN ALLEGHENY HEALTH SYSTEM INC., FORBES REGIONAL HOSPITAL | 250969492 - (PA) HIGHMARK HEALTH | PA | General Acute Care Hospital (282N00000X) |
United | 949 | $34953.10 | 1942326970 - PANA COMMUNITY HOSPITAL ASSOCIATION | 376062326 - (IL) PANA COMMUNITY HOSPITAL ASSOCIATION | IL | Critical Access Hospital (282NC0060X) |
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 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.
| Code | Complexity | Description |
|---|---|---|
| 948-MS-DRG | High | Signs and Symptoms without MCC |
| 949-MS-DRG | High | Aftercare with CC/MCC |
| 950-APR-DRG | High | EXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS |
| 950-MS-DRG | High | Aftercare 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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