MS-DRG 959 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 | • Multiple Significant Trauma |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 959 by major payers:

$32,616.91

$34,477.43

$41,449.98

$43,585.89
| 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 959 | ||||||
United | 959 | $74533.60 | 1912938788 - DESERT REGIONAL MEDICAL CENTER, INC., DESERT REGIONAL MEDICAL CENTER | 752694137 | CA | Rehabilitation Hospital Unit (273Y00000X) |
United | 959 | $26010.66 | 1689627903 - ORO VALLEY HOSPITAL LLC, NORTHWEST TRANSITIONS | 522379881 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 959 | $27757.36 | 1033180765 - ASCENSION MACOMB OAKLAND HOSPITAL, ST. JOHN MACOMB OAKLAND HOSPITAL-WARREN CAMPUS | 383322109 - ASCENSION MACOMB OAKLAND HOSPITAL | MI | Rehabilitation Hospital Unit (273Y00000X) |
United | 959 | $5761.00 | 1598196206 - EBD BEMC BURLESON, LLC, BAYLOR EMERGENCY MEDICAL CENTER AT MANSFIELD | 364755936 | TX | General Acute Care Hospital (282N00000X) |
United | 959 | $66395.75 | 1356366314 - LEXINGTON COUNTY HEALTH SERVICES DISTRICT INC, LEXINGTON MEDICAL CENTER | 852276567 - LEXINGTON HEALTH INC | SC | General Acute Care Hospital (282N00000X) |
United | 959 | $16751.83 | 1548254931 - MARY RUTAN HOSPITAL | 341407259 - MARY RUTAN HOSPITAL | OH | General Acute Care Hospital (282N00000X) |
United | 959 | $56209.14 | 1508899204 - TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE | 751748586 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE | TX | General Acute Care Hospital (282N00000X) |
United | 959 | $63476.00 | 1962987677 - MH MISSION HOSPITAL, LLLP, MISSION HOSPITAL | 832048706 | NC | General Acute Care Hospital (282N00000X) |
United | 959 | $35147.51 | 1346247368 - MERIDIAN HOSPITALS CORPORATION, JERSEY SHORE UNIVERSITY MEDICAL CENTER | 340714755 - SUMMA HEALTH SYSTEM | NJ | General Acute Care Hospital (282N00000X) |
United | 959 | $20137.69 | 1952560914 - BANNER BOSWELL MEDICAL CENTER | 900389314 | AZ | General Acute Care Hospital (282N00000X) |
United | 959 | $24299.90 | 1639192891 - FORT PAYNE HOSPITAL CORPORATION, DEKALB REGIONAL MEDICAL CENTER | 204370870 | AL | Psychiatric Hospital Unit (273R00000X) |
United | 959 | $11052.00 | 1841948254 - CHILDREN'S HOSPITAL COLORADO | 840166760 - CHILDRENS HOSPITAL COLORADO | CO | Children's Hospital (282NC2000X) |
United | 959 | $12334.24 | 1689628984 - COLUMBIA HOSPITAL AT MEDICAL CITY DALLAS SUBSIDIARY LP, MEDICAL CITY DALLAS | 621682198 | TX | General Acute Care Hospital (282N00000X) |
United | 959 | $13786.04 | 1609840545 - KC REHABILITATION HOSPITAL INC, MIDAMERICA REHABILITATION HOSPITAL | 742491473 - (KS) KC REHABILITATION HOSPITAL INC | KS | Rehabilitation Hospital (283X00000X) |
United | 959 | $36554.55 | 1710109186 - ST. MARY MEDICAL CENTER, PROVIDENCE ST. MARY MEDICAL CENTER | 951914489 - (CA) ST MARY MEDICAL CENTER | 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 959 vs. Other Multiple Significant Trauma Codes
The MS-DRG 959 code is part of the Multiple Significant Trauma 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 959 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 |
|---|---|---|
| 958-MS-DRG | High | Other O.R. Procedures for Multiple Significant Trauma with CC |
| 959-MS-DRG | High | Other O.R. Procedures for Multiple Significant Trauma without CC/MCC |
| 963-MS-DRG | High | Other Multiple Significant Trauma 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 959. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 959 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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