MS-DRG 975 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 | • Human Immunodeficiency Virus Infections |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 975 by major payers:
$17,382.20
$18,777.52
$22,286.22
$22,855.27
| 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 975 | ||||||
United | 975 | $34500.21 | 1003956913 - MISSION HOSPITAL REGIONAL MEDICAL CENTER, PROVIDENCE MISSION HOSPITAL | 951643360 - (CA) MISSION HOSPITAL REGIONAL MEDICAL CENTER | CA | Rehabilitation Hospital (283X00000X) |
United | 975 | $31130.72 | 1043224355 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION, KINGS COUNTY HOSPITAL CENTER | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | General Acute Care Hospital (282N00000X) |
United | 975 | $23896.58 | 1043600026 - PALOS COMMUNITY HOSPITAL | 362169179 - (IL) NORTHWESTERN MEMORIAL HEALTHCARE | IL | General Acute Care Hospital (282N00000X) |
United | 975 | $38593.85 | 1841376092 - PROVIDENCE HEALTH & SERVICES OREGON, PROVIDENCE PORTLAND MEDICAL CENTER | 930386906 | OR | Rehabilitation Hospital Unit (273Y00000X) |
United | 975 | $5761.00 | 1235510090 - HERITAGE PARK SURGICAL HOSPITAL LLC, BAYLOR SCOTT & WHITE SURGICAL HOSPITAL AT SHERMAN | 611762781 | TX | General Acute Care Hospital (282N00000X) |
United | 975 | $7895.87 | 1417554437 - HOSPITAL AUTHORITY OF JEFFERSON COUNTY AND THE CITY OF LOUISVILLE, JEFFERSON HOSPITAL | 581309961 - (GA) HOSPITAL AUTHORITY OF JEFFERSON COUNTY AND THE CITY OF LOUISVILLE | GA | Psychiatric Hospital Unit (273R00000X) |
United | 975 | $24506.05 | 1881048221 - BBH CBMC, LLC, CITIZENS BAPTIST MEDICAL CENTER | 474802869 | AL | Psychiatric Hospital Unit (273R00000X) |
United | 975 | $16795.25 | 1427114883 - FRANCISCAN HEALTH CROWN POINT, FRANCISCAN ST. ANTHONY HEALTH - CROWN POINT | 352074283 - (IN) FRANCISCAN HEALTH CROWN POINT | IN | Rehabilitation Hospital Unit (273Y00000X) |
United | 975 | $16152.79 | 1639172869 - CUMBERLAND COUNTY HOSPITAL SYSTEM INC, CAPE FEAR VALLEY MEDICAL CENTER | 800164702 | NC | General Acute Care Hospital (282N00000X) |
United | 975 | $11015.23 | 1477757151 - TAYLOR COUNTY HOSPITAL DISTRICT HEALTH FACILITIES CORPORATION | 610676546 - (KY) TAYLOR COUNTY HOSPITAL DISTRICT HEALTH FACILITIES CORP | KY | General Acute Care Hospital (282N00000X) |
United | 975 | $38593.85 | 1841376092 - PROVIDENCE HEALTH & SERVICES OREGON, PROVIDENCE PORTLAND MEDICAL CENTER | 930386906 | OR | Rehabilitation Hospital Unit (273Y00000X) |
United | 975 | $21089.31 | 1992131734 - DIGNITY HEALTH, ST. JOSEPH'S WESTGATE MEDICAL CENTER | 721561134 - (AZ) ST JOSEPHS HOSPITAL AND MEDICAL CENTER | AZ | General Acute Care Hospital (282N00000X) |
United | 975 | $20803.33 | 1497792527 - UNIVERSITY HEALTHCARE SYSTEM, L.C., TULANE LAKESIDE HOSPITAL | 621596506 | LA | General Acute Care Hospital (282N00000X) |
United | 975 | $1820.00 | 1538108725 - JACKSON COUNTY HOSPITAL DISTRICT, JACKSON HOSPITAL | 596001321 - (FL) JACKSON COUNTY HOSPITAL DISTRICT | FL | General Acute Care Hospital (282N00000X) |
United | 975 | $31643.21 | 1427133883 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
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 975 vs. Other Human Immunodeficiency Virus Infections Codes
The MS-DRG 975 code is part of the Human Immunodeficiency Virus Infections 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 975 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 |
|---|---|---|
| 974-APR-DRG | Moderate | Tonsil And Adenoid Procedures |
| 974-MS-DRG | High | HIV with Major Related Condition with MCC |
| 975-MS-DRG | High | HIV with Major Related Condition with CC |
| 976-MS-DRG | High | HIV with Major Related Condition 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 975. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 975 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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