MS-DRG 976 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 976 by major payers:
$12,751.32
$13,669.21
$15,692.07
$16,291.74
| 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 976 | ||||||
United | 976 | $10339.53 | 1104819366 - CHILDREN'S HOSPITAL | 720467503 - CHILDRENS HOSPITAL INC | LA | Children's Hospital (282NC2000X) |
United | 976 | $17502.34 | 1427722974 - SOUTHERN BAPTIST HOSPITAL OF FLORIDA, INC, BAPTIST NORTH | 590747311 - SOUTHERN BAPTIST HOSPITAL OF FLORIDA INC | FL | General Acute Care Hospital (282N00000X) |
United | 976 | $9560.20 | 1770568123 - VHS ACQUISITION SUBSIDIARY NUMBER 3 INC, LOUIS A. WEISS MEMORIAL HOSPITAL | 352637418 | IL | General Acute Care Hospital (282N00000X) |
United | 976 | $4350.00 | 1720152945 - SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC, LAKE CHARLES MEMORIAL HOSPITAL | 720551963 - (LA) SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC | LA | General Acute Care Hospital (282N00000X) |
United | 976 | $9454.08 | 1851369243 - PARKWEST MEDICAL CENTER | 581897274 - (TN) PARKWEST MEDICAL CENTER | TN | Psychiatric Hospital Unit (273R00000X) |
United | 976 | $27997.74 | 1386189520 - FLORIDA HOSPITAL CELEBRATION HEALTH | 590724459 - (FL) ADVENTIST HEALTH SYSTEM-SUNBELT INC | FL | General Acute Care Hospital (282N00000X) |
United | 976 | $9234.12 | 1699773465 - UPMC ALTOONA | 231352155 - UPMC | PA | Psychiatric Hospital Unit (273R00000X) |
United | 976 | $26513.30 | 1821155912 - BAPTIST MEDICAL CENTER OF THE BEACHES, INC | 592980620 - (FL) BAPTIST MEDICAL CENTER BEACHES | FL | General Acute Care Hospital (282N00000X) |
United | 976 | $11335.41 | 1477585958 - KEARNEY CO HEALTH SERVICES, KEARNEY COUNTY HEALTH SERVICES | 476014070 - KEARNEY CO HEALTH SERVICES | NE | Critical Access Hospital (282NC0060X) |
United | 976 | $11385.04 | 1871977751 - GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION, MACNEAL HOSPITAL | 363332852 - (IL) GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 976 | $23436.34 | 1396087672 - DOCTORS MEDICAL CENTER OF MODESTO, INC., EMANUEL MEDICAL CENTER | 752918774 | CA | General Acute Care Hospital (282N00000X) |
United | 976 | $12386.04 | 1780837435 - ROANE COUNTY MEDICAL CENTER, ROANE MEDICAL CENTER | 680673354 - (TN) ROANE COUNTY MEDICAL CENTER | TN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 976 | $26355.83 | 1366932162 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY, UCHEALTH EMERGENCY ROOM - THORNTON | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 976 | $19745.15 | 1790860856 - CARONDELET HEALTH NETWORK, ST JOSEPH'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 976 | $7518.14 | 1467493551 - MERCY HEALTH, MERCY HEALTH ST VINCENT MEDICAL CENTER | 344428250 - MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC | OH | 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 976 vs. Other Human Immunodeficiency Virus Infections Codes
The MS-DRG 976 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 976 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 |
|---|---|---|
| 975-APR-DRG | Moderate | Tonsil And Adenoid Procedures |
| 975-MS-DRG | High | HIV with Major Related Condition with CC |
| 976-MS-DRG | High | HIV with Major Related Condition without CC/MCC |
| 977-APR-DRG | Moderate | Tonsil And Adenoid Procedures |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 976. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 976 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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