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MS-DRG 043

Inpatient MS-DRG

Reported by 21 hospitals in the network under the case rate methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.

National pricing summary

Low

$70

Average

$10.5k

Median

$9.2k

High

$47.1k

Hospitals reporting this code

#HospitalLocation
1Central Iowa Hospital CorporationDes Moines, IA$69$70$70$71$1
2Twin City Hospital CorporationDennison, OH$46.2k$47.5k$47.1k$47.5k$573
3Trinity Hospital Holding CompanySteubenville, OH$45.3k$47.5k$46.6k$47.5k$1.1k
4UPMC PresbyterianPittsburgh, PA$4.1k$7.2k$7.2k$10.3k$3.1k
5UPMC Passavant - McCandlessPittsburgh, PA$4.1k$7.2k$7.2k$10.3k$3.1k
6UPMC Horizon - GreenvilleGreenville, PA$9.5k$9.5k$9.5k$9.5k—
7UPMC LititzLititz, PA$3.4k$3.4k$3.4k$3.4k—
8UPMC MercyPittsburgh, PA$10.3k$10.3k$10.3k$10.3k—
9UPMC HamotErie, PA$9.5k$9.5k$9.5k$9.5k—
10UPMC WilliamsportWilliamsport, PA$3.1k$3.3k$3.3k$3.4k$162
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