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Definition

Billing code

A standard code, such as CPT, HCPCS or MS-DRG, that identifies the service or item a rate applies to.

Every rate in an MRF is tied to a billing code. The most common types are CPT codes for physician and outpatient procedures, HCPCS Level II codes for supplies, drugs and some services, and MS-DRGs for inpatient hospital stays.

MRFs also record the billing code type version, since code sets are revised every year. Comparing the same code across providers is the basis of any price comparison.

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