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MS-DRG 655 Fee Schedule

Last Updated: August 2025

Major Bladder Procedures without CC/MCC
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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 FactDetail
Service Type

Diseases & Disorders of the Kidney & Urinary Tract

Common Place of Service

21 - Inpatient Hospital

22 - On Campus-Outpatient Hospital

Common Modifiers
Complexity LevelHigh

National average reimbursement for MS-DRG 655 by major payers:

bcbs

$24,925.35

uhc

$27,578.20

aetna

$32,840.59

cigna

$33,737.96


Find Fee Schedule & Reimbursement for Other Codes

Use our free lookup tool to explore fee schedules and reimbursement rates for any billing code. Select a code type, then type or select a code to view its details.


What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 655. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 655 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.

MS-DRG 655 vs. Other Diseases & Disorders of the Kidney & Urinary Tract Codes

The MS-DRG 655 code is part of the Diseases & Disorders of the Kidney & Urinary Tract 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 655 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.

MS-DRG CodeComplexity LevelDescription
654High
Major Bladder Procedures with CC
655High
Major Bladder Procedures without CC/MCC
656High
Kidney and Ureter Procedures for Neoplasm with MCC

See what providers are getting paid in 2025 for 655:

MS-DRG 655 Fee Schedule & Reimbursement Rates

The MS-DRG 655 fee schedule varies by payer type. Below are Medicare rates for 2025 and average in-network rates by state across major payers:

CodeMedicare RateAvg. BCBS National RateMore Info
654$33,586.73

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655$24,925.35

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656$37,232.06

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Reimbursement rates depend on provider contracts, region, and payer. Always verify rates with your insurance provider or medical billing department.


What is price transparency?

The Price Transparency Rule is a federal law that took effect in July 2022, requiring all commercial payers to publicly disclose their prices through machine-readable files (MRFs). In short, this regulation mandates that insurance companies make healthcare costs transparent to the public.

Our data comes directly from these insurer-posted MRFs, ensuring compliance with the Price Transparency Rule. While PayerPrice is working toward a future where providers and payers collaborate for 100% upfront price certainty, it's important to acknowledge that data limitations and occasional errors may exist.


Unlock access to price transparency insights today.

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