MS-DRG 655 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 | • Diseases & Disorders of the Kidney & Urinary Tract |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 655 by major payers:
$24,925.35
$27,578.20
$32,840.59
$33,737.96
| 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 655 | ||||||
United | 655 | $45249.82 | 1154314789 - ASCENSION VIA CHRISTI HOSPITALS WICHITA INC. | 481172106 - ASCENSION VIA CHRISTI HOSPITALS WICHITA INC | KS | General Acute Care Hospital (282N00000X) |
United | 655 | $23940.39 | 1083931109 - MINERS COLFAX MEDICAL CENTER | 850323546 - (NM) MINERS COLFAX MEDICAL CENTER | NM | Critical Access Hospital (282NC0060X) |
United | 655 | $51839.23 | 1699756221 - MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE, INC., MCLEOD REGIONAL MEDICAL CENTER | 570370242 - MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE INC | SC | General Acute Care Hospital (282N00000X) |
United | 655 | $37384.37 | 1306212923 - SMSJ TUCSON HOLDINGS LLC, ST. JOSEPHS HOSPITAL | 474131755 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 655 | $37384.37 | 1306212923 - SMSJ TUCSON HOLDINGS LLC, ST. JOSEPHS HOSPITAL | 474131755 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 655 | $33905.69 | 1992703540 - DUKE UNIVERSITY HEALTH SYSTEM, INC., DUKE UNIVERSITY HOSPITAL | 562070036 - DUKE UNIVERSITY HEALTH SYSTEM INC | NC | General Acute Care Hospital (282N00000X) |
United | 655 | $39023.80 | 1962453936 - WINCHESTER MEDICAL CENTER, WINCHESTER REHABILITATION CENTER | 540505979 - VALLEY HEALTH SYSTEM | VA | Rehabilitation Hospital Unit (273Y00000X) |
United | 655 | $4660.00 | 1518327733 - CASA COLINA HOSPITAL AND CENTERS FOR HEALTHCARE, CASA COLINA HOSPITAL | 951643989 - (CA) CASA COLINA HOSPITAL AND CENTERS FOR HEALTHCARE | CA | Rehabilitation Hospital (283X00000X) |
United | 655 | $119769.40 | 1639101116 - SIERRA VISTA HOSPITAL, INC., SIERRA VISTA REGIONAL MEDICAL CENTER | 952588614 | CA | General Acute Care Hospital (282N00000X) |
United | 655 | $42301.44 | 1972652063 - COMMUNITY MEDICAL CENTER | 240862246 - (PA) COMMUNITY MEDICAL CENTER | PA | General Acute Care Hospital (282N00000X) |
United | 655 | $22085.84 | 1518591809 - MERCY HOSPITAL ROGERS, MERCY HOSPITAL NORTHWEST ARKANSAS | 710294390 - MERCY HOSPITAL ROGERS | AR | Rehabilitation Hospital Unit (273Y00000X) |
United | 655 | $119769.40 | 1639101116 - SIERRA VISTA HOSPITAL, INC., SIERRA VISTA REGIONAL MEDICAL CENTER | 952588614 | CA | General Acute Care Hospital (282N00000X) |
United | 655 | $27482.67 | 1083669683 - LEHIGH HMA LLC, LEHIGH REGIONAL MEDICAL CENTER | 871999484 | FL | General Acute Care Hospital (282N00000X) |
United | 655 | $25620.31 | 1700901873 - EAST TEXAS MEDICAL CENTER REHABILITATION HOSPITAL | 823913174 | TX | Rehabilitation Hospital (283X00000X) |
United | 655 | $27482.67 | 1083669683 - LEHIGH HMA LLC, LEHIGH REGIONAL MEDICAL CENTER | 871999484 | FL | 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 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.
| Code | Complexity | Description |
|---|---|---|
| 654-MS-DRG | High | Major Bladder Procedures with CC |
| 655-MS-DRG | High | Major Bladder Procedures without CC/MCC |
| 656-MS-DRG | High | Kidney and Ureter Procedures for Neoplasm with 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 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.
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