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 | $14850.96 | 1548296106 - MERCY HEALTH YOUNGSTOWN LLC, MERCY HEALTH ST ELIZABETH YOUNGSTOWN HOSPITAL | 340505560 - HUMILITY OF MARY HEALTH PARTNERS | OH | General Acute Care Hospital (282N00000X) |
United | 655 | $29833.23 | 1003347279 - AHS PRYOR HOSPITAL, LLC, HILLCREST HOSPITAL PRYOR | 820651263 | OK | General Acute Care Hospital (282N00000X) |
United | 655 | $27230.66 | 1033163092 - JACKSON HMA LLC, MERIT HEALTH CENTRAL | 640907122 | MS | 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 | $23940.39 | 1083931109 - MINERS COLFAX MEDICAL CENTER | 850323546 - (NM) MINERS COLFAX MEDICAL CENTER | NM | Critical Access Hospital (282NC0060X) |
United | 655 | $40248.96 | 1689821944 - STATEN ISLAND UNIVERSITY HOSPITAL | 112868878 - (NY) STATEN ISLAND UNIVERSITY HOSPITAL | NY | 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 | $40326.67 | 1902466840 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 655 | $39265.12 | 1427093962 - MERCY MEDICAL CENTER-CLINTON, INC, MERCYONE CLINTON MEDICAL CENTER | 421336618 - (IA) MERCY MEDICAL CENTER-CLINTON INC | IA | General Acute Care Hospital (282N00000X) |
United | 655 | $62036.76 | 1912938788 - DESERT REGIONAL MEDICAL CENTER, INC., DESERT REGIONAL MEDICAL CENTER | 752694137 | CA | Rehabilitation Hospital Unit (273Y00000X) |
United | 655 | $19144.40 | 1073598439 - VALLEY MEDICAL FACILITIES, INC., HERITAGE VALLEY KENNEDY | 251801532 - (PA) HERITAGE VALLEY HEALTH SYSTEM | PA | General Acute Care Hospital (282N00000X) |
United | 655 | $18515.16 | 1356345318 - NEBRASKA ORTHOPAEDIC HOSPITAL LLC | 470845237 - (NE) NEBRASKA ORTHOPAEDIC HOSPITAL, LLC | NE | General Acute Care Hospital (282N00000X) |
United | 655 | $34395.92 | 1538671946 - THE BARIATRIC CENTER OF KANSAS CITY LLC | 823025378 - (KS) THE BARIATRIC CENTER OF KANSAS CITY LLC | KS | Special Hospital (284300000X) |
United | 655 | $32590.75 | 1598905762 - CENTRAL IOWA HOSPITAL CORPORATION, UNITYPOINT HEALTH - DES MOINES IOWA METHODIST MEDICAL CENTER | 420680452 - CENTRAL IOWA HOSPITAL CORPORATION | IA | General Acute Care Hospital (282N00000X) |
United | 655 | $44932.00 | 1306871223 - SOUTHCOAST HOSPITALS GROUP, INC, CHARLTON MEMORIAL HOSPITAL | 222592333 - SOUTHCOAST HOSPITALS GROUP INC | MA | 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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