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See a sample rate comparisonMS-DRG 799 Fee Schedule
Last Verified: October 2026
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.
SPLENIC PROCEDURES WITH MCC
| Key Fact | Detail |
|---|---|
| Service Type | Diseases & Disorders of Blood, Blood Forming Organs, Immunologic Disorders |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 799 by major payers:
$55,408.97
$60,570.61
$74,752.01
$76,601.43
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MS-DRG 799
5 of 25 sample ratesHigher to lower in this preview
Maimonides Medical Center
Maimonides Medical Center-
$144,122.73Published rateAllina Health System, Mercy Hospital
Allina Health System
$93,066.81Published rateOttumwa Regional Health Center, Inc
$69,748.64Published rateFresno Surgery Center Lp
Fresno Surgical Center, Lp Dba Fresno Surgical Hospital
$47,327.57Published rateCreek Nation Hospital & Clinics, Muscogee (Creek) Nation Medical Center
Muscogee (Creek) Nation Department Of Health
$3,308.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 799 vs. Other Diseases & Disorders of Blood, Blood Forming Organs, Immunologic Disorders Codes
The MS-DRG 799 code is part of the Diseases & Disorders of Blood, Blood Forming Organs, Immunologic Disorders 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 799 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 |
|---|---|---|
| 798-MS-DRG | High | VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC |
| 799-MS-DRG | High | SPLENIC PROCEDURES WITH MCC |
| 800-MS-DRG | High | SPLENIC PROCEDURES WITH CC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 799. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 799 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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