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See a sample rate comparisonMS-DRG 801 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 WITHOUT CC/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 801 by major payers:
$20,621.75
$21,481.43
$25,965.77
$26,834.21
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MS-DRG 801
5 of 25 sample ratesHigher to lower in this preview
John Muir Medical Center
$79,665.13Published rateBon Secours-Richmond Community Hospital LLC, Bon Secours Richmond Community Hospital Pro Fee Service
$34,217.39Published rateOsf Healthcare System, Osf Heart Of Mary Medical Center
Osf Healthcare System
$19,795.86Published rateScott & White Hospital Brenham, Baylor Scott & White Medical Center - Brenham
Scott & White Hospital Brenham
$8,161.00Published rateMccamey County Hospital District, Mccamey County Hospital District-Swing Bed
Mccamey County Hospital District
$1,500.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 801 vs. Other Diseases & Disorders of Blood, Blood Forming Organs, Immunologic Disorders Codes
The MS-DRG 801 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 801 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 |
|---|---|---|
| 800-MS-DRG | High | SPLENIC PROCEDURES WITH CC |
| 801-MS-DRG | High | SPLENIC PROCEDURES WITHOUT CC/MCC |
| 802-APR-DRG | Moderate | Acute Major Eye Infections |
| 802-MS-DRG | High | OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS 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 801. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 801 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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