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See a sample rate comparisonMS-DRG 811 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.
RED BLOOD CELL DISORDERS 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 811 by major payers:
$16,067.84
$18,639.40
$22,040.63
$22,544.29
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MS-DRG 811
5 of 25 sample ratesHigher to lower in this preview
Medstar Washington Hospital Center
Washington Hospital Center Corporation
$35,909.71Published rateAurora Health Care Southern Lakes, Inc., Aurora Medical Center Burlington
Aurora Health Care Inc
$28,961.03Published rateCleveland Clinic Health System, South Pointe Hospital
Cleveland Clinic Health System East Region
$19,365.47Published rateKittson Memorial Hospital Association, Kittson Memorial Hospital Association
Kittson Memorial Hospital Association
$13,346.87Published rateTyrone Hospital
$8,507.51Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 811 vs. Other Diseases & Disorders of Blood, Blood Forming Organs, Immunologic Disorders Codes
The MS-DRG 811 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 811 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 |
|---|---|---|
| 810-APR-DRG | High | HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION |
| 810-MS-DRG | High | MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC |
| 811-MS-DRG | High | RED BLOOD CELL DISORDERS WITH MCC |
| 812-APR-DRG | High | POISONING OF MEDICINAL AGENTS |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 811. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 811 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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