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See a sample rate comparisonMS-DRG 812 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 WITHOUT 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 812 by major payers:
$10,055.38
$12,803.14
$14,558.91
$14,968.04
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MS-DRG 812
5 of 25 sample ratesHigher to lower in this preview
Sentara Hospitals, Sentara Careplex Hospital
Sentara Hospitals
$21,298.75Published rateUniversity Of Colorado Hospital Authority
$16,775.53Published rateLucy Webb Hayes National Training School For Deaconesses & Missionarie, Sibley Memorial Hospital
Lucy Webb Haynes National Training School For Deaconesses And Mission
$15,266.00Published rateStaten Island University Hospital
$8,622.00Published rateParish Hospital Service District For The Parish Of Orleans, New Orleans East Hospital
$3,191.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 812 vs. Other Diseases & Disorders of Blood, Blood Forming Organs, Immunologic Disorders Codes
The MS-DRG 812 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 812 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 |
|---|---|---|
| 811-APR-DRG | High | ALLERGIC REACTIONS |
| 811-MS-DRG | High | RED BLOOD CELL DISORDERS WITH MCC |
| 812-MS-DRG | High | RED BLOOD CELL DISORDERS WITHOUT MCC |
| 813-APR-DRG | High | OTHER COMPLICATIONS OF TREATMENT |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 812. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 812 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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