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See a sample rate comparisonMS-DRG 815 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.
RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC
| 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 815 by major payers:
$12,267.66
$13,859.01
$16,069.77
$16,467.96
Compare published rates across providers.
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MS-DRG 815
5 of 25 sample ratesHigher to lower in this preview
Fletcher Allen Health Care
University Of Vermont Medical Center Inc
$32,431.80Published rateProvidence Sacred Heart Medical Center
$19,892.18Published rateGottlieb Memorial Hospital
$13,120.90Published rateJewish Hospital & St. Mary'S Healthcare, Inc., Frazier Rehab Institute Springhurst
Uofl Health-Louisville Inc
$10,953.37Published ratePecos County Memorial Hospital District
$8,984.36Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 815 vs. Other Diseases & Disorders of Blood, Blood Forming Organs, Immunologic Disorders Codes
The MS-DRG 815 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 815 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 |
|---|---|---|
| 814-MS-DRG | High | RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC |
| 815-MS-DRG | High | RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC |
| 816-APR-DRG | High | TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES |
| 816-MS-DRG | High | RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/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 815. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 815 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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