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See a sample rate comparisonMS-DRG 849 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.
RADIOTHERAPY
| Key Fact | Detail |
|---|---|
| Service Type | Myeloproliferative Diseases & Disorders, Poorly Differentiated Neoplasms |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 849 by major payers:
$25,677.06
$31,804.74
$41,441.67
$42,193.77
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MS-DRG 849
5 of 25 sample ratesHigher to lower in this preview
St. Joseph Health Northern California, LLC, Providence Queen Of The Valley Medical Center
St Joseph Health Northern California LLC
$86,431.45Published rateCommunity Memorial Hospital Of Menomonee Falls Inc
$48,228.12Published rateVhs San Antonio Partners LLC, Baptist Health System
$36,887.89Published rateSt. Joseph Mercy Port Hurton
$22,867.42Published rateSt. Vincent'S Birmingham, Ascension St. Vincent'S Birmingham
St Vincents Birmingham
$5,148.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 849 vs. Other Myeloproliferative Diseases & Disorders, Poorly Differentiated Neoplasms Codes
The MS-DRG 849 code is part of the Myeloproliferative Diseases & Disorders, Poorly Differentiated Neoplasms 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 849 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 |
|---|---|---|
| 848-MS-DRG | High | CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC |
| 849-MS-DRG | High | RADIOTHERAPY |
| 850-APR-DRG | High | PROCEDURE W DIAG OF REHAB, AFTERCARE OR OTH CONTACT W HEALTH SERVICE |
| 850-MS-DRG | High | ACUTE LEUKEMIA WITH OTHER PROCEDURES |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 849. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 849 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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