MS-DRG 853 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Infectious & Parasitic Diseases, Systemic or Unspecified Sites |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 853 by major payers:
$57,334.53
$64,613.26
$79,418.58
$80,468.24
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for MS-DRG 853 | ||||||
United | 853 | $91555.57 | 1154980118 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 853 | $57660.75 | 1760446009 - SIERRA VISTA HOSPITAL 69 | 850422820 | NM | Critical Access Hospital (282NC0060X) |
United | 853 | $116210.21 | 1285940247 - MORTON PLANT MEASE HOSPITAL | 590624462 - (FL) MORTON PLANT HOSPITAL ASSOCIATION INC | FL | General Acute Care Hospital (282N00000X) |
United | 853 | $162938.65 | 1417980566 - MCKEE MEDICAL CENTER | 840826332 - (CO) MCKEE MEDICAL CENTER | CO | General Acute Care Hospital (282N00000X) |
United | 853 | $84436.95 | 1609834001 - LEHIGH VALLEY HOSPITAL | 231689692 - LEHIGH VALLEY HOSPITAL | PA | Psychiatric Hospital Unit (273R00000X) |
United | 853 | $130283.86 | 1356687735 - CENTRAL VALLEY PERFUSION, INC | 752918774 | CA | General Acute Care Hospital (282N00000X) |
United | 853 | $130283.86 | 1356687735 - CENTRAL VALLEY PERFUSION, INC | 752918774 | CA | General Acute Care Hospital (282N00000X) |
United | 853 | $91069.00 | 1508845322 - HUNTINGTON HOSPITAL ASSOCIATION | 111630914 - (NY) HUNTINGTON HOSPITAL ASSOCIATION | NY | General Acute Care Hospital (282N00000X) |
United | 853 | $68545.39 | 1669475950 - HENDRICKS COUNTY HOSPITAL | 351361243 - HENDRICKS COUNTY HOSPITAL | IN | General Acute Care Hospital (282N00000X) |
United | 853 | $88342.96 | 1558446617 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 853 | $35964.35 | 1568463701 - JERSEY COMMUNITY HOSPITAL DISTRICT, JERSEY COMMUNITY HOSPITAL | 376013958 | IL | General Acute Care Hospital (282N00000X) |
United | 853 | $169294.01 | 1154775401 - VHS HARLINGEN HOSPITAL COMPANY, LLC, VALLEY BAPTIST MEDICAL CENTER - HARLINGEN | 452662980 | TX | Psychiatric Hospital Unit (273R00000X) |
United | 853 | $59855.55 | 1003933797 - SILVER CROSS HOSPITAL & MEDICAL CENTERS | 362174832 - (IL) SILVER CROSS HOSPITAL & MEDICAL CENTERS | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 853 | $52063.32 | 1861554438 - UNIVERSITY MEDICAL CENTER, INC, DBA UNIVERSITY OF LOUSIVILLE HOSPITAL | 611293786 - (KY) UNIVERSITY MEDICAL CENTER INC | KY | General Acute Care Hospital (282N00000X) |
United | 853 | $41205.71 | 1285918094 - OAKLAWN HOSPITAL | 381368347 - ELLA E M BROWN CHARITABLE CIRCLE | MI | Psychiatric Hospital Unit (273R00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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MS-DRG 853 vs. Other Infectious & Parasitic Diseases, Systemic or Unspecified Sites Codes
The MS-DRG 853 code is part of the Infectious & Parasitic Diseases, Systemic or Unspecified Sites 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 853 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 |
|---|---|---|
| 853-MS-DRG | High | Infectious and Parasitic Diseases with O.R. Procedures with MCC |
| 854-MS-DRG | High | Infectious and Parasitic Diseases with O.R. Procedures with CC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 853. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 853 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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