MS-DRG 854 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 854 by major payers:
$28,234.84
$26,790.78
$31,937.00
$32,529.92
| 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 854 | ||||||
United | 854 | $21979.09 | 1710931985 - JEFFERSON HOSPITAL ASSOCIATION INC, JEFFERSON REGIONAL MEDICAL CENTER | 710329353 - (AR) JEFFERSON HOSPITAL ASSN INC | AR | General Acute Care Hospital (282N00000X) |
United | 854 | $25166.71 | 1639293483 - COOKEVILLE REGIONAL MEDICAL CENTER, COOKEVILLE REGIONAL MEDICAL CENTER INPATIENT REHABILITATION CENTER | 626002166 | TN | Rehabilitation Hospital Unit (273Y00000X) |
United | 854 | $44907.30 | 1942267869 - MARIN GENERAL HOSPITAL | 942823538 - (CA) MARIN GENERAL HOSPITAL | CA | Psychiatric Hospital Unit (273R00000X) |
United | 854 | $27026.52 | 1477537363 - VHS OF PHOENIX INC, ABRAZO CENTRAL CAMPUS | 621811285 | AZ | General Acute Care Hospital (282N00000X) |
United | 854 | $36205.57 | 1326002049 - UNIVERSITY OF WASHINGTON, UNIVERSITY OF WASHINGTON MEDICAL CENTER | 916001537 | WA | General Acute Care Hospital (282N00000X) |
United | 854 | $62865.60 | 1811957681 - SENTARA HOSPITALS, SENTARA LEIGH HOSPITAL | 541547408 - SENTARA HOSPITALS | VA | General Acute Care Hospital (282N00000X) |
United | 854 | $52985.62 | 1013130145 - BANNER HEALTH | 900412842 | AZ | General Acute Care Hospital (282N00000X) |
United | 854 | $49335.89 | 1043533706 - OCHSNER MEDICAL CENTER, OCHSNER MEDICAL CENTER - NORTHSHORE | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | General Acute Care Hospital (282N00000X) |
United | 854 | $27828.71 | 1184687790 - BON SECOURS ST MARY'S HOSPITAL OF RICHMOND LLC, BON SECOURS ST. MARY'S HOSPITAL OF RICHMOND PSYCHIATRIC UNIT | 540793767 - BON SECOURS ST MARYS HOSPITAL OF RICHMOND LLC | VA | Psychiatric Hospital Unit (273R00000X) |
United | 854 | $25501.75 | 1255668448 - ST. FRANCIS HOSPITAL | 992441755 | IL | General Acute Care Hospital (282N00000X) |
United | 854 | $36079.69 | 1023308608 - ADVOCATE LUTHERAN GENERAL HOSPITAL | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Children's Hospital (282NC2000X) |
United | 854 | $25711.55 | 1669991675 - TOPEKA HOSPITAL, LLC, THE UNIVERSITY OF KANSAS HEALTH SYSTEM, ST. FRANCIS CAMPUS | 822034009 | KS | Rehabilitation Hospital Unit (273Y00000X) |
United | 854 | $34943.14 | 1659725901 - BBH PBMC, LLC, PRINCETON BAPTIST MEDICAL CENTER | 474775351 | AL | Psychiatric Hospital Unit (273R00000X) |
United | 854 | $24866.34 | 1487755112 - ST. CLAIR MEMORIAL HOSPITAL, PSYCH UNIT | 251010303 - (PA) ST CLAIR HEALTH CORPORATION | PA | Psychiatric Hospital Unit (273R00000X) |
United | 854 | $18002.88 | 1578569885 - OLEAN GENERAL HOSPITAL, BRADFORD HOSPITAL | 160743102 - OLEAN GENERAL HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
MS-DRG 854 vs. Other Infectious & Parasitic Diseases, Systemic or Unspecified Sites Codes
The MS-DRG 854 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 854 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 |
| 855-MS-DRG | High | Infectious and Parasitic Diseases with O.R. Procedures 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 854. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 854 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like MS-DRG 854) and we'll show you how you compare in 15 minutes or less.