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See a sample rate comparisonMS-DRG 854 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.
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC
| 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
Compare published rates across providers.
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MS-DRG 854
5 of 25 sample ratesHigher to lower in this preview
Sentara Hospitals, Sentara Leigh Hospital
Sentara Hospitals
$62,865.60Published rateChenango Memorial Hospital Inc
$43,840.30Published rateRoane County Medical Center, Roane Medical Center
Roane County Medical Center
$29,579.86Published rateCookeville Regional Medical Center, Cookeville Regional Medical Center Inpatient Rehabilitation Center
$25,166.71Published rateMountain States Health Alliance, James H. & Cecile C. Quillen Rehabilitation Hospital
Mountain States Health Alliance
$3,891.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-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.
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