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See a sample rate comparisonMS-DRG 855 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 WITHOUT CC/MCC
| 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 855 by major payers:
$22,759.06
$22,202.59
$25,896.49
$26,570.84
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MS-DRG 855
5 of 25 sample ratesHigher to lower in this preview
Harborview Medical Center
$69,791.88Published rateUch-Mhs, Uchealth Emergency Room - Woodmen
Uch-Mhs
$31,806.71Published rateSt. Joseph'S Medical Center
St Joseph S Medical Center
$27,550.66Published rate, Valleywise Health
$20,469.65Published ratePhc-Los Alamos Inc, Los Alamos Medical Center - Swing Bed Unit
$7,640.31Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 855 vs. Other Infectious & Parasitic Diseases, Systemic or Unspecified Sites Codes
The MS-DRG 855 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 855 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 |
|---|---|---|
| 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 |
| 856-MS-DRG | High | POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH 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 855. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 855 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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