MS-DRG 856 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 856 by major payers:
$51,297.56
$58,278.36
$70,631.97
$72,550.88
| 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 856 | ||||||
United | 856 | $23689.82 | 1134204720 - KINDRED HOSPITALS EAST, LLC, KINDRED HOSPITAL - NORTH FLORIDA | 522085555 | FL | Long Term Care Hospital (282E00000X) |
United | 856 | $89723.42 | 1902858459 - FORSYTH MEMORIAL HOSPITAL, INC. | 560928089 - FORSYTH MEMORIAL HOSPITAL INC | NC | General Acute Care Hospital (282N00000X) |
United | 856 | $47113.75 | 1295755676 - PALM SPRINGS GENERAL HOSPITAL INC NEW CORPORATION, PALM SPRINGS GENERAL HOSPITAL, INC. | 475625607 | FL | General Acute Care Hospital (282N00000X) |
United | 856 | $103608.89 | 1629138029 - ROCKWALL REGIONAL HOSPITAL, LLC, TEXAS HEALTH PRESBYTERIAN HOSPITAL ROCKWALL | 202848116 - (TX) ROCKWALL REGIONAL HOSPITAL, LLC | TX | General Acute Care Hospital (282N00000X) |
United | 856 | $115763.14 | 1548536006 - EDEN MEDICAL CENTER, SAN LEANDRO HOSPITAL | 943302014 | CA | General Acute Care Hospital (282N00000X) |
United | 856 | $84096.21 | 1659330173 - MERCY MEDICAL CENTER | 111635088 - (NY) MERCY MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 856 | $74918.82 | 1417032145 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 856 | $27572.08 | 1063429694 - MEMORIAL COMMUNITY HEALTH, INC, MEMORIAL HOSPITAL | 470461859 - MEMORIAL COMMUNITY HEALTH INC | NE | Critical Access Hospital (282NC0060X) |
United | 856 | $2764.00 | 1245260660 - WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL INC., HAWKINS COUNTY MEMORIAL HOSPITAL SWING BED | 621816368 - (TN) WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL INC | TN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 856 | $85831.42 | 1235109778 - COMMUNITY HOSPITAL SOUTH, INC., COMMUNITY HOSPITAL SOUTH | 351088640 - COMMUNITY HOSPITALS OF INDIANA INC | IN | General Acute Care Hospital (282N00000X) |
United | 856 | $49596.01 | 1265818488 - SMSJ TUCSON HOLDINGS LLC, ST. MARYS HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 856 | $82433.64 | 1629637608 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 856 | $16589.19 | 1053854653 - LIFEBRITE HOSPITAL GROUP OF STOKES, LLC, LIFEBRITE COMMUNITY HOSPITAL OF STOKES | 814216501 - (NC) LIFEBRITE HOSPITAL GROUP OF ST | NC | Critical Access Hospital (282NC0060X) |
United | 856 | $152717.65 | 1154618742 - VHS HARLINGEN HOSPITAL COMPANY LLC, VALLEY BAPTIST MEDICAL CENTER | 452662980 | TX | General Acute Care Hospital (282N00000X) |
United | 856 | $30376.96 | 1477757151 - TAYLOR COUNTY HOSPITAL DISTRICT HEALTH FACILITIES CORPORATION | 610676546 - (KY) TAYLOR COUNTY HOSPITAL DISTRICT HEALTH FACILITIES CORP | KY | 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 856 vs. Other Infectious & Parasitic Diseases, Systemic or Unspecified Sites Codes
The MS-DRG 856 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 856 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 |
|---|---|---|
| 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 |
| 857-MS-DRG | High | Postoperative or Post-traumatic Infections 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 856. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 856 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 856) and we'll show you how you compare in 15 minutes or less.