MS-DRG 857 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 857 by major payers:
$25,957.35
$28,596.20
$34,243.88
$35,341.14
| 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 857 | ||||||
United | 857 | $7117.00 | 1578656161 - ST JOHN MEDICAL CENTER INC, BERNSEN REHAB | 730579286 - (OK) ST JOHN MEDICAL CENTER INC | OK | Rehabilitation Hospital Unit (273Y00000X) |
United | 857 | $18171.33 | 1275592131 - METHODIST HOSPITALS OF DALLAS, METHODIST CHARLTON MEDICAL CENTER | 750800661 - METHODIST HOSPITALS OF DALLAS | TX | General Acute Care Hospital (282N00000X) |
United | 857 | $53831.89 | 1831759794 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 857 | $38207.01 | 1083286801 - STEWARD CGH, INC. | 862608394 | FL | General Acute Care Hospital (282N00000X) |
United | 857 | $35947.48 | 1447571658 - SUMNER REGIONAL MEDICAL CENTER LLC, SUMNER REGIONAL MEDICAL CENTER | 272618766 | TN | General Acute Care Hospital (282N00000X) |
United | 857 | $44890.28 | 1003986423 - MIAMI VALLEY HOSPITAL, MIAMI VALLEY HOSPITAL - PSYCH | 310537504 - (OH) MIAMI VALLEY HOSPITAL | OH | Psychiatric Hospital Unit (273R00000X) |
United | 857 | $56651.39 | 1528056066 - HAMILTON MEDICAL CENTER, INC. | 581519911 - HAMILTON MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | 857 | $24952.75 | 1912553744 - OCHSNER MORGAN CITY LLC, OCHSNER ST. MARY | 842237042 | LA | Psychiatric Hospital Unit (273R00000X) |
United | 857 | $10334.09 | 1144212556 - PUSHMATAHA COUNTY HOSPITAL AUTHORITY, PUSHMATAHA HOSPITAL | 736069650 - (OK) PUSHMATAHA COUNTY - TOWN OF ANTLERS HOSPITAL AUTHORITY | OK | Rural Acute Care Hospital (282NR1301X) |
United | 857 | $27784.74 | 1811957681 - SENTARA HOSPITALS, SENTARA LEIGH HOSPITAL | 541547408 - SENTARA HOSPITALS | VA | General Acute Care Hospital (282N00000X) |
United | 857 | $31040.60 | 1689628794 - CATAWBA VALLEY MEDICAL CENTER | 560789196 | NC | Rehabilitation Hospital Unit (273Y00000X) |
United | 857 | $28357.82 | 1396745832 - ARIZONA SPINE AND JOINT HOSPITAL LLC | 364399746 - (AZ) ARIZONA SPINE AND JOINT HOSPITAL LLC | AZ | General Acute Care Hospital (282N00000X) |
United | 857 | $14588.83 | 1457364408 - KANSAS CITY ORTHOPAEDIC INSTITUTE LLC | 481197295 - (KS) KANSAS CITY ORTHOPAEDIC INSTITUTE | KS | General Acute Care Hospital (282N00000X) |
United | 857 | $19324.66 | 1164750840 - CENTRAL LOUISIANA SURGICAL HOSPITAL LLC, CHRISTUS CENTRAL LOUISIANA SURGICAL HOSPITAL | 264732898 - (LA) CENTRAL LOUISIANA SURGICAL HOSPITAL, LLC | LA | General Acute Care Hospital (282N00000X) |
United | 857 | $24952.75 | 1912553744 - OCHSNER MORGAN CITY LLC, OCHSNER ST. MARY | 842237042 | LA | 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 857 vs. Other Infectious & Parasitic Diseases, Systemic or Unspecified Sites Codes
The MS-DRG 857 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 857 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 |
|---|---|---|
| 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 |
| 858-MS-DRG | High | Postoperative or Post-traumatic Infections 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 857. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 857 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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