MS-DRG 867 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 867 by major payers:
$25,402.44
$28,309.24
$33,777.64
$34,169.87
| 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 867 | ||||||
United | 867 | $42866.08 | 1639376445 - INDIANA UNIVERSITY HEALTH MORGAN HOSPITAL INC | 351955872 - (IN) INDIANA UNIVERSITY HEALTH INC | IN | Rehabilitation Hospital Unit (273Y00000X) |
United | 867 | $72584.56 | 1457994188 - VHS HARLINGEN HOSPITAL COMPANY, LLC, VALLEY BAPTIST MICRO-HOSPITAL WESLACO | 452662980 | TX | General Acute Care Hospital (282N00000X) |
United | 867 | $30526.25 | 1699541870 - STATE UNIVERSITY OF IOWA, UNIVERSITY OF IOWA HEALTH CARE MEDICAL CENTER DOWNTOWN | 426004813 | IA | General Acute Care Hospital (282N00000X) |
United | 867 | $54885.50 | 1508687021 - NYU LANGONE HOSPITALS | 133971298 - NYU LANGONE HOSPITALS | NY | Psychiatric Hospital Unit (273R00000X) |
United | 867 | $18303.74 | 1043292899 - METRO KNOXVILLE HMA LLC, TENNOVA HEALTHCARE NORTH KNOXVILLE MEDICAL CENTER | 452528414 | TN | General Acute Care Hospital (282N00000X) |
United | 867 | $17129.83 | 1477759462 - HOSPITAL AUTHORITY OF WILKES COUNTY, WILLS MEMORIAL HOSPITAL | 586001920 - (GA) HOSPITAL AUTHORITY OF WILKES COUNTY D/B/A WILLS MEMORIAL & NURSING HOM | GA | Critical Access Hospital (282NC0060X) |
United | 867 | $24125.57 | 1366416208 - ENCOMPASS HEALTH REHABILITATION HOSPITAL OF NORTHWEST TUCSON, L.P., ENCOMPASS HEALTH REHABILITATION HOSPITAL OF NORTHWEST TUCSON | 251654947 | AZ | Rehabilitation Hospital (283X00000X) |
United | 867 | $19761.86 | 1164741617 - VALLEY MEDICAL FACILITIES, INC., BEAVER INPATIENT REHAB UNIT | 251801532 - (PA) HERITAGE VALLEY HEALTH SYSTEM | PA | Rehabilitation Hospital Unit (273Y00000X) |
United | 867 | $24701.41 | 1306176839 - ORTHOCOLORADO, LLC, ORTHO COLORADO HOSPITAL AT ST ANTHONY MEDI | 371577105 - (CO) ORTHOCOLORADO HOSPITAL | CO | Special Hospital (284300000X) |
United | 867 | $31768.63 | 1992815195 - OCHSNER BAPTIST MEDICAL CENTER | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | General Acute Care Hospital (282N00000X) |
United | 867 | $2602.00 | 1023061496 - CRESTWOOD HEALTHCARE LP, CRESTWOOD MEDICAL CENTER | 621647983 | AL | General Acute Care Hospital (282N00000X) |
United | 867 | $60057.37 | 1477807436 - UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS | 753175630 | TX | General Acute Care Hospital (282N00000X) |
United | 867 | $2602.00 | 1023061496 - CRESTWOOD HEALTHCARE LP, CRESTWOOD MEDICAL CENTER | 621647983 | AL | General Acute Care Hospital (282N00000X) |
United | 867 | $36675.94 | 1942218441 - NORTH IOWA MERCY CLINICS, NORTH IOWA MERCY CLINICS-HOSPITALIST | 311373080 - MERCY HEALTH SERVICES IOWA CORP | IA | Hospitalist Physician (208M00000X) |
United | 867 | $71126.42 | 1255334173 - FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC., FROEDTERT HOSPITAL | 396105970 - (WI) FROEDTERT MEMORIAL LUTHERAN HOSPITAL INC | WI | 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 |
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MS-DRG 867 vs. Other Infectious & Parasitic Diseases, Systemic or Unspecified Sites Codes
The MS-DRG 867 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 867 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 |
|---|---|---|
| 866-MS-DRG | High | Viral Illness without MCC |
| 867-MS-DRG | High | Other Infectious and Parasitic Diseases Diagnoses with MCC |
| 868-MS-DRG | High | Other Infectious and Parasitic Diseases Diagnoses 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 867. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 867 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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