MS-DRG 870 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 870 by major payers:
$73,593.46
$85,478.97
$106,065.50
$106,907.90
| 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 870 | ||||||
United | 870 | $130847.06 | 1396346946 - | 310621866 - (OH) KETTERING COLLEGE | OH | Rehabilitation Hospital Unit (273Y00000X) |
United | 870 | $53662.44 | 1306825997 - WILLIAM BEAUMONT HOSPITAL, BEAUMONT HOSPITAL, TROY | 381459362 - WILLIAM BEAUMONT HOSPITAL | MI | General Acute Care Hospital (282N00000X) |
United | 870 | $185815.70 | 1821221144 - WEST GEORGIA MEDICAL CENTER, INC., WEST GEORGIA MEDICAL CENTER | 205497506 - (GA) WEST GEORGIA MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | 870 | $204521.09 | 1922031541 - TEXAS HEALTH HARRIS METHODIST HOSPITAL STEPHENVILLE | 751752253 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL STEPHENVILLE | TX | General Acute Care Hospital (282N00000X) |
United | 870 | $88785.81 | 1679659585 - PRESENCE CHICAGO HOSPITALS NETWORK, PRESENCE SAINT JOSEPH HOSPITAL-CHICAGO | 362235165 - (IL) PRESENCE CHICAGO HOSPITALS NETWORK | IL | General Acute Care Hospital (282N00000X) |
United | 870 | $221251.48 | 1568605277 - CHILDREN'S HOSPITAL | 530196580 - CHILDRENS HOSPITAL | DC | Children's Hospital (282NC2000X) |
United | 870 | $114711.88 | 1427030774 - SOUTHEASTERN REGIONAL MEDICAL CENTER, UNC HEALTH SOUTHEASTERN | 560530233 - SOUTHEASTERN REGIONAL MEDICAL CENTER | NC | General Acute Care Hospital (282N00000X) |
United | 870 | $97391.00 | 1821162314 - BUTLER MEMORIAL HOSPITAL | 250965274 - (PA) BUTLER HEALTHCARE PROVIDERS | PA | Substance Use Disorder Rehabilitation Hospital Unit (276400000X) |
United | 870 | $84876.25 | 1548306343 - ELMHURST MEMORIAL HOSPITAL | 362167784 - (IL) ELMHURST MEMORIAL HEALTHCARE | IL | General Acute Care Hospital (282N00000X) |
United | 870 | $166309.04 | 1902396708 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY, UCHEALTH EMERGENCY ROOM - COMMERCE CITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 870 | $111123.13 | 1447639398 - SAINT THOMAS STONES RIVER HOSPITAL, LLC, ASCENSION SAINT THOMAS STONES RIVER | 474063232 | TN | General Acute Care Hospital (282N00000X) |
United | 870 | $99596.21 | 1568618379 - DLP HAYWOOD REGIONAL MEDICAL CENTER LLC, HAYWOOD REGIONAL MEDICAL CENTER BEHAVIORAL HEALTH UNIT | 300830918 | NC | Psychiatric Hospital Unit (273R00000X) |
United | 870 | $93453.61 | 1861479545 - MAURY REGIONAL HOSPITAL, MAURY REGIONAL MEDICAL CENTER | 626002623 - MAURY REGIONAL HOSPITAL | TN | General Acute Care Hospital (282N00000X) |
United | 870 | $5798.00 | 1427098391 - BRANDON HMA LLC, MERIT HEALTH RANKIN | 640885458 | MS | Psychiatric Hospital Unit (273R00000X) |
United | 870 | $92126.39 | 1437119310 - SENTARA HOSPITALS, SENTARA NORFOLK GENERAL HOSPITAL | 541547408 - SENTARA HOSPITALS | VA | 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 870 vs. Other Infectious & Parasitic Diseases, Systemic or Unspecified Sites Codes
The MS-DRG 870 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 870 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 |
|---|---|---|
| 869-MS-DRG | High | Other Infectious and Parasitic Diseases Diagnoses without CC/MCC |
| 870-MS-DRG | High | Septicemia or Severe Septis with MV >96 Hours |
| 871-MS-DRG | High | Septicemia or Severe Septis without MV >96 Hours 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 870. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 870 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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