MS-DRG 872 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 872 by major payers:
$13,075.47
$14,154.44
$17,050.99
$17,516.99
| 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 872 | ||||||
United | 872 | $14649.29 | 1528052578 - LECONTE MEDICAL CENTER | 621114867 - (TN) LECONTE MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | 872 | $20746.07 | 1639320484 - PROVIDENCE HEALTH & SERVICES, PROV SCRED HRT MED CTR & CHLDS HOS | 364640211 | WA | Psychiatric Hospital Unit (273R00000X) |
United | 872 | $7683.00 | 1578506762 - CITRUS HMA LLC, BRAVERA HEALTH SEVEN RIVERS | 200195256 | FL | General Acute Care Hospital (282N00000X) |
United | 872 | $14185.53 | 1366404014 - HOT SPRING COUNTY MEDICAL CENTER | 710236856 - (AR) BAPTIST HEALTH | AR | Rehabilitation Hospital Unit (273Y00000X) |
United | 872 | $39860.51 | 1821484262 - HDMC HOLDINGS, LLC, HI-DESERT MEDICAL CENTER | 473550779 | CA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 872 | $14140.16 | 1265651764 - J C BLAIR MEMORIAL HOSPITAL, PENN HIGHLANDS HUNTINGDON | 231352159 - (PA) J C BLAIR MEMORIAL HOSPITAL | PA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 872 | $8106.00 | 1265546048 - FREEMAN-OAK HILL HEALTH SYSTEM, FREEMAN HEALTH SYSTEM | 431704371 - FREEMAN HEALTH SYSTEM | MO | General Acute Care Hospital (282N00000X) |
United | 872 | $32280.00 | 1285641514 - LONG ISLAND JEWISH MEDICAL CENTER | 112241326 - LONG ISLAND JEWISH MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 872 | $11950.32 | 1255785382 - ST. LUKE'S COMMUNITY HEALTH SERVICES, CHI ST. LUKE'S HEALTH - BAYLOR REHABILITATION | 760536234 - (TX) ST LUKES COMMUNITY HEALTH SERVICES | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 872 | $18854.92 | 1598703019 - NEW YORK SOCIETY FOR THE RELIEF OF RUPTURED & CRIPPLED MAINTAINING, HOSPITAL FOR SPECIAL SURGERY | 131624135 - NEW YORK SOCIETY FOR THE RELIEF OF RUPTURED & CRIPPLED MAINTAINING | NY | General Acute Care Hospital (282N00000X) |
United | 872 | $14080.37 | 1386868289 - NICHOLAS H. NOYES MEMORIAL HOSPITAL | 160743979 - (NY) NICHOLAS H NOYES MEMORIAL HOSPITAL | NY | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 872 | $6143.00 | 1790719524 - THE BROOKLYN HOSPITAL CENTER | 111630755 - (NY) THE BROOKLYN HOSPITAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 872 | $39860.51 | 1821484262 - HDMC HOLDINGS, LLC, HI-DESERT MEDICAL CENTER | 473550779 | CA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 872 | $11403.04 | 1114974029 - CALDWELL MEMORIAL HOSPITAL, INC. | 560554202 - CALDWELL MEMORIAL HOSPITAL INC | NC | General Acute Care Hospital (282N00000X) |
United | 872 | $11840.00 | 1952307027 - NORTON HOSPITALS, INC, NORTON AUDUBON HOSPITAL | 610703799 - (KY) NORTON HOSPITALS INC | 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 |
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MS-DRG 872 vs. Other Infectious & Parasitic Diseases, Systemic or Unspecified Sites Codes
The MS-DRG 872 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 872 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 |
|---|---|---|
| 871-MS-DRG | High | Septicemia or Severe Septis without MV >96 Hours with MCC |
| 872-MS-DRG | High | Septicemia or Severe Septis without MV >96 Hours without 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 872. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 872 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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