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See a sample rate comparisonMS-DRG 876 Fee Schedule
Last Verified: October 2026
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.
O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS
| Key Fact | Detail |
|---|---|
| Service Type | Mental Diseases & Disorders |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 876 by major payers:
$29,778.74
$48,406.60
$60,663.13
$62,125.58
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MS-DRG 876
5 of 25 sample ratesHigher to lower in this preview
Washington Hospital
Warren General Hospital
$181,916.48Published ratePrisma Health-Upstate, Prisma Health Op Surgery Patewood
Prisma Health - Upstate
$66,402.03Published rateThibodaux Regional Health System Inc
$41,284.37Published rateChristus Health Central Louisiana, Christus Coushatta Rural Health Center
Christus Health Central Louisiana
$26,820.15Published rateGeneva County Healthcare Authority, Inc.
Geneva County Health Care Authority Inc Dba Wiregrass Medical Center
$2,122.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 876 vs. Other Mental Diseases & Disorders Codes
The MS-DRG 876 code is part of the Mental Diseases & Disorders 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 876 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 |
|---|---|---|
| 876-MS-DRG | High | O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS |
| 880-MS-DRG | High | ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 876. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 876 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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