MS-DRG 003 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 | • Pre-MDC |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 003 by major payers:
$218,575.22
$263,919.52
$339,369.74
$338,157.12
| 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 003 | ||||||
United | 003 | $163948.06 | 1083659734 - NESHOBA COUNTY GENERAL HOSPITAL | 646000892 | MS | General Acute Care Hospital (282N00000X) |
United | 003 | $163948.06 | 1083659734 - NESHOBA COUNTY GENERAL HOSPITAL | 646000892 | MS | General Acute Care Hospital (282N00000X) |
United | 003 | $432466.84 | 1851390744 - THE FAUQUIER HOSPITAL INC | 463107896 | VA | General Acute Care Hospital (282N00000X) |
United | 003 | $545584.25 | 1912282369 - PROVIDENCE HEALTH & SERVICES, PROVIDENCE WILLAMETTE FALLS MEDICAL CENTER | 611659489 | OR | General Acute Care Hospital (282N00000X) |
United | 003 | $505178.71 | 1407082308 - HUGHSTON HOSPITAL, INC., NORTHSIDE MEDICAL CENTER | 331216751 - (GA) HUGHSTON HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | 003 | $228075.90 | 1821103516 - PONTOTOC HEALTH SERVICES, INC., PONTOTOC HEALTH SERVICES CAH | 640751410 - (MS) PONTOTOC HEALTH SERVICES INC | MS | Critical Access Hospital (282NC0060X) |
United | 003 | $247080.95 | 1407804669 - THE LOWELL GENERAL HOSPITAL, LOWELL GENERAL HOSPITAL | 42103590 - (MA) THE LOWELL GENERAL HOSPITAL | MA | General Acute Care Hospital (282N00000X) |
United | 003 | $375138.71 | 1790868982 - MERCY HEALTH YOUNGSTOWN LLC, ST ELIZABETH BOARDMAN HOSPITAL | 340505560 - HUMILITY OF MARY HEALTH PARTNERS | OH | General Acute Care Hospital (282N00000X) |
United | 003 | $500928.93 | 1073535027 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION, BELLEVUE HOSPITAL CENTER | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | General Acute Care Hospital (282N00000X) |
United | 003 | $93055.77 | 1043552177 - POST ACUTE MEDICAL AT ALLEN LLC, PAM REHABILITATION HOSPITAL OF ALLEN | 462071012 | TX | Rehabilitation Hospital (283X00000X) |
United | 003 | $93055.77 | 1043552177 - POST ACUTE MEDICAL AT ALLEN LLC, PAM REHABILITATION HOSPITAL OF ALLEN | 462071012 | TX | Rehabilitation Hospital (283X00000X) |
United | 003 | $317423.43 | 1427083153 - LAKEWOOD REGIONAL MEDICAL CENTER, INC., LAKEWOOD REGIONAL MEDICAL CENTER | 952226406 - REGENTS OF THE UNIVERSITY OF CALIFORNIA AT IRVINE | CA | Rehabilitation Hospital Unit (273Y00000X) |
United | 003 | $235447.56 | 1124110820 - TRINITY MEDICAL CENTER, TRINITY BETTENDORF | 362739299 - TRINITY MEDICAL CENTER | IA | General Acute Care Hospital (282N00000X) |
United | 003 | $290955.40 | 1700828852 - THE METROHEALTH SYSTEM, METROHEALTH MEDICAL CENTER | 346004382 | OH | General Acute Care Hospital (282N00000X) |
United | 003 | $411936.78 | 1982733655 - DIGNITY HEALTH, ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER | 463533638 - (AZ) DIGNITY HEALTH | AZ | 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 003 vs. Other Pre-MDC Codes
The MS-DRG 003 code is part of the Pre-MDC 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 003 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 |
|---|---|---|
| 002-APR-DRG | High | HEART &/OR LUNG TRANSPLANT |
| 002-MS-DRG | High | Heart Transplant or Implant of Heart Assist System without MCC |
| 003-MS-DRG | High | ECMO or Tracheostomy with MV >96 Hours or Principal Diagnosis Except Face, Mouth and Neck with Major O.R. Procedures |
| 004-APR-DRG | High | TRACHEOSTOMY W MV 96+ HOURS W EXTENSIVE PROCEDURE |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 003. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 003 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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