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See a sample rate comparisonMS-DRG 003 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.
ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES
| 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
Compare published rates across providers.
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MS-DRG 003
5 of 25 sample ratesHigher to lower in this preview
Westchester County Health Care Corporation, Mid-Hudson Valley Division Of Westchester Medical Center
Peo Mid-Hudson Valley Staffco
$662,443.06Published rateMount Sinai Services
New York City Health And Hospitals Corporation
$466,801.68Published rateDlp Conemaugh Memorial Medical Center LLC, Memorial Behavioral Health Unit - Gero
$295,370.31Published rateCox Walnut Lawn Pharmacy
Lester E Cox Medical Center
$224,753.23Published rateFreedom Hospital Of Magnolia LLC, Beacham Memorial Hospital
$1,000.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-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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