MS-DRG 020 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 | • Diseases & Disorders of the Nervous System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 020 by major payers:
$103,551.63
$104,952.61
$126,151.29
$131,201.09
| 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 020 | ||||||
United | 020 | $192252.68 | 1053321919 - UNIVERSITY COMMUNITY HOSPITAL, INC, ADVENTHEALTH TAMPA | 591113901 - (FL) UNIVERSITY COMMUNITY HOSPITAL INC | FL | General Acute Care Hospital (282N00000X) |
United | 020 | $90178.65 | 1043450828 - SSM SELECT REHAB ST LOUIS LLC, SSM PHYSICAL THERAPY | 263694972 | MO | Rehabilitation Hospital (283X00000X) |
United | 020 | $173892.00 | 1568772507 - STATEN ISLAND UNIVERSITY HOSPITAL | 112868878 - (NY) STATEN ISLAND UNIVERSITY HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 020 | $128768.00 | 1518346469 - SAINT THOMAS RIVER PARK HOSPITAL, LLC, ASCENSION SAINT THOMAS RIVER PARK | 474063149 | TN | General Acute Care Hospital (282N00000X) |
United | 020 | $93767.96 | 1023398807 - AHS CLAREMORE REGIONAL HOSPITAL, LLC., HILLCREST HOSPITAL CLAREMORE | 452652006 | OK | General Acute Care Hospital (282N00000X) |
United | 020 | $2765.00 | 1386657161 - WELLMONT HEALTH SYSTEM, NORTON COMMUNITY REHABILITAION UNIT | 621636465 - WELLMONT HEALTH SYSTEM | VA | Rehabilitation Hospital Unit (273Y00000X) |
United | 020 | $70937.67 | 1467608869 - CALHOUN HEALTH SERVICES | 813257997 - (MS) BAPTIST MEMORIAL HOSPITAL - CALHOUN INC | MS | Critical Access Hospital (282NC0060X) |
United | 020 | $108728.11 | 1689776882 - ST CATHERINE HOSPITAL INC | 351738708 - (IN) ST CATHERINE HOSPITAL INC | IN | General Acute Care Hospital (282N00000X) |
United | 020 | $100763.75 | 1528348489 - SHERMAN GRAYSON HOSPITAL LLC, WILSON N. JONES REGIONAL MEDICAL CENTER - BHS | 272025690 | TX | Psychiatric Hospital Unit (273R00000X) |
United | 020 | $195918.18 | 1780643411 - PIEDMONT MOUNTAINSIDE HOSPITAL, INC., PIEDMONT MOUNTAINSIDE HOSPITAL | 352228583 - (GA) PIEDMONT MOUNTAINSIDE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | 020 | $157457.46 | 1073893020 - PASCO-PINELLAS HILLSBOROUGH COMMUNITY HEALTH SYSTEM INC, ADVENTHEALTH WESLEY CHAPEL | 208488713 - (FL) PASCO-PINELLAS HILLSBOROUGH COMMUNITY HEALTH SYSTEM INC | FL | General Acute Care Hospital (282N00000X) |
United | 020 | $120942.89 | 1669409314 - NORTHFIELD HOSPITAL | 416007241 | MN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 020 | $3036.00 | 1073517058 - ROOSEVELT COUNTY SPECIAL HOSPITAL DISTRICT, ROOSEVELT GENERAL HOSPITAL | 850458844 - (NM) ROOSEVELT COUNTY SPECIAL HOSPITAL DISTRICT | NM | General Acute Care Hospital (282N00000X) |
United | 020 | $116837.57 | 1619270188 - VALLEY BAPTIST MEDICAL CENTER | 452663071 | TX | General Acute Care Hospital (282N00000X) |
United | 020 | $109437.49 | 1881631471 - THE METROHEALTH SYSTEM, METROHEALTH MEDICAL CENTER | 346004382 | OH | Psychiatric Hospital Unit (273R00000X) |
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 020 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 020 code is part of the Diseases & Disorders of the Nervous System 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 020 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 |
|---|---|---|
| 020-MS-DRG | High | Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage with MCC |
| 021-APR-DRG | High | OPEN CRANIOTOMY EXCEPT TRAUMA |
| 021-MS-DRG | High | Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage with CC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 020. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 020 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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