MS-DRG 021 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 021 by major payers:
$79,127.78
$74,228.41
$88,796.57
$90,877.41
| 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 021 | ||||||
United | 021 | $118522.88 | 1659531952 - SOUTHEASTERN REGIONAL MEDICAL CENTER, SRMC-HOSPITALIST | 560530233 - SOUTHEASTERN REGIONAL MEDICAL CENTER | NC | Hospitalist Physician (208M00000X) |
United | 021 | $44804.62 | 1366416208 - ENCOMPASS HEALTH REHABILITATION HOSPITAL OF NORTHWEST TUCSON, L.P., ENCOMPASS HEALTH REHABILITATION HOSPITAL OF NORTHWEST TUCSON | 251654947 | AZ | Rehabilitation Hospital (283X00000X) |
United | 021 | $99806.46 | 1548375082 - ADVOCATE HEALTH AND HOSPITALS CORPORATION, ADVOCATE CHRIST MEDICAL CENTER | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | General Acute Care Hospital (282N00000X) |
United | 021 | $252436.03 | 1821484262 - HDMC HOLDINGS, LLC, HI-DESERT MEDICAL CENTER | 473550779 | CA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 021 | $60498.55 | 1659868297 - FLOYD CHEROKEE MEDICAL CENTER LLC | 825207287 | AL | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 021 | $49745.69 | 1457393571 - ANSON HOSPITAL DISTRICT | 811008596 | TX | Rural Acute Care Hospital (282NR1301X) |
United | 021 | $55438.82 | 1316412034 - RESILIENCE HEALTHCARE, LOUIS A. WEISS MEMORIAL HOSPITAL | 352637418 | IL | General Acute Care Hospital (282N00000X) |
United | 021 | $121151.39 | 1720252893 - | 391211629 - (WI) AURORA HEALTH CARE INC | WI | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 021 | $89583.49 | 1073967329 - BBH SBMC, LLC, SHELBY BAPTIST MEDICAL CENTER | 474780023 | AL | Psychiatric Hospital Unit (273R00000X) |
United | 021 | $73764.35 | 1871596403 - CUMBERLAND MEDICAL CENTER, INC., CUMBERLAND MEDICAL CENTER | 620790132 - (TN) CUMBERLAND MEDICAL CENTER INC | TN | General Acute Care Hospital (282N00000X) |
United | 021 | $69541.78 | 1104019215 - HOLYOKE MEDICAL CENTER, INC. | 222520073 - (MA) HOLYOKE MEDICAL CENTER INC | MA | Hospitalist Physician (208M00000X) |
United | 021 | $119533.39 | 1568427383 - ALLINA HEALTH SYSTEM, CAMBRIDGE MEDICAL CENTER | 363261413 - ALLINA HEALTH SYSTEM | MN | General Acute Care Hospital (282N00000X) |
United | 021 | $132599.87 | 1144236571 - INTEGRIS BASS BAPTIST HEALTH CENTER, INTEGRIS BASS BAPTIST HEALTH CENTER | 730612674 | OK | General Acute Care Hospital (282N00000X) |
United | 021 | $35028.98 | 1639797913 - SINGING RIVER GULFPORT | 851538878 | MS | General Acute Care Hospital (282N00000X) |
United | 021 | $125911.00 | 1093718728 - JOHN T. MATHER MEMORIAL HOSPITAL | 111639818 - (NY) JOHN T MATHER MEMORIAL HOSPITAL | NY | 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 021 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 021 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 021 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-APR-DRG | High | OPEN CRANIOTOMY FOR TRAUMA |
| 020-MS-DRG | High | Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage with MCC |
| 021-MS-DRG | High | Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage with CC |
| 022-APR-DRG | High | VENTRICULAR SHUNT PROCEDURES |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 021. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 021 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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