MS-DRG 026 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 026 by major payers:

$36,353.74

$40,125.95

$48,847.09

$50,378.73
| 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 026 | ||||||
United | 026 | $44046.89 | 1700878840 - J. C. BLAIR MEMORIAL HOSPITAL, PENN HIGHLANDS HUNTINGDON | 231352159 - (PA) J C BLAIR MEMORIAL HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 026 | $41811.05 | 1679660617 - UNIVERSITY OF MIAMI HOSPITAL AND CLINICS, SYLVESTER COMPREHENSIVE CANCER CENTER | 592616017 | FL | Special Hospital (284300000X) |
United | 026 | $66478.67 | 1003986423 - MIAMI VALLEY HOSPITAL, MIAMI VALLEY HOSPITAL - PSYCH | 310537504 - (OH) MIAMI VALLEY HOSPITAL | OH | Psychiatric Hospital Unit (273R00000X) |
United | 026 | $63388.28 | 1265419907 - TRUSTEES OF MEASE HOSPITAL INC, MEASE COUNTRYSIDE HOSPITAL | 590855412 - (FL) TRUSTEES OF MEASE HOSPITAL INC | FL | General Acute Care Hospital (282N00000X) |
United | 026 | $50387.37 | 1669505301 - JAMAICA HOSPITAL | 111631788 - (NY) JAMAICA HOSPITAL MEDICAL CENTER | NY | Psychiatric Hospital Unit (273R00000X) |
United | 026 | $68316.89 | 1952359986 - SOUTHWESTERN MEDICAL CENTER, LLC, SOUTHWESTERN MEDICAL CENTER | 621757662 | OK | General Acute Care Hospital (282N00000X) |
United | 026 | $52781.23 | 1710353339 - SMSJ TUCSON HOLDINGS LLC, ST. MARYS HOSPITAL | 474131755 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 026 | $52781.23 | 1710353339 - SMSJ TUCSON HOLDINGS LLC, ST. MARYS HOSPITAL | 474131755 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 026 | $31907.32 | 1184868879 - ST LUKE'S LAKESIDE HOSPITAL, LLC, ST LUKE'S LAKESIDE HOSPITAL | 300427437 - (TX) ST LUKES LAKESIDE HOSPITAL LLC | TX | Special Hospital (284300000X) |
United | 026 | $74935.70 | 1487803383 - BOULDER COMMUNITY HEALTH, BOULDER COMMUNITY HOSPITAL | 840175870 - BOULDER COMMUNITY HEALTH | CO | General Acute Care Hospital (282N00000X) |
United | 026 | $64714.98 | 1285293274 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 821885403 - (CO) UCHEALTH HIGHLANDS RANCH HOSPITAL | CO | General Acute Care Hospital (282N00000X) |
United | 026 | $57945.17 | 1851344907 - NORTH MEMORIAL HEALTH CARE, NORTH MEMORIAL HEALTH HOSPITAL | 410729979 - NORTH MEMORIAL HEALTH CARE | MN | General Acute Care Hospital (282N00000X) |
United | 026 | $32139.81 | 1295763241 - NORTH BROWARD HOSPITAL DISTRICT, BROWARD HEALTH NORTH - REHAB | 596012065 - NORTH BROWARD HOSPITAL DISTRICT | FL | Rehabilitation Hospital Unit (273Y00000X) |
United | 026 | $23108.60 | 1508859661 - MERCY HOSPITAL JEFFERSON, JEFFERSON MEMORIAL HOSPITAL ASSOCIATION | 430687077 - (MO) MERCY HOSPITAL JEFFERSON | MO | General Acute Care Hospital (282N00000X) |
United | 026 | $22956.46 | 1760415939 - ADVENTIST GLENOAKS HOSPITAL, ADVENTHEALTH GLENOAKS | 363208390 - (IL) ADVENTIST GLENOAKS HOSPITAL | IL | 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 026 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 026 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 026 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 |
|---|---|---|
| 025-APR-DRG | Moderate | Heart And/Or Lung Transplant |
| 025-MS-DRG | High | Craniotomy and Endovascular Intracranial Procedures with MCC |
| 026-MS-DRG | High | Craniotomy and Endovascular Intracranial Procedures with CC |
| 027-APR-DRG | High | OTHER OPEN CRANIOTOMY |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 026. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 026 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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