MS-DRG 036 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 036 by major payers:
$21,674.92
$23,695.81
$29,176.90
$30,468.57
| 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 036 | ||||||
United | 036 | $11494.00 | 1447597240 - BAYLOR UNIVERSITY MEDICAL CENTER | 751837454 - (TX) BAYLOR UNIVERSITY MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 036 | $23976.73 | 1326022765 - VHS OF ARROWHEAD, INC, ABRAZO ARROWHEAD CAMPUS | 621811285 | AZ | General Acute Care Hospital (282N00000X) |
United | 036 | $16571.22 | 1922182831 - SALINE HOSPITAL LLC, SALINE MEMORIAL HOSPITAL | 812816675 | AR | Psychiatric Hospital Unit (273R00000X) |
United | 036 | $36295.62 | 1659531952 - SOUTHEASTERN REGIONAL MEDICAL CENTER, SRMC-HOSPITALIST | 560530233 - SOUTHEASTERN REGIONAL MEDICAL CENTER | NC | Hospitalist Physician (208M00000X) |
United | 036 | $10299.00 | 1124218367 - METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO LTD LLP, METHODIST SPECIALTY AND TRANSPLANT HOSPITAL | 742730328 | TX | General Acute Care Hospital (282N00000X) |
United | 036 | $55951.12 | 1750737565 - LONG ISLAND JEWISH MEDICAL CENTER, LONG ISLAND JEWISH VALLEY STREAM PSYCHIATRIC UNIT | 112241326 - LONG ISLAND JEWISH MEDICAL CENTER | NY | Psychiatric Hospital Unit (273R00000X) |
United | 036 | $13277.83 | 1497792568 - MERCY HEALTH-ST CHARLES HOSPITAL LLC, ST CHARLES HOSPITAL OF OREGON, OHIO | 344428250 - MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC | OH | General Acute Care Hospital (282N00000X) |
United | 036 | $36409.00 | 1689611501 - ORANGE PARK MEDICAL CENTER, INC., HCA FLORIDA ORANGE PARK HOSPITAL | 611269295 - (FL) ORANGE PARK MEDICAL CENTER INC | FL | General Acute Care Hospital (282N00000X) |
United | 036 | $16395.00 | 1215066584 - RARITAN BAY MEDICAL CENTER | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | General Acute Care Hospital (282N00000X) |
United | 036 | $21032.98 | 1013969013 - EDWARD HOSPITAL | 363297173 - (IL) EDWARD HOSPITAL | IL | General Acute Care Hospital (282N00000X) |
United | 036 | $28119.75 | 1811904063 - OVERLAKE HOSPITAL MEDICAL CENTER | 910652651 - (WA) OVERLAKE HOSPITAL MEDICAL CENTER | WA | Psychiatric Hospital Unit (273R00000X) |
United | 036 | $21117.31 | 1629185053 - UPMC WASHINGTON, WASHINGTON HOSPITAL-PSYCHIATRIC UNIT | 250965600 - (PA) WASHINGTON HOSPITAL | PA | Psychiatric Hospital Unit (273R00000X) |
United | 036 | $58719.48 | 1457382483 - AMISUB OF SOUTH CAROLINA, INC., PIEDMONT MEDICAL CENTER | 953561198 - (SC) AMISUB OF SOUTH CAROLINA INC | SC | General Acute Care Hospital (282N00000X) |
United | 036 | $21095.31 | 1992159925 - HOSPITAL SERVICE DISTRICT NO 1 OF IBERIA PARISH, IBERIA MEDICAL CENTER | 726014963 | LA | Rehabilitation Hospital Unit (273Y00000X) |
United | 036 | $21095.31 | 1992159925 - HOSPITAL SERVICE DISTRICT NO 1 OF IBERIA PARISH, IBERIA MEDICAL CENTER | 726014963 | LA | Rehabilitation Hospital Unit (273Y00000X) |
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 036 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 036 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 036 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 |
|---|---|---|
| 035-MS-DRG | High | Carotid Artery Stent Procedures with CC |
| 036-MS-DRG | High | Carotid Artery Stent Procedures without CC/MCC |
| 037-MS-DRG | High | Extracranial Procedures with MCC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 036. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 036 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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