MS-DRG 037 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 037 by major payers:
$36,863.31
$41,164.07
$51,401.22
$53,170.16
| 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 037 | ||||||
United | 037 | $3524.00 | 1962435792 - HOUSTON HOSPITALS INC, HOUSTON MEDICAL CENTER | 711045290 - (GA) HOUSTON HOSPITALS INC | GA | General Acute Care Hospital (282N00000X) |
United | 037 | $46920.83 | 1033716147 - USC VERDUGO HILLS HOSPITAL | 851634852 - (CA) USC VERDUGO HILLS HOSPITAL | CA | General Acute Care Hospital (282N00000X) |
United | 037 | $39120.19 | 1316279003 - METROSOUTH MEDICAL CENTER, HOSPITAL | 510382045 | IL | General Acute Care Hospital (282N00000X) |
United | 037 | $101632.82 | 1801212410 - WESTCHESTER COUNTY HEALTH CARE CORPORATION, MID-HUDSON VALLEY DIVISION OF WESTCHESTER MEDICAL CENTER | 133964321 - (NY) PEO MID-HUDSON VALLEY STAFFCO | NY | Rehabilitation Hospital Unit (273Y00000X) |
United | 037 | $8106.00 | 1891809679 - FREEMAN-OAK HILL HEALTH SYSTEM, FREEMAN HEALTH SYSTEM | 431704371 - FREEMAN HEALTH SYSTEM | MO | General Acute Care Hospital (282N00000X) |
United | 037 | $5761.00 | 1831629526 - EBD BEMC BURLESON, LLC, BAYLOR SCOTT & WHITE EMERGENCY HOSPITAL GRAND PRAIRIE | 364755936 | TX | General Acute Care Hospital (282N00000X) |
United | 037 | $40996.66 | 1710958582 - MERCY HOSPITAL OZARK | 710689680 - MERCY HOSPITAL OZARK | AR | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 037 | $43849.00 | 1154353993 - SOUTHWEST GENERAL HEALTH CENTER | 340753531 - (OH) SOUTHWEST GENERAL HEALTH CENTER | OH | General Acute Care Hospital (282N00000X) |
United | 037 | $81994.25 | 1841843455 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE EMERGENCY ROOM MONTWOOD | 813935393 - (TX) HCN EP HORIZON CITY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 037 | $72172.07 | 1427133883 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 037 | $70967.63 | 1912334517 - FAUQUIER MEDICAL CENTER LLC, FAUQUIER HOSPITAL | 463107896 | VA | General Acute Care Hospital (282N00000X) |
United | 037 | $78526.81 | 1740254143 - AHS HOSPITAL CORP., OVERLOOK HOSPITAL | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | General Acute Care Hospital (282N00000X) |
United | 037 | $34859.48 | 1992776041 - WATERTOWN MEDICAL CENTER LLC, WATERTOWN REGIONAL MEDICAL CENTER | 473937421 | WI | General Acute Care Hospital (282N00000X) |
United | 037 | $47555.92 | 1821019571 - FLORIDA HOSPITAL WATERMAN INC, ADVENTHEALTH WATERMAN | 593140669 - (FL) FLORIDA HOSPITAL WATERMAN INC | FL | General Acute Care Hospital (282N00000X) |
United | 037 | $58660.37 | 1558446617 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | 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 037 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 037 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 037 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 |
|---|---|---|
| 036-MS-DRG | High | Carotid Artery Stent Procedures without CC/MCC |
| 037-MS-DRG | High | Extracranial Procedures with MCC |
| 038-MS-DRG | High | Extracranial Procedures 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 037. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 037 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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