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See a sample rate comparisonMS-DRG 037 Fee Schedule
Last Verified: October 2026
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.
EXTRACRANIAL PROCEDURES WITH MCC
| 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
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MS-DRG 037
5 of 25 sample ratesHigher to lower in this preview
Tenet Hospitals Limited, The Hospitals Of Providence Memorial Campus
$115,494.25Published rateCarondelet Health Network, St Mary'S Hospital
$72,172.07Published rateUsc Verdugo Hills Hospital
$46,920.83Published rateWatertown Medical Center LLC, Watertown Regional Medical Center
$34,859.48Published rateHouston Hospitals Inc, Houston Medical Center
Houston Hospitals Inc
$3,524.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-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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