MS-DRG 052 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 052 by major payers:
$22,562.60
$30,137.59
$31,332.83
$31,964.73
| 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 052 | ||||||
United | 052 | $48112.83 | 1629637608 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 052 | $65246.21 | 1568458297 - DISTRICT HOSPITAL PARTNERS L P, THE GEORGE WASHINGTON UNIVERSITY HOSPITAL | 232896725 | DC | Psychiatric Hospital Unit (273R00000X) |
United | 052 | $47461.35 | 1356901235 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 052 | $78509.45 | 1740215219 - JOHN MUIR HEALTH, JOHN MUIR HEALTH, WALNUT CREEK MEDICAL CENTER | 941461843 - (CA) JOHN MUIR HEALTH | CA | General Acute Care Hospital (282N00000X) |
United | 052 | $7170.00 | 1245597418 - SOUTHCOAST HOSPITALS GROUP | 222592333 - SOUTHCOAST HOSPITALS GROUP INC | MA | General Acute Care Hospital (282N00000X) |
United | 052 | $46217.05 | 1003883158 - TEXAS HEALTH PRESBYTERIAN HOSPITAL DENTON, TEXAS HEALTH PRESBYTERIAN HOSPITAL DENTON | 432008974 - (TX) TEXAS HEALTH PRESBYTERIAN HOSPITAL DENTON | TX | General Acute Care Hospital (282N00000X) |
United | 052 | $21058.80 | 1720419583 - STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER, UMMC GRENADA EKG/EEG SERVICES | 646008520 | MS | General Acute Care Hospital (282N00000X) |
United | 052 | $21058.80 | 1720419583 - STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER, UMMC GRENADA EKG/EEG SERVICES | 646008520 | MS | General Acute Care Hospital (282N00000X) |
United | 052 | $3250.00 | 1477874337 - RCHP, NORTH ALABAMA MEDICAL CENTER | 272451336 | AL | General Acute Care Hospital (282N00000X) |
United | 052 | $3250.00 | 1477874337 - RCHP, NORTH ALABAMA MEDICAL CENTER | 272451336 | AL | General Acute Care Hospital (282N00000X) |
United | 052 | $17466.49 | 1235111071 - SALINE HOSPITAL LLC, SALINE MEMORIAL HOSPITAL | 812816675 | AR | General Acute Care Hospital (282N00000X) |
United | 052 | $14631.86 | 1821098286 - TOURO INFIRMARY | 720423659 - (LA) TOURO INFIRMARY | LA | General Acute Care Hospital (282N00000X) |
United | 052 | $504.00 | 1508913609 - NORTH SUNFLOWER MEDICAL CENTER | 646001408 | MS | Critical Access Hospital (282NC0060X) |
United | 052 | $54923.14 | 1073535027 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION, BELLEVUE HOSPITAL CENTER | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | General Acute Care Hospital (282N00000X) |
United | 052 | $26882.52 | 1265063010 - HONORHEALTH, HONORHEALTH SONORAN CROSSING MEDICAL CENTER | 860181654 - HONORHEALTH | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
MS-DRG 052 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 052 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 052 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 |
|---|---|---|
| 042-APR-DRG | High | DEGENERATIVE NERVOUS SYSTEM DISORDERS EXC MULT SCLEROSIS |
| 042-MS-DRG | High | Peripheral, Cranial Nerve and Other Nervous System Procedures without CC/MCC |
| 052-MS-DRG | High | Spinal Disorders and Injuries with CC/MCC |
| 053-APR-DRG | High | SEIZURE |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 052. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 052 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like MS-DRG 052) and we'll show you how you compare in 15 minutes or less.