MS-DRG 053 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 053 by major payers:
$12,714.29
$17,840.62
$14,671.68
$15,114.29
| 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 053 | ||||||
United | 053 | $20950.01 | 1962577890 - INTEGRIS BASS BAPTIST HEALTH CENTER, INTEGRIS BASS BEHAVIORAL HEALTH CENTER ACUTE | 731089149 - (OK) INTEGRIS SOUTH OKLAHOMA CITY HOSPITAL CORPORATION | OK | Psychiatric Hospital Unit (273R00000X) |
United | 053 | $5633.72 | 1730635301 - POST ACUTE MEDICAL REHABILITATION HOSPITAL OF TULSA, LLC, PAM REHABILITATION HOSPITAL OF TULSA | 473895137 - (OK) POST ACUTE MEDICAL REHABILITATION HOSPITAL OF TULSA LLC | OK | Rehabilitation Hospital (283X00000X) |
United | 053 | $8604.95 | 1063900975 - MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC., MCCURTAIN MEMORIAL HOSPITAL | 736617937 - (OK) MCCURTAIN MEMORIAL MEDICAL MANAGEMENT INC | OK | Critical Access Hospital (282NC0060X) |
United | 053 | $34511.96 | 1841687787 - JOHN MUIR MEDICAL CENTER | 680396600 | CA | General Acute Care Hospital (282N00000X) |
United | 053 | $12853.05 | 1811341290 - BBH BMC, LLC, BROOKWOOD MEDICAL CENTER | 474757851 | AL | Psychiatric Hospital Unit (273R00000X) |
United | 053 | $14565.49 | 1619163854 - COMMUNITY HEALTH NETWORK, INC, COMMUNITY HOSPITAL NORTH | 743230935 | IN | General Acute Care Hospital (282N00000X) |
United | 053 | $7117.81 | 1831193499 - HOSPITAL SERVICE DISTRICT NO 2 OF PARISH OF BEAUREGARD STATE OF LA, BEAUREGARD MEMORIAL HOSPITAL | 720491106 - WEST LOUISIANA HEALTH SERVICES INC | LA | Rural Acute Care Hospital (282NR1301X) |
United | 053 | $9274.28 | 1881654259 - BAPTIST HEALTHCARE SYSTEM INC, BAPTIST HEALTH CORBIN | 610444707 - BAPTIST HEALTHCARE SYSTEM INC | KY | Psychiatric Hospital Unit (273R00000X) |
United | 053 | $18448.26 | 1306898960 - ST. VINCENT HOSPITAL & HEALTH CARE CENTER, INC., ASCENSION ST. VINCENT HOSPITAL | 743107055 - (IN) ST VINCENT CARMEL HOSPITAL INC | IN | General Acute Care Hospital (282N00000X) |
United | 053 | $8248.37 | 1336101302 - SWEDISH COVENANT HEALTH | 362179813 - (IL) SWEDISH COVENANT HEALTH | IL | Psychiatric Hospital Unit (273R00000X) |
United | 053 | $4120.00 | 1548640717 - SMYTH COUNTY COMMUNITY HOSPITAL, SMYTH COUNTY COMMUNITY HOSPITAL REHABILITATION | 540794913 - (VA) SMYTH COUNTY COMMUNITY HOSPITAL | VA | General Acute Care Hospital (282N00000X) |
United | 053 | $18679.41 | 1457500191 - FLORIDA HOSPITAL | 590724459 - (FL) ADVENTIST HEALTH SYSTEM-SUNBELT INC | FL | General Acute Care Hospital (282N00000X) |
United | 053 | $4636.47 | 1356417505 - THE MEMORIAL HOSPITAL OF WILLIAM F AND GERTRUDE F JONES, JONES MEMORIAL HOSPITAL | 222807681 - (NY) MEMORIAL HOSPITAL OF WILLIAM F AND GERTRUDE F JONES INC | NY | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 053 | $25373.50 | 1821647801 - ST MARY'S HOSPITAL AND MEDICAL CENTER, INC, ST MARY'S HOSPITAL & MEDICAL CENTER LIFE CENTER OT/PT/SP | 840425720 - (CO) ST MARYS HOSPITAL AND MEDICAL CENTER INC | CO | General Acute Care Hospital (282N00000X) |
United | 053 | $13178.78 | 1396036695 - JORDAN VALLEY MEDICAL CENTER LP, JORDAN VALLEY MEDICAL CENTER | 820588653 | UT | Psychiatric Hospital Unit (273R00000X) |
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 053 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 053 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 053 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 |
|---|---|---|
| 052-APR-DRG | High | ALTERATION IN CONSCIOUSNESS |
| 052-MS-DRG | High | Spinal Disorders and Injuries with CC/MCC |
| 053-MS-DRG | High | Spinal Disorders and Injuries without CC/MCC |
| 054-APR-DRG | High | MIGRAINE & OTHER HEADACHES |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 053. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 053 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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