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 | $31809.49 | 1780196345 - THE NEW YORK AND PRESBYTERIAN HOSPITAL | 133957095 - (NY) THE NEW YORK AND PRESBYTERIAN HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 053 | $4500.00 | 1003961038 - IASIS GLENWOOD REGIONAL MEDICAL CENTER LP | 205249827 - (LA) IASIS GLENWOOD REGIONAL MEDICAL CENTER LP | LA | Rehabilitation Hospital Unit (273Y00000X) |
United | 053 | $24242.41 | 1902355654 - SWEDISH HEALTH SERVICES, SWEDISH MEDICAL CENTER-BALLARD PSYCH | 910433740 - (WA) SWEDISH HEALTH SERVICES | WA | Psychiatric Hospital Unit (273R00000X) |
United | 053 | $10135.40 | 1891796710 - REEDSBURG AREA MEDICAL CENTER, INC., REEDSBURG MEMORIAL HOSPITAL | 391091432 - (WI) REEDSBURG AREA MEDICAL CENTER INC | WI | Critical Access Hospital (282NC0060X) |
United | 053 | $17712.84 | 1578648614 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 053 | $24780.40 | 1750312997 - WELLSTAR NORTH FULTON HOSPITAL, INC, WELLSTAR NORTH FULTON HOSPITAL | 810851756 - (GA) WELLSTAR NORTH FULTON HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | 053 | $19667.27 | 1598337339 - STEWARD NSMC, INC., SWING BED | 862695690 | FL | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 053 | $24195.58 | 1518949817 - MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE, INC., MCLEOD MEDICAL CENTER - DARLINGTON | 570370242 - MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE INC | SC | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 053 | $16837.66 | 1902261860 - VANDERBILT UNIVERSITY MEDICAL CENTER | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Children's Hospital (282NC2000X) |
United | 053 | $16302.33 | 1700026077 - STONY BROOK HOSPITAL | 113243405 | NY | General Acute Care Hospital (282N00000X) |
United | 053 | $4498.00 | 1093171860 - ST VINCENTS CHILTON LLC, ASCENSION ST. VINCENT'S CHILTON | 810935368 | AL | General Acute Care Hospital (282N00000X) |
United | 053 | $12801.13 | 1154367258 - AHS HOSPITAL CORP, MORRISTOWN MEDICAL CENTER | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | General Acute Care Hospital (282N00000X) |
United | 053 | $9326.00 | 1275541104 - SOUTHSIDE HOSPITAL, REHABILITATION UNIT | 111667761 - (NY) SOUTH SHORE UNIVERSITY HOSPITAL | NY | Rehabilitation Hospital Unit (273Y00000X) |
United | 053 | $6685.37 | 1871953802 - FREEDOM HOSPITAL OF MAGNOLIA, LLC, BEACHAM MEMORIAL HOSPITAL | 811097331 | MS | Rural Acute Care Hospital (282NR1301X) |
United | 053 | $20276.66 | 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 | 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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