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See a sample rate comparisonMS-DRG 056 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.
DEGENERATIVE NERVOUS SYSTEM DISORDERS 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 056 by major payers:
$25,050.70
$34,594.97
$38,924.62
$39,543.64
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MS-DRG 056
5 of 25 sample ratesHigher to lower in this preview
Lincoln County Public Hospital District 1, Odessa Memorial Healthcare Center
Lincoln County Public Hospital District 1
$130,590.32Published rateFranciscan Health Michigan City, Franciscan St. Anthony Health - Michigan City
Franciscan Health Michigan City
$33,610.03Published rateUt Medical Center Knoxville
University Health Systems Inc
$23,523.51Published rateSelect Specialty Hospital, Select Specialty Hospital - Arizona (Phoenix Downtown)
Select Specialty Hospital
$18,393.07Published rateNatchitoches Parish Hospital Service District, Natchitoches Regional Medical Center
Natchitoches Regional Medical Center
$1,829.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 056 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 056 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 056 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 |
|---|---|---|
| 055-APR-DRG | High | HEAD TRAUMA W COMA >1 HR OR HEMORRHAGE |
| 055-MS-DRG | High | NERVOUS SYSTEM NEOPLASMS WITHOUT MCC |
| 056-MS-DRG | High | DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC |
| 057-APR-DRG | High | CONCUSSION, CLOSED SKULL FX NOS,UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HR OR NO COMA |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 056. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 056 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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