MS-DRG 057 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 057 by major payers:
$15,224.49
$20,899.48
$20,970.68
$21,372.92
| 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 057 | ||||||
United | 057 | $13738.62 | 1467560128 - ADVOCATE HEALTH AND HOSPITALS CORPORATION, ADVOCATE SOUTH SUBURBAN HOSPITAL | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | General Acute Care Hospital (282N00000X) |
United | 057 | $29197.84 | 1609824010 - OREGON HEALTH & SCIENCE UNIVERSITY | 931176109 | OR | General Acute Care Hospital (282N00000X) |
United | 057 | $24366.14 | 1740747559 - COLUMBIA ST MARY'S HOSPITAL OZAUKEE, INC., ASCENSION COLUMBIA ST MARY'S HOSPITAL OZAUKEE | 390806315 - COLUMBIA ST MARYS HOSPITAL MILWAUKEE INC | WI | Psychiatric Hospital Unit (273R00000X) |
United | 057 | $4784.00 | 1437211893 - SLIDELL MEMORIAL HOSPITAL, SLIDELL MEMORIAL HOSPITAL | 726014895 - (LA) SLIDELL MEMORIAL HOSPITAL | LA | Rehabilitation Hospital Unit (273Y00000X) |
United | 057 | $54621.00 | 1790969509 - HARBORVIEW MEDICAL CENTER | 911631806 | WA | Chronic Disease Hospital (281P00000X) |
United | 057 | $18664.25 | 1205987898 - UVA PRINCE WILLIAM MEDICAL CENTER, UVA HEALTH PRINCE WILLIAM MEDICAL CENTER | 540696355 - (VA) UVA PRINCE WILLIAM MEDICAL CENTER | VA | General Acute Care Hospital (282N00000X) |
United | 057 | $1688.00 | 1982719621 - WEBSTER HEALTH SERVICES, INC., WEBSTER GENERAL HOSPITAL | 640819193 - (MS) WEBSTER HEALTH SERVICES INC | MS | General Acute Care Hospital (282N00000X) |
United | 057 | $26810.75 | 1841376092 - PROVIDENCE HEALTH & SERVICES OREGON, PROVIDENCE PORTLAND MEDICAL CENTER | 930386906 | OR | Rehabilitation Hospital Unit (273Y00000X) |
United | 057 | $20703.22 | 1154411338 - KING COUNTY PUBLIC HOSPITAL DISTRICT NO. 2, EVERGREENHEALTH MEDICAL CENTER | 910844563 | WA | Rehabilitation Hospital Unit (273Y00000X) |
United | 057 | $26398.43 | 1982784534 - MOUNT CARMEL HEALTH SYSTEM | 311439334 - MOUNT CARMEL HEALTH SYSTEM | OH | General Acute Care Hospital (282N00000X) |
United | 057 | $35852.16 | 1639108434 - WILLAMETTE FALLS HOSPITAL, PROVIDENCE WILLAMETTE FALLS MEDICAL CENTER | 611659489 | OR | General Acute Care Hospital (282N00000X) |
United | 057 | $25350.07 | 1851568687 - DIGNITY HEALTH, ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER | 463533638 - (AZ) DIGNITY HEALTH | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 057 | $20755.01 | 1568413573 - MCKENZIE-WILLAMETTE REGIONAL MEDICAL CENTER ASSOCIATES LLC, MCKENZIE-WILLAMETTE MEDICAL CENTER | 200214051 - (OR) MCKENZIE-WILLAMETTE REGIONAL MEDICAL CENTER ASSOCIATES, LLC | OR | General Acute Care Hospital (282N00000X) |
United | 057 | $23777.09 | 1538123567 - ALLINA HEALTH SYSTEM, BUFFALO HOSPITAL | 363261413 - ALLINA HEALTH SYSTEM | MN | General Acute Care Hospital (282N00000X) |
United | 057 | $29454.21 | 1154748416 - AGH LAVEEN LLC, DIGNITY HEALTH ARIZONA GENERAL HOSPITAL | 471587223 - (AZ) AGH LAVEEN LLC | 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 |
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MS-DRG 057 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 057 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 057 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 |
|---|---|---|
| 056-APR-DRG | High | BRAIN CONTUSION/LACERATION & COMPLICATED SKULL FX, COMA < 1 HR OR NO COMA |
| 056-MS-DRG | High | Degenerative Nervous System Disorders with MCC |
| 057-MS-DRG | High | Degenerative Nervous System Disorders without MCC |
| 058-APR-DRG | High | OTHER DISORDERS OF NERVOUS SYSTEM |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 057. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 057 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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