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 | $44468.94 | 1568419976 - UNIVERSITY OF VERMONT MEDICAL CENTER INC | 30219309 - UNIVERSITY OF VERMONT MEDICAL CENTER INC | VT | General Acute Care Hospital (282N00000X) |
United | 057 | $13513.46 | 1518591809 - MERCY HOSPITAL ROGERS, MERCY HOSPITAL NORTHWEST ARKANSAS | 710294390 - MERCY HOSPITAL ROGERS | AR | Rehabilitation Hospital Unit (273Y00000X) |
United | 057 | $36725.96 | 1184800468 - | 390987025 - (WI) COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INC | WI | Psychiatric Hospital Unit (273R00000X) |
United | 057 | $8359.00 | 1841290228 - MONARCH HEALTH CARE, A MEDICAL GROUP, INC., ORANGE COUNTY HOSPITALISTS PHYSICIANS (OCHP), INC. | 952585792 - (CA) MEMORIAL HEALTH SERVICES | CA | General Acute Care Hospital (282N00000X) |
United | 057 | $2765.00 | 1558391045 - WELLMONT HEALTH SYSTEM, BRISTOL REGIONAL MEDICAL CENTER PSYCHIATRIC UNIT | 621636465 - WELLMONT HEALTH SYSTEM | TN | Psychiatric Hospital Unit (273R00000X) |
United | 057 | $37531.35 | 1104845015 - TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | 751438726 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | TX | General Acute Care Hospital (282N00000X) |
United | 057 | $14856.62 | 1194776351 - THE FREDERICK FERRIS THOMPSON HOSPITAL, THOMSPON HEALTH | 160743024 - (NY) THE FREDERICK FERRIS THOMPSON HOSPI TAL | NY | General Acute Care Hospital (282N00000X) |
United | 057 | $25699.21 | 1376214981 - FRANCISCAN HEALTH INDIANAPOLIS & MOORESVILLE, FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL - CARMEL | 350913537 | IN | Special Hospital (284300000X) |
United | 057 | $25699.21 | 1376214981 - FRANCISCAN HEALTH INDIANAPOLIS & MOORESVILLE, FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL - CARMEL | 350913537 | IN | Special Hospital (284300000X) |
United | 057 | $22092.33 | 1609869916 - APPALACHIAN REGIONAL HEALTHCARE, INC., HAZARD ARH REGIONAL MEDICAL CENTER | 520795508 - APPALACHIAN REGIONAL HEALTHCARE INC | KY | 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 | $14522.28 | 1679628838 - GENESIS MEDICAL CENTER | 421418847 - GENESIS HEALTH SYSTEM | IA | General Acute Care Hospital (282N00000X) |
United | 057 | $11016.65 | 1225050396 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL CHEROKEE | 581954432 - (GA) NORTHSIDE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | 057 | $9104.00 | 1861486870 - ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT RAHWAY, RAHWAY HOSPITAL | 221487305 - (NJ) ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL RAHWAY | NJ | General Acute Care Hospital (282N00000X) |
United | 057 | $33013.05 | 1619938016 - DANBURY HOSPITAL, DANBURY HOSPITAL DBA NEW MILFORD HOSPITAL | 60646597 - DANBURY HOSPITAL | CT | 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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