MS-DRG 058 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 058 by major payers:
$19,951.20
$26,099.51
$28,769.71
$29,367.07
| 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 058 | ||||||
United | 058 | $11052.00 | 1043455108 - THE CHILDREN'S HOSPITAL AURORA CO | 840166760 - CHILDRENS HOSPITAL COLORADO | CO | Children's Hospital (282NC2000X) |
United | 058 | $45446.12 | 1538522412 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE TRANSMOUNTAIN CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 058 | $45446.12 | 1538522412 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE TRANSMOUNTAIN CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 058 | $21145.27 | 1922163922 - | 420680448 - CATHOLIC HEALTH INITIATIVES-IOWA CORP | IA | Rehabilitation Hospital Unit (273Y00000X) |
United | 058 | $30701.71 | 1598716060 - GREENVILLE HEALTH SYSTEM, GHS GREER MEMORIAL HOSPITAL | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 058 | $20304.90 | 1205203775 - PLANO SURGICAL HOSPITAL | 843385649 | TX | General Acute Care Hospital (282N00000X) |
United | 058 | $28208.66 | 1215903018 - COMMUNITY MEMORIAL HEALTH SYSTEM, COMMUNITY MEMORIAL HOSPITAL OF SAN BUENA VENTURA | 951683892 - COMMUNITY MEMORIAL HEALTH SYSTEM | CA | General Acute Care Hospital (282N00000X) |
United | 058 | $22549.09 | 1679885347 - VHS SINAI-GRACE HOSPITAL INC, SINAI GRACE HOSPITAL | 272844632 | MI | Rehabilitation Hospital Unit (273Y00000X) |
United | 058 | $22549.09 | 1679885347 - VHS SINAI-GRACE HOSPITAL INC, SINAI GRACE HOSPITAL | 272844632 | MI | Rehabilitation Hospital Unit (273Y00000X) |
United | 058 | $31974.67 | 1770673535 - PRINCETON BAPTIST MEDICAL CENTER, PRINCETON BAPTIST MEDICAL CENTER | 474775351 | AL | Psychiatric Hospital Unit (273R00000X) |
United | 058 | $36918.00 | 1316158793 - ST. JOSEPH'S HOSPITAL | 580566257 - (GA) SAINT JOSEPHS HOSPITAL OF ATLANTA INC | GA | Critical Access Hospital (282NC0060X) |
United | 058 | $16507.66 | 1528516192 - WESTERN MISSOURI MEDICAL CENTER, BRIDGES SENIOR BEHAVIORAL HEALTH | 440665266 - (MO) WESTERN MISSOURI MEDICAL CENTER | MO | Psychiatric Hospital Unit (273R00000X) |
United | 058 | $28463.69 | 1518957950 - BOLIVAR GENERAL HOSPITAL, INC., WEST TENNESSEE HEALTHCARE BOLIVAR HOSPITAL | 621624171 - (TN) BOLIVAR GENERAL HOSPITAL INC | TN | Critical Access Hospital (282NC0060X) |
United | 058 | $21597.02 | 1669538047 - UVA CULPEPER MEDICAL CENTER, UVA CULPEPER MEDICAL CENTER | 540622371 - (VA) UVA CULPEPER MEDICAL CENTER | VA | General Acute Care Hospital (282N00000X) |
United | 058 | $77108.78 | 1528292596 - WESTCHESTER COUNTY HEALTHCARE CORP, ACT PROGRAM | 133964321 - (NY) PEO MID-HUDSON VALLEY STAFFCO | NY | 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 058 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 058 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 058 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 |
|---|---|---|
| 057-APR-DRG | High | CONCUSSION, CLOSED SKULL FX NOS,UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HR OR NO COMA |
| 057-MS-DRG | High | Degenerative Nervous System Disorders without MCC |
| 058-MS-DRG | High | Multiple Sclerosis and Cerebellar Ataxia with MCC |
| 059-APR-DRG | High | ANOXIC & OTHER SEVERE BRAIN DAMAGE |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 058. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 058 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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