MS-DRG 079 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 079 by major payers:
$8,861.69
$9,565.97
$10,732.77
$11,024.03
| 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 079 | ||||||
United | 079 | $2536.00 | 1124495239 - PRIME HEALTHCARE SERVICES-SUBURBAN HOSPITAL LLC, SUBURBAN COMMUNITY HOSPITAL | 472819044 | PA | General Acute Care Hospital (282N00000X) |
United | 079 | $7581.04 | 1598905762 - CENTRAL IOWA HOSPITAL CORPORATION, UNITYPOINT HEALTH - DES MOINES IOWA METHODIST MEDICAL CENTER | 420680452 - CENTRAL IOWA HOSPITAL CORPORATION | IA | General Acute Care Hospital (282N00000X) |
United | 079 | $13745.95 | 1952309098 - FRANCISCAN HEALTH SYSTEM, ST JOSEPH MEDICAL CENTER | 910564491 - (WA) FRANCISCAN HEALTH SYSTEM | WA | General Acute Care Hospital (282N00000X) |
United | 079 | $7859.33 | 1043297401 - INSIGHT CHICAGO, INC., INSIGHT HOSPITAL & MEDICAL CENTER CHICAGO | 862358048 - INSIGHT CHICAGO INC | IL | Psychiatric Hospital Unit (273R00000X) |
United | 079 | $9702.49 | 1861943409 - THEDACARE REGIONAL MEDICAL CENTER-NEENAH, INC., THEDA CLARK MEDICAL CENTER INC. | 390830664 - (WI) THEDACARE REGIONAL MEDICAL CENTER - NEENAH INC | WI | General Acute Care Hospital (282N00000X) |
United | 079 | $6226.31 | 1629020177 - MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC., MCCURTAIN MEMORIAL HOSPITAL | 736617937 - (OK) MCCURTAIN MEMORIAL MEDICAL MANAGEMENT INC | OK | Rural Acute Care Hospital (282NR1301X) |
United | 079 | $5685.41 | 1386665826 - TOWNER COUNTY MEDICAL CENTER INC, TOWNER COUNTY MEDICAL CENTER | 450425948 - (ND) TOWNER COUNTY MEDICAL CENTER INC | ND | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 079 | $13170.67 | 1447284039 - ST. MARY'S MEDICAL CENTER, INC, ST. MARY'S MEDICAL CENTER | 752932830 | FL | Psychiatric Hospital Unit (273R00000X) |
United | 079 | $5849.35 | 1588770416 - VALLEY MEDICAL FACILITIES INC, VALLEY MEDICAL FACILITIES INC DBA HERITAGE VALLEY SEWICKLEY | 251801532 - (PA) HERITAGE VALLEY HEALTH SYSTEM | PA | General Acute Care Hospital (282N00000X) |
United | 079 | $6598.25 | 1265820179 - BANNER | 901074557 | AZ | General Acute Care Hospital (282N00000X) |
United | 079 | $4853.58 | 1508895079 - MISSION HOSPITAL, INC, MISSION REGIONAL MEDICAL CENTER | 742206635 - (TX) MISSION HOSPITAL INC | TX | Rehabilitation Hospital (283X00000X) |
United | 079 | $14815.41 | 1932134384 - AMISUB OF SOUTH CAROLINA, INC., PIEDMONT MEDICAL CENTER | 953561198 - (SC) AMISUB OF SOUTH CAROLINA INC | SC | Psychiatric Hospital Unit (273R00000X) |
United | 079 | $13008.00 | 1912992215 - NORTHERN WESTCHESTER HOSPITAL ASSOCIATION, NORTHERN WESTCHESTER HOSPITAL | 131740118 - (NY) NORTHERN WESTCHESTER HOSPITAL ASSOCIATION | NY | General Acute Care Hospital (282N00000X) |
United | 079 | $11020.54 | 1184655581 - UNIVERSITY OF CALIFORNIA IRVINE, UCI HEALTH LAKEWOOD | 952226406 - REGENTS OF THE UNIVERSITY OF CALIFORNIA AT IRVINE | CA | General Acute Care Hospital (282N00000X) |
United | 079 | $5638.95 | 1134130289 - VALLEY MEDICAL FACILITIES, INC., VALLEY MEDICAL FACILITIES, HERITAGE VALLEY BEAVER | 251801532 - (PA) HERITAGE VALLEY HEALTH SYSTEM | PA | 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 079 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 079 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 079 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 |
|---|---|---|
| 078-MS-DRG | High | Hypertensive Encephalopathy with CC |
| 079-MS-DRG | High | Hypertensive Encephalopathy without CC/MCC |
| 080-APR-DRG | High | Autologous Bone Marrow Transplant |
| 080-MS-DRG | High | Non-traumatic Stupor and Coma with MCC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 079. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 079 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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