MS-DRG 080 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 080 by major payers:
$21,988.46
$24,507.35
$31,211.30
$31,621.42
| 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 080 | ||||||
United | 080 | $1864.00 | 1598875460 - NORTH MISSISSIPPI MEDICAL CENTER, INC., NORTH MISSISSIPPI MEDICAL CENTER | 640662976 - NORTH MISSISSIPPI MEDICAL CENTER INC | MS | General Acute Care Hospital (282N00000X) |
United | 080 | $6098.00 | 1497910012 - HUMC OPCO LLC, HOBOKEN UNIVERSITY MEDICAL CENTER | 452147328 - (NJ) HUMC OPCO LLC (D/B/A CAREPOINT HEALTH - HOBOKEN UNIVERSITY MED CENTER) | NJ | Rehabilitation Hospital Unit (273Y00000X) |
United | 080 | $45649.82 | 1972637619 - TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH | 756001743 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH | TX | Chronic Disease Hospital (281P00000X) |
United | 080 | $49046.39 | 1487875498 - NEW ENGLAND MEDICAL CENTER | 43400617 - TUFTS MEDICAL CENTER PARENT INC | MA | Critical Access Hospital (282NC0060X) |
United | 080 | $30715.49 | 1659393932 - DLP FRYE REGIONAL MEDICAL CENTER LLC, FRYE REGIONAL MEDICAL CENTER | 352547114 | NC | Psychiatric Hospital Unit (273R00000X) |
United | 080 | $58821.71 | 1356960132 - TEXAS HEALTH HOSPITAL MANSFIELD | 831869297 - (TX) TEXAS HEALTH HOSPITAL MANSFIELD | TX | General Acute Care Hospital (282N00000X) |
United | 080 | $21552.52 | 1396835138 - CARONDELET HEALTH NETWORK, ST. MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 080 | $10339.53 | 1023074028 - GEORGE COUNTY HOSPITAL | 646001398 | MS | Rural Acute Care Hospital (282NR1301X) |
United | 080 | $53972.75 | 1841376092 - PROVIDENCE HEALTH & SERVICES OREGON, PROVIDENCE PORTLAND MEDICAL CENTER | 930386906 | OR | Rehabilitation Hospital Unit (273Y00000X) |
United | 080 | $17572.88 | 1174940084 - DLP RUTHERFORD REGIONAL HEALTH SYSTEM, LLC, RUTHERFORD REGIONAL MEDICAL CENTER | 300811171 | NC | Psychiatric Hospital Unit (273R00000X) |
United | 080 | $66519.74 | 1841277704 - SCRIPPS HEALTH, SCRIPPS MEMORIAL HOSPITAL LA JOLLA | 951684089 - SCRIPPS HEALTH | CA | General Acute Care Hospital (282N00000X) |
United | 080 | $17570.16 | 1356692297 - H H HEALTH SYSTEM-MORGAN LLC, DECATUR MORGAN HOSPITAL-DECATUR CAMPUS | 460928982 | AL | General Acute Care Hospital (282N00000X) |
United | 080 | $17570.16 | 1356692297 - H H HEALTH SYSTEM-MORGAN LLC, DECATUR MORGAN HOSPITAL-DECATUR CAMPUS | 460928982 | AL | General Acute Care Hospital (282N00000X) |
United | 080 | $22421.48 | 1023060472 - ST. JOSEPH HEALTH SYSTEM, LLC, LUTHERAN DOWNTOWN HOSPITAL | 510382045 | IN | General Acute Care Hospital (282N00000X) |
United | 080 | $2737.00 | 1871642488 - FORDHAM TREMONT COMMUNITY MENTAL HEALTH CENTER | 131740122 - (NY) ST BARNABAS HOSPITAL | NY | 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 080 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 080 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 080 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 |
|---|---|---|
| 079-MS-DRG | High | Hypertensive Encephalopathy without CC/MCC |
| 080-MS-DRG | High | Non-traumatic Stupor and Coma with MCC |
| 081-APR-DRG | Moderate | Autologous Bone Marrow Transplant |
| 081-MS-DRG | High | Non-traumatic Stupor and Coma without 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 080. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 080 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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