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See a sample rate comparisonMS-DRG 090 Fee Schedule
Last Verified: October 2026
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.
CONCUSSION WITHOUT CC/MCC
| 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 090 by major payers:
$9,724.59
$11,085.88
$13,630.36
$13,946.76
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MS-DRG 090
5 of 25 sample ratesHigher to lower in this preview
North Colorado Medical Center
$23,575.23Published rateProvidence Health & Services, Prov Scred Hrt Med Ctr & Chlds Hos
$18,865.19Published rateVanderbilt Bedford Hospital, LLC, Vanderbilt Bedford Hospital
$12,251.66Published rateDlp Twin County Regional Healthcare LLC, Twin County Regional Hospital
$7,415.12Published rateThe Dch Healthcare Authority, Northport Medical Center
The Dch Health Care Authority
$1,875.00Published rate
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See a sample payer proposalMS-DRG 090 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 090 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 090 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 |
|---|---|---|
| 089-APR-DRG | High | MAJOR CRANIAL/FACIAL BONE PROCEDURES |
| 089-MS-DRG | High | CONCUSSION WITH CC |
| 090-MS-DRG | High | CONCUSSION WITHOUT CC/MCC |
| 091-APR-DRG | High | OTHER MAJOR HEAD & NECK PROCEDURES |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 090. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 090 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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