MS-DRG 091 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 091 by major payers:
$19,923.54
$24,479.51
$28,671.86
$28,968.00
| 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 091 | ||||||
United | 091 | $24492.80 | 1952512469 - VALLEY BAPTIST MEDICAL CENTER, VALLEY BAPTIST MEDICAL FACILITY BROWNSVILLE | 452663071 | TX | Psychiatric Hospital Unit (273R00000X) |
United | 091 | $59068.64 | 1386871788 - EMANUEL MEDICAL CENTER, INC., EMANUEL FAMILY PRACTICE - MONTE VISTA | 752918774 | CA | General Acute Care Hospital (282N00000X) |
United | 091 | $26323.84 | 1821030842 - VANDERBILT UNIVERSITY MEDICAL CENTER, VANDERBILT WILSON COUNTY HOSPITAL | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Psychiatric Hospital Unit (273R00000X) |
United | 091 | $24492.80 | 1952512469 - VALLEY BAPTIST MEDICAL CENTER, VALLEY BAPTIST MEDICAL FACILITY BROWNSVILLE | 452663071 | TX | Psychiatric Hospital Unit (273R00000X) |
United | 091 | $19475.85 | 1184132524 - PITTSBURG HOSPITAL LLC | 823953636 | TX | Critical Access Hospital (282NC0060X) |
United | 091 | $70476.96 | 1851787295 - HDMC HOLDINGS, LLC, HI-DESERT MEDICAL CENTER | 473550779 | CA | General Acute Care Hospital (282N00000X) |
United | 091 | $20039.14 | 1467537506 - CARONDELET HEALTH NETWORK, ST. MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 091 | $15137.99 | 1023011657 - SWEENY HOSPITAL DISTRICT, SWEENY COMMUNITY HOSPITAL | 741498067 | TX | Critical Access Hospital (282NC0060X) |
United | 091 | $70476.96 | 1851787295 - HDMC HOLDINGS, LLC, HI-DESERT MEDICAL CENTER | 473550779 | CA | General Acute Care Hospital (282N00000X) |
United | 091 | $51289.10 | 1184038663 - NEW YORK SOCIETY FOR THE RELIEF OF THE RUPTURED AND CRIPPLED, HOSPITAL FOR SPECIAL SURGERY | 131624135 - NEW YORK SOCIETY FOR THE RELIEF OF RUPTURED & CRIPPLED MAINTAINING | NJ | General Acute Care Hospital (282N00000X) |
United | 091 | $35579.35 | 1144742537 - COMMUNITY MERCY HEALTH PARTNERS, MERCY HEALTH-URBANA HOSPITAL | 310785684 - COMMUNITY MERCY HEALTH PARTNERS | OH | Psychiatric Hospital Unit (273R00000X) |
United | 091 | $15137.99 | 1023011657 - SWEENY HOSPITAL DISTRICT, SWEENY COMMUNITY HOSPITAL | 741498067 | TX | Critical Access Hospital (282NC0060X) |
United | 091 | $9732.00 | 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 | 091 | $15686.95 | 1821042979 - HCA HEALTHONE LLC, NORTH SUBURBAN MEDICAL CENTER | 841321373 | CO | General Acute Care Hospital (282N00000X) |
United | 091 | $15686.95 | 1821042979 - HCA HEALTHONE LLC, NORTH SUBURBAN MEDICAL CENTER | 841321373 | CO | 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 091 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 091 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 091 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 |
|---|---|---|
| 090-APR-DRG | High | Major Larynx & Trachea Procedures |
| 090-MS-DRG | High | Concussion without CC/MCC |
| 091-MS-DRG | High | Other Disorders of Nervous System with MCC |
| 092-APR-DRG | High | FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL/FACIAL BONE 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 091. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 091 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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