MS-DRG 092 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 092 by major payers:
$12,272.22
$15,140.89
$16,706.98
$17,065.12
| 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 092 | ||||||
United | 092 | $4958.00 | 1972606465 - MOUNTAIN STATES HEALTH ALLIANCE, JOHNSON CITY MEDICAL CENTER | 620476282 - MOUNTAIN STATES HEALTH ALLIANCE | TN | General Acute Care Hospital (282N00000X) |
United | 092 | $11136.25 | 1265818488 - SMSJ TUCSON HOLDINGS LLC, ST. MARYS HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 092 | $10724.62 | 1740273994 - ECTOR COUNTY HOSPITAL DISTRICT, MEDICAL CENTER HOSPITAL | 752302928 | TX | General Acute Care Hospital (282N00000X) |
United | 092 | $7754.83 | 1427437334 - T.G.C.H. INC., WASHINGTON HEALTH SYSTEM GREENE | 473884840 - (PA) TGCH INC | PA | Psychiatric Hospital Unit (273R00000X) |
United | 092 | $39387.75 | 1790702371 - COUNTY OF YOAKUM, YOAKUM COUNTY HOSPITAL | 756001212 | TX | Critical Access Hospital (282NC0060X) |
United | 092 | $9994.12 | 1487993630 - LUBBOCK COUNTY HOSPITAL DISTRICT, UMC MEDICAL PROFESSIONAL SERVICES | 751301362 - LUBBOCK COUNTY HOSPITAL DISTRICT | TX | Hospitalist Physician (208M00000X) |
United | 092 | $8131.66 | 1447221742 - ROSWELL HOSPITAL CORPORATION, EASTERN NEW MEXICO MEDICAL CENTER | 742870118 | NM | General Acute Care Hospital (282N00000X) |
United | 092 | $24599.94 | 1235371378 - MORTON PLANT HOSPITAL ASSOCIATION, INC., MORTON PLANT HOSPITAL PSYCHATRIC UNIT | 590624462 - (FL) MORTON PLANT HOSPITAL ASSOCIATION INC | FL | Psychiatric Hospital Unit (273R00000X) |
United | 092 | $14984.09 | 1922487966 - SAINT THOMAS HIGHLANDS HOSPITAL, LLC, ASCENSION SAINT THOMAS HIGHLANDS | 474063406 | TN | General Acute Care Hospital (282N00000X) |
United | 092 | $19129.65 | 1679121024 - FAIRVIEW HEALTH SERVICES, UMMC, FAIRVIEW (PSYCH UNIT) | 410991680 - FAIRVIEW HEALTH SERVICES | MN | Psychiatric Hospital Unit (273R00000X) |
United | 092 | $17693.57 | 1821544925 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH CANCER INST-SENECA | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 092 | $10524.66 | 1144695081 - HH HEALTH SYSTEM, ATHENS LIMESTONE HOSPITAL | 475531420 | AL | General Acute Care Hospital (282N00000X) |
United | 092 | $10661.00 | 1396791414 - LONG BEACH MEMORIAL MEDICAL, MEMORIAL REHABILITATION HOSPITAL | 953527031 - (CA) LONG BEACH MEMORIAL MEDICAL CENTER | CA | Rehabilitation Hospital Unit (273Y00000X) |
United | 092 | $13744.04 | 1447221056 - THE HEALTH CARE AUTHORITY OF THE CITY OF HUNTSVILLE, HUNTSVILLE HOSPITAL | 630845288 | AL | General Acute Care Hospital (282N00000X) |
United | 092 | $18735.81 | 1770515991 - GOOD SAMARITAN MEDICAL CENTER, INC., GOOD SAMARITAN MEDICAL CENTER | 752932824 | FL | 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 092 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 092 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 092 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 |
|---|---|---|
| 091-APR-DRG | High | OTHER MAJOR HEAD & NECK PROCEDURES |
| 091-MS-DRG | High | Other Disorders of Nervous System with MCC |
| 092-MS-DRG | High | Other Disorders of Nervous System with CC |
| 093-APR-DRG | High | Extracorporeal Membrane Oxygenation (Ecmo) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 092. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 092 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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