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See a sample rate comparisonMS-DRG 096 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.
BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM 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 096 by major payers:
$26,105.69
$29,983.87
$37,683.52
$37,985.52
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MS-DRG 096
5 of 25 sample ratesHigher to lower in this preview
Banner Goldfield Medical Center
$60,390.26Published rateFranciscan Health Indianapolis & Mooresville, Franciscan Health - Mooresville
$39,082.01Published rateWilliam Beaumont Hospital, Beaumont Hospital, Troy
William Beaumont Hospital
$25,453.47Published rateWamego Hospital Association, Wamego Health Center And Wamego Family Clinic
Wamego Hospital Association
$15,366.59Published rateShelby County Health Care Corporation, Regional One Health Rehabilitation Hospital
Shelby County Health Care Corporation
$4,898.00Published rate
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See a sample payer proposalMS-DRG 096 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 096 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 096 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 |
|---|---|---|
| 095-APR-DRG | High | CLEFT LIP & PALATE REPAIR |
| 095-MS-DRG | High | BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC |
| 096-MS-DRG | High | BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC |
| 097-APR-DRG | High | TONSIL & ADENOID 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 096. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 096 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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