MS-DRG 098 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 098 by major payers:
$23,979.00
$27,444.08
$34,097.30
$34,450.75
| 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 098 | ||||||
United | 098 | $31087.92 | 1962492660 - MCALLEN HOSPITALS L P, SOUTH TEXAS HEALTH SYSTEM | 233069260 | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 098 | $38240.21 | 1588640692 - EMORY UNIVERSITY, EMORY UNIVERSITY HOSPITAL | 580566256 - (GA) EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | 098 | $51331.76 | 1619341716 - NYU LANGONE HOSPITALS | 133971298 - NYU LANGONE HOSPITALS | NY | General Acute Care Hospital (282N00000X) |
United | 098 | $46967.51 | 1063504132 - PINNACLE HEALTH HOSPITALS, PINNACLE HEALTH HOSPITAL OUTPATIENT SERVICES AT SEIDLE | 251778644 - (PA) UPMC PINNACLE HOSPITALS | PA | General Acute Care Hospital (282N00000X) |
United | 098 | $8557.00 | 1659546729 - ST MARY'S HOSPITAL | 463499370 | NJ | General Acute Care Hospital (282N00000X) |
United | 098 | $8557.00 | 1659546729 - ST MARY'S HOSPITAL | 463499370 | NJ | General Acute Care Hospital (282N00000X) |
United | 098 | $17232.55 | 1902870132 - ENCOMPASS HEALTH REHABILITATION HOSPITAL OF SCOTTSDALE, LLC, ENCOMPASS HEALTH REHABILITATION HOSPITAL OF SCOTTSDALE | 631184846 | AZ | Rehabilitation Hospital (283X00000X) |
United | 098 | $17232.55 | 1902870132 - ENCOMPASS HEALTH REHABILITATION HOSPITAL OF SCOTTSDALE, LLC, ENCOMPASS HEALTH REHABILITATION HOSPITAL OF SCOTTSDALE | 631184846 | AZ | Rehabilitation Hospital (283X00000X) |
United | 098 | $84954.07 | 1568676880 - NEW YORK PRESBYTERIAN HOSPITAL, HOSPITAL | 133957095 - (NY) THE NEW YORK AND PRESBYTERIAN HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 098 | $34407.26 | 1982611281 - NORTHERN ILLINOIS MEDICAL CENTER, CENTEGRA HOSPITAL MCHENRY | 362338884 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | General Acute Care Hospital (282N00000X) |
United | 098 | $33817.21 | 1184732851 - ST JOSEPH MEDICAL CENTER, ST JOSEPH MEDICAL CENTER MEDICAID PRO FEES | 370662576 | IL | General Acute Care Hospital (282N00000X) |
United | 098 | $83869.47 | 1851787295 - HDMC HOLDINGS, LLC, HI-DESERT MEDICAL CENTER | 473550779 | CA | General Acute Care Hospital (282N00000X) |
United | 098 | $28116.23 | 1760794044 - VHS SINAI-GRACE HOSPITAL INC, SINAI-GRACE HOSPITAL | 272844632 | MI | General Acute Care Hospital (282N00000X) |
United | 098 | $57002.69 | 1477531580 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 098 | $6098.00 | 1871859306 - HUDSON HOSPITAL OPCO LLC, CHRIST HOSPITAL | 383870608 - (NJ) HUDSON HOSPITAL OPCO, LLC DBA CHRIST HOSPITAL | NJ | 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 098 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 098 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 098 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 |
|---|---|---|
| 097-APR-DRG | High | TONSIL & ADENOID PROCEDURES |
| 097-MS-DRG | High | Non-bacterial Infection of Nervous System except Viral Meningitis with MCC |
| 098-MS-DRG | High | Non-bacterial Infection of Nervous System except Viral Meningitis with CC |
| 099-MS-DRG | High | Non-bacterial Infection of Nervous System except Viral Meningitis without CC/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 098. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 098 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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