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 | $23382.78 | 1659456994 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 098 | $31398.14 | 1114931342 - INTEGRIS MIAMI HOSPITAL, INTEGRIS MIAMI HOSPITAL | 730584411 | OK | General Acute Care Hospital (282N00000X) |
United | 098 | $46036.87 | 1710938949 - NOVANT HEALTH THOMASVILLE MEDICAL CENTER, LLC, THOMASVILLE MEDICAL CENTER | 560636250 - NOVANT HEALTH THOMASVILLE MEDICAL CENTER LLC | NC | Psychiatric Hospital Unit (273R00000X) |
United | 098 | $31863.25 | 1104881507 - PARKVIEW MEDICAL CENTER, INC. | 840935136 - (CO) PARKVIEW MEDICAL CENTER INC | CO | General Acute Care Hospital (282N00000X) |
United | 098 | $16298.21 | 1396790325 - THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY, CAROLINAS HEALTHCARE SYSTEM UNION | 560529945 | NC | General Acute Care Hospital (282N00000X) |
United | 098 | $18537.32 | 1720623853 - BON SECOURS MERCY HEALTH PETERSBURG LLC, BON SECOURS - SOUTHSIDE MEDICAL CENTER | 843050337 | VA | General Acute Care Hospital (282N00000X) |
United | 098 | $27686.77 | 1679627376 - SAINTS MARY AND ELIZABETH MEDICAL CENTER, SAINT ELIZABETH HOSPITAL | 992171028 | IL | 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 | $18252.49 | 1922404284 - MERCY HOSPITAL LINCOLN | 472219204 - (MO) MERCY HOSPITAL LINCOLN | MO | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 098 | $31087.92 | 1962492660 - MCALLEN HOSPITALS L P, SOUTH TEXAS HEALTH SYSTEM | 233069260 | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 098 | $23259.66 | 1457314502 - MEDICAL UNIVERSITY OF OHIO AT TOLEDO, UNIVERSITY OF TOLEDO MEDICAL CENTER | 340967014 | OH | Psychiatric Hospital Unit (273R00000X) |
United | 098 | $23786.36 | 1326022765 - VHS OF ARROWHEAD, INC, ABRAZO ARROWHEAD CAMPUS | 621811285 | AZ | General Acute Care Hospital (282N00000X) |
United | 098 | $20100.73 | 1093744187 - BAPTIST HOSPITALS OF SOUTHEAST TEXAS, MEMORIAL HERMANN BAPTIST BEAUMONT HOSPITAL | 741303720 - BAPTIST HOSPITALS OF SOUTHEAST TEXAS | TX | General Acute Care Hospital (282N00000X) |
United | 098 | $8557.00 | 1659546729 - ST MARY'S HOSPITAL | 463499370 | NJ | General Acute Care Hospital (282N00000X) |
United | 098 | $22008.22 | 1023251923 - CLAIBORNE COUNTY HOSPITAL CLAIBORNE COUNTY AMBULANCE, CLAIBORNE COUNTY HOSPITAL | 464420358 - (TN) CLAIBORNE MEDICAL CENTER | TN | Rural Acute Care Hospital (282NR1301X) |
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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