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MS-DRG 101 Fee Schedule

Last Verified: December 2025

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.

Seizures without MCC
Key FactDetail
Service Type

Diseases & Disorders of the Nervous System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Complexity LevelHigh

National average reimbursement for MS-DRG 101 by major payers:

bcbs

$10,291.84

uhc

$12,262.08

aetna

$14,603.69

cigna

$14,957.60

Preview provider-level rates for...
For billing codeMS-DRG 101
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for MS-DRG 101

United
101$18448.501063504132 - PINNACLE HEALTH HOSPITALS, PINNACLE HEALTH HOSPITAL OUTPATIENT SERVICES AT SEIDLE251778644 - (PA) UPMC PINNACLE HOSPITALSPAGeneral Acute Care Hospital (282N00000X)
United
101$19955.731689107328 - UPMC CARLISLE820880337 - (PA) UPMC CARLISLEPAGeneral Acute Care Hospital (282N00000X)
United
101$26637.131104070234 - CHILDRENS HOSPITAL OF WISCONSIN390812532 - CHILDRENS HOSPITAL OF WISCONSIN INCWIChildren's Hospital (282NC2000X)
United
101$8241.001841624756 - PECONIC BAY MEDICAL CENTER111661359 - (NY) CENTRAL SUFFOLK HOSPITALNYGeneral Acute Care Hospital (282N00000X)
United
101$24821.381912061706 - GOOD SAMARITAN HOSPITAL131740104 - (NY) BON SECOURS CHARITY HEALTH SYSTEM INCNYHospitalist Physician (208M00000X)
United
101$4235.141134204720 - KINDRED HOSPITALS EAST, LLC, KINDRED HOSPITAL - NORTH FLORIDA522085555FLLong Term Care Hospital (282E00000X)
United
101$19369.921285709261 - INTEGRIS BASS BAPTIST HEALTH CENTER, INTEGRIS BASS BEHAVIORAL HEALTH CENTER RTC730612674OKPsychiatric Hospital Unit (273R00000X)
United
101$23220.391548517410 - STONY BROOK UNIVERSITY HOSPITAL113243405NYChildren's Hospital (282NC2000X)
United
101$20122.551114958584 - INDIANA UNIVERSITY HEALTH INC351955872 - (IN) INDIANA UNIVERSITY HEALTH INCINChildren's Hospital (282NC2000X)
United
101$18289.001326056193 - MISSOURI BAPTIST MEDICAL CENTER430652656 - (MO) MISSOURI BAPTIST MEDICAL CENTERMORehabilitation Hospital Unit (273Y00000X)
United
101$21416.611407917057 - WINTER HAVEN HOSPITAL590724462 - (FL) WINTER HAVEN HOSPITAL INCFLGeneral Acute Care Hospital (282N00000X)
United
101$13195.981306829288 - DLP HAYWOOD REGIONAL MEDICAL CENTER LLC.300830918NCGeneral Acute Care Hospital (282N00000X)
United
101$19293.011548232838 - COMMUNITY HEALTH NETWORK, INC.., HOOK REHABILITATION CENTER350983617 - COMMUNITY HEALTH NETWORK INCINRehabilitation Hospital Unit (273Y00000X)
United
101$13195.981306829288 - DLP HAYWOOD REGIONAL MEDICAL CENTER LLC.300830918NCGeneral Acute Care Hospital (282N00000X)
United
101$8587.691558328971 - CLAREMORE REGIONAL HOSPITAL LLC, CLAREMORE REGIONAL HOSPITAL452652006OKPsychiatric Hospital Unit (273R00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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MS-DRG 101 vs. Other Diseases & Disorders of the Nervous System Codes

The MS-DRG 101 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 101 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.

CodeComplexityDescription
100-MS-DRGHighSeizures with MCC
101-MS-DRGHighSeizures without MCC
102-APR-DRGModerateHead Trauma With Deep Coma
102-MS-DRGHighHeadaches with 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 101. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 101 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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