MS-DRG 101 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 101 by major payers:
$10,291.84
$12,262.08
$14,603.69
$14,957.60
| 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 101 | ||||||
United | 101 | $8587.69 | 1558328971 - CLAREMORE REGIONAL HOSPITAL LLC, CLAREMORE REGIONAL HOSPITAL | 452652006 | OK | Psychiatric Hospital Unit (273R00000X) |
United | 101 | $19675.24 | 1750788667 - CARONDELET HEALTH NETWORK, BRIDGES GEROPSYCHIATRIC PROGRAM AT ST. MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 101 | $13195.98 | 1306829288 - DLP HAYWOOD REGIONAL MEDICAL CENTER LLC. | 300830918 | NC | General Acute Care Hospital (282N00000X) |
United | 101 | $28543.25 | 1790969269 - THE NEW YORK AND PRESBYTERIAN HOSPITAL, NEW YORK-PRESBYTERIAN HOSPITAL | 133957095 - (NY) THE NEW YORK AND PRESBYTERIAN HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 101 | $11968.30 | 1710333893 - THEDACARE MEDICAL CENTER, RIVERSIDE MEDICAL CENTER, INC. | 390871113 - (WI) THEDACARE MEDICAL CENTER-WAUPACA INC | WI | Critical Access Hospital (282NC0060X) |
United | 101 | $8795.09 | 1346275328 - RAWLINS COUNTY HEALTH CENTER | 480545181 - (KS) RAWLINS COUNTY HEALTH CENTER | KS | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 101 | $21311.01 | 1821026089 - MERCY HEALTH | 344428250 - MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC | OH | Psychiatric Hospital Unit (273R00000X) |
United | 101 | $7472.64 | 1124341672 - BANNER IRONWOOD MEDICAL CENTER | 900412842 | AZ | General Acute Care Hospital (282N00000X) |
United | 101 | $6893.02 | 1538449830 - SUMMA REHAB HOSPITAL LLC, SUMMA REHAB HOSPITAL | 271952573 - (OH) SUMMA REHAB HOSPITAL, LLC. | OH | Rehabilitation Hospital (283X00000X) |
United | 101 | $9339.76 | 1538196100 - MERCY HOSPITAL SOUTH, ST. ANTHONY'S MEDICAL CENTER | 430980256 - (MO) MERCY HOSPITAL SOUTH | MO | Psychiatric Hospital Unit (273R00000X) |
United | 101 | $19293.01 | 1548232838 - COMMUNITY HEALTH NETWORK, INC.., HOOK REHABILITATION CENTER | 350983617 - COMMUNITY HEALTH NETWORK INC | IN | Rehabilitation Hospital Unit (273Y00000X) |
United | 101 | $10142.29 | 1487745501 - UPLAND HILLS HEALTH, INC., UPLAND HILLS HEALTH | 421017512 - (WI) UPLAND HILLS HEALTH INC | WI | Critical Access Hospital (282NC0060X) |
United | 101 | $15752.45 | 1467537506 - CARONDELET HEALTH NETWORK, ST. MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 101 | $12340.40 | 1265698948 - UNIVERSITY OF IOWA HOSPITAL AND CLINICS | 426004813 | IA | General Acute Care Hospital (282N00000X) |
United | 101 | $1829.00 | 1689676835 - NATCHITOCHES PARISH HOSPITAL SERVICE DISTRICT, NATCHITOCHES REGIONAL MEDICAL CENTER | 726013916 - (LA) NATCHITOCHES REGIONAL MEDICAL CENTER | LA | 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 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.
| Code | Complexity | Description |
|---|---|---|
| 100-MS-DRG | High | Seizures with MCC |
| 101-MS-DRG | High | Seizures without MCC |
| 102-APR-DRG | Moderate | Head Trauma With Deep Coma |
| 102-MS-DRG | High | Headaches 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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