MS-DRG 103 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 103 by major payers:
$9,515.07
$11,757.21
$13,518.61
$13,854.53
| 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 103 | ||||||
United | 103 | $20670.06 | 1942294053 - COMMUNITY GENERAL HOSPITAL OF GREATER SYRACUSE | 161469571 | NY | General Acute Care Hospital (282N00000X) |
United | 103 | $8556.15 | 1467455154 - DESOTO HOSPITAL ASSOCIATION | 720500565 - (LA) DESOTO HOSPITAL ASSOCIATION | LA | General Acute Care Hospital (282N00000X) |
United | 103 | $9500.99 | 1497798847 - BAPTIST HEALTHCARE SYSTEM, INC., BAPTIST HEALTH FLOYD | 610444707 - BAPTIST HEALTHCARE SYSTEM INC | IN | General Acute Care Hospital (282N00000X) |
United | 103 | $15847.73 | 1225097652 - ST. CHARLES HOSPITAL | 111871039 - (NY) ST CHARLES HOSPITAL CORP | NY | Rehabilitation Hospital Unit (273Y00000X) |
United | 103 | $6706.00 | 1487697215 - ST.FRANCIS MEDICAL CENTER | 850737566 | CA | General Acute Care Hospital (282N00000X) |
United | 103 | $6893.02 | 1477939296 - SELECT SPECIALTY HOSPITAL | 352498003 | GA | Special Hospital (284300000X) |
United | 103 | $12029.46 | 1295723229 - ST FRANCIS MEDICAL CENTER, INC | 720408970 - (LA) ST FRANCIS MEDICAL CENTER INC | LA | General Acute Care Hospital (282N00000X) |
United | 103 | $8447.37 | 1447363783 - BLACKWELL HMA LLC, ALLIANCEHEALTH BLACKWELL | 730927647 | OK | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 103 | $14814.33 | 1821544925 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH CANCER INST-SENECA | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 103 | $6470.54 | 1558364802 - MOBILE INFIRMARY ASSOCIATION, MOBILE INFIRMARY MEDICAL CENTER | 630288856 - (AL) MOBILE INFIRMARY ASSOCIATION | AL | General Acute Care Hospital (282N00000X) |
United | 103 | $12841.41 | 1598703019 - NEW YORK SOCIETY FOR THE RELIEF OF RUPTURED & CRIPPLED MAINTAINING, HOSPITAL FOR SPECIAL SURGERY | 131624135 - NEW YORK SOCIETY FOR THE RELIEF OF RUPTURED & CRIPPLED MAINTAINING | NY | General Acute Care Hospital (282N00000X) |
United | 103 | $14772.25 | 1699541870 - STATE UNIVERSITY OF IOWA, UNIVERSITY OF IOWA HEALTH CARE MEDICAL CENTER DOWNTOWN | 426004813 | IA | General Acute Care Hospital (282N00000X) |
United | 103 | $20325.73 | 1477531580 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 103 | $17072.01 | 1881758126 - KISHWAUKEE COMMUNITY HOSPITAL, NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL | 237087041 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | General Acute Care Hospital (282N00000X) |
United | 103 | $14120.03 | 1972535052 - OHIOHEALTH CORPORATION, DOCTORS HOSPITAL | 314394942 - OHIOHEALTH CORPORATION GRANT RIVERSIDE DOCTORS DUBLIN MET | OH | 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 103 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 103 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 103 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 |
|---|---|---|
| 102-APR-DRG | Moderate | Head Trauma With Deep Coma |
| 102-MS-DRG | High | Headaches with MCC |
| 103-MS-DRG | High | Headaches without 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 103. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 103 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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