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 | $16484.33 | 1326010273 - ALAMANCE REGIONAL MEDICAL CENTER, INC. | 560529994 - ALAMANCE REGIONAL MEDICAL CENTER | NC | General Acute Care Hospital (282N00000X) |
United | 103 | $15398.00 | 1962453936 - WINCHESTER MEDICAL CENTER, WINCHESTER REHABILITATION CENTER | 540505979 - VALLEY HEALTH SYSTEM | VA | Rehabilitation Hospital Unit (273Y00000X) |
United | 103 | $23341.39 | 1013514199 - KECK MEDICAL CENTER OF USC, KECK HOSPITAL OF USC | 851644866 - (CA) KECK MEDICAL CENTER OF USC | CA | 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 | 103 | $20055.83 | 1336252717 - INTEGRIS SOUTH OKLAHOMA CITY HOSPITAL CORPORATION, INTEGRIS JIM THORPE INPATIENT REHABILITATION | 731089149 - (OK) INTEGRIS SOUTH OKLAHOMA CITY HOSPITAL CORPORATION | OK | Rehabilitation Hospital Unit (273Y00000X) |
United | 103 | $13485.01 | 1689948655 - DELNOR COMMUNITY HOSPITAL | 363484281 - (IL) NORTHWESTERN MEMORIAL HEALTHCARE | IL | General Acute Care Hospital (282N00000X) |
United | 103 | $13338.79 | 1396837951 - CENTRAL IOWA HOSPITAL CORPORATION, IOWA METHODIST MEDICAL CENTER | 420680452 - CENTRAL IOWA HOSPITAL CORPORATION | IA | General Acute Care Hospital (282N00000X) |
United | 103 | $14966.08 | 1063968196 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 103 | $15138.66 | 1720454341 - SMSJ TUCSON HOLDINGS LLC, BRIDGES GEROPSYCHIATRIC PROGRAM AT ST. MARYS HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 103 | $15138.66 | 1720454341 - SMSJ TUCSON HOLDINGS LLC, BRIDGES GEROPSYCHIATRIC PROGRAM AT ST. MARYS HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 103 | $10190.50 | 1780731737 - MADISON ST JOSEPH HEALTH CENTER, CHI ST JOSEPH HEALTH MADISON HOSPITAL | 742761145 - (TX) MADISON ST JOSEPH HEALTH CENTER | TX | Critical Access Hospital (282NC0060X) |
United | 103 | $6893.02 | 1477939296 - SELECT SPECIALTY HOSPITAL | 352498003 | GA | Special Hospital (284300000X) |
United | 103 | $6893.02 | 1477939296 - SELECT SPECIALTY HOSPITAL | 352498003 | GA | Special Hospital (284300000X) |
United | 103 | $7408.75 | 1588636351 - LUCAS COUNTY HEALTH CENTER | 426039708 - LUCAS COUNTY HEALTH CENTER | IA | Critical Access Hospital (282NC0060X) |
United | 103 | $30954.01 | 1851787295 - HDMC HOLDINGS, LLC, HI-DESERT MEDICAL CENTER | 473550779 | CA | 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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