MS-DRG 151 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 Ear, Nose, Mouth & Throat |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 151 by major payers:
$8,662.99
$10,471.82
$12,042.91
$12,402.26
| 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 151 | ||||||
United | 151 | $16412.06 | 1881760759 - INTEGRIS BAPTIST MEDICAL CENTER INC, INTEGRIS MENTAL HEALTH CENTER ACUTE | 731034824 - (OK) INTEGRIS BAPTIST MEDICAL CENTER INC | OK | Psychiatric Hospital Unit (273R00000X) |
United | 151 | $1875.00 | 1265516462 - FAYETTE MEDICAL CENTER, FAYETTE MEDICAL CENTER SWING BED UNIT | 636004942 | AL | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 151 | $11618.96 | 1336520840 - SAINT THOMAS STONES RIVER HOSPITAL, LLC, ASCENSION SAINT THOMAS STONES RIVER | 474063232 | TN | Rehabilitation Hospital Unit (273Y00000X) |
United | 151 | $5609.20 | 1073698262 - CHRISTIAN UNITY HOSPITAL CORPORATION, UNITY MEDICAL CENTER-SWINGBED | 450310159 - (ND) CHRISTIAN UNITY HOSPITAL CORPORATION | ND | Critical Access Hospital (282NC0060X) |
United | 151 | $20422.78 | 1700359205 - MEDICAL UNIVERSITY HOSPITAL AUTHORITY, MUSC HEALTH LANCASTER MEDICAL CENTER | 571098556 - (SC) MEDICAL UNIVERSITY HOSPITAL AUTHORITY | SC | General Acute Care Hospital (282N00000X) |
United | 151 | $8561.17 | 1437111713 - HOT SPRING COUNTY MEDICAL CENTER | 710236856 - (AR) BAPTIST HEALTH | AR | Psychiatric Hospital Unit (273R00000X) |
United | 151 | $21310.63 | 1205889458 - PRISMA HEALTH-MIDLANDS, PRISMA HEALTH BAPTIST HOSPITAL | 582296052 - (SC) PRISMA HEALTH-MIDLANDS | SC | General Acute Care Hospital (282N00000X) |
United | 151 | $34457.16 | 1407016793 - DOCTORS MEDICAL CENTER, DOCTORS BEHAVIORAL HEALTH | 952588614 | CA | Psychiatric Hospital (283Q00000X) |
United | 151 | $34457.16 | 1407016793 - DOCTORS MEDICAL CENTER, DOCTORS BEHAVIORAL HEALTH | 952588614 | CA | Psychiatric Hospital (283Q00000X) |
United | 151 | $8193.21 | 1518950674 - INDIANA REGIONAL MEDICAL CENTER | 250965404 - (PA) INDIANA REGIONAL MEDICAL CENTER | PA | Rehabilitation Hospital Unit (273Y00000X) |
United | 151 | $6358.41 | 1184682874 - S P ACQUISITION CORP., GRANDVIEW MEDICAL CENTER | 620840204 | TN | General Acute Care Hospital (282N00000X) |
United | 151 | $13258.17 | 1104887199 - UNIVERSITY PHYSICIANS HEALTHCARE, UNIVERSITY PHYSICIANS HOSPITAL @ KINO | 901074558 | AZ | General Acute Care Hospital (282N00000X) |
United | 151 | $6032.16 | 1740287531 - GUTHRIE CORTLAND MEDICAL CENTER | 150532079 - (NY) GUTHRIE CORTLAND MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 151 | $8338.00 | 1568801116 - VICTORY MEDICAL CENTER LANDMARK, LP | 474612520 | TX | General Acute Care Hospital (282N00000X) |
United | 151 | $19957.27 | 1477584993 - JFK MEMORIAL HOSPITAL, INC., JOHN F. KENNEDY MEMORIAL HOSPITAL | 752919774 | 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 151 vs. Other Diseases & Disorders of the Ear, Nose, Mouth & Throat Codes
The MS-DRG 151 code is part of the Diseases & Disorders of the Ear, Nose, Mouth & Throat 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 151 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 |
|---|---|---|
| 150-MS-DRG | High | Epistaxis with MCC |
| 151-MS-DRG | High | Epistaxis without MCC |
| 152-MS-DRG | High | Otitis Media and URI 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 151. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 151 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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