MS-DRG 153 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 153 by major payers:
$8,272.25
$9,962.46
$11,474.61
$11,766.00
| 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 153 | ||||||
United | 153 | $13143.67 | 1669490819 - PROVIDENCE HEALTH SYSTEM, PROVIDENCE SAINT JOSEPH MEDICAL CENTER | 951675600 - (CA) PROVIDENCE HEALTH SYSTEMS SO. CA SAN FERNANDO VALLEY SERVICE AREA | CA | Rehabilitation Hospital Unit (273Y00000X) |
United | 153 | $23942.30 | 1386871788 - EMANUEL MEDICAL CENTER, INC., EMANUEL FAMILY PRACTICE - MONTE VISTA | 752918774 | CA | General Acute Care Hospital (282N00000X) |
United | 153 | $13770.67 | 1265833487 - VANDERBILT UNIVERSITY MEDICAL CENTER | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | 153 | $35455.78 | 1912937624 - HILTON HEAD HEALTH SYSTEM, L.P., HILTON HEAD HOSPITAL | 752550947 - (SC) HILTON HEAD HEALTH SYSTEM LP | SC | General Acute Care Hospital (282N00000X) |
United | 153 | $8788.78 | 1851369243 - PARKWEST MEDICAL CENTER | 581897274 - (TN) PARKWEST MEDICAL CENTER | TN | Psychiatric Hospital Unit (273R00000X) |
United | 153 | $8237.92 | 1619923919 - METROPOLITAN HOSPITAL, METRO HEALTH HOSPITAL | 380593405 - METROPOLITAN HOSPITAL | MI | General Acute Care Hospital (282N00000X) |
United | 153 | $7170.00 | 1497775381 - SOUTHCOAST HOSPITALS GROUP, INC, ST. LUKE'S HOSPITAL - PSYCH | 222592333 - SOUTHCOAST HOSPITALS GROUP INC | MA | Psychiatric Hospital Unit (273R00000X) |
United | 153 | $11063.87 | 1932208576 - UNIVERSITY OF NORTH CAROLINA HOSPITALS AT CHAPEL HILL, UNC HOSPITALS | 561118388 | NC | General Acute Care Hospital (282N00000X) |
United | 153 | $22796.16 | 1518271782 - EMANUEL MEDICAL CENTER, INC., EMANUEL SPECIALTY CARE - SURGERY | 752918774 | CA | General Acute Care Hospital (282N00000X) |
United | 153 | $6250.85 | 1669441176 - WILSON COUNTY HOSPITAL | 486040227 - (KS) WILSON COUNTY HOSPITAL | KS | Critical Access Hospital (282NC0060X) |
United | 153 | $13174.95 | 1386749893 - FRANCISCAN HEALTH INDIANAPOLIS & MOORESVILLE, FRANCISCAN HEALTH - INDIANAPOLIS | 350913537 | IN | General Acute Care Hospital (282N00000X) |
United | 153 | $9792.28 | 1245409663 - BAPTIST MEDICAL CENTER HEBER SPRINGS | 710236856 - (AR) BAPTIST HEALTH | AR | General Acute Care Hospital (282N00000X) |
United | 153 | $7862.14 | 1144247982 - HENDERSON COUNTY HOSPITAL CORPORATION, MARGARET R. PARDEE MEMORIAL HOSPITAL | 562084959 | NC | General Acute Care Hospital (282N00000X) |
United | 153 | $5854.97 | 1417432840 - THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 560529945 | NC | General Acute Care Hospital (282N00000X) |
United | 153 | $8200.37 | 1457314502 - MEDICAL UNIVERSITY OF OHIO AT TOLEDO, UNIVERSITY OF TOLEDO MEDICAL CENTER | 340967014 | OH | Psychiatric Hospital Unit (273R00000X) |
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 153 vs. Other Diseases & Disorders of the Ear, Nose, Mouth & Throat Codes
The MS-DRG 153 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 153 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 |
|---|---|---|
| 152-MS-DRG | High | Otitis Media and URI with MCC |
| 153-MS-DRG | High | Otitis Media and URI without MCC |
| 154-MS-DRG | High | Other Ear, Nose, Mouth and Throat Diagnoses 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 153. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 153 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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