MS-DRG 157 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 157 by major payers:
$18,496.88
$21,141.24
$25,791.79
$26,300.05
| 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 157 | ||||||
United | 157 | $44091.32 | 1063541266 - GEORGETOWN UNIVERSITY HOSPITAL | 522218584 - (DC) MEDSTAR-GEORGETOWN MEDICAL CENTER INC | DC | General Acute Care Hospital (282N00000X) |
United | 157 | $28972.28 | 1881690691 - UNIVERSITY HOSPITAL AT STONY BROOK, STONY BROOK EASTERN LONG ISLAND HOSPITAL | 113243405 | NY | General Acute Care Hospital (282N00000X) |
United | 157 | $7632.31 | 1427048453 - MEDINA COUNTY HOSPITAL DISTRICT, MEDINA REGIONAL HOSPITAL | 270492434 | TX | Critical Access Hospital (282NC0060X) |
United | 157 | $21082.81 | 1770671182 - NEWARK WAYNE COMMUNITY HOSPITAL | 150584188 - NEWARK WAYNE COMMUNITY HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 157 | $44060.21 | 1538522412 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE TRANSMOUNTAIN CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 157 | $5532.00 | 1205846037 - BAILEY MEDICAL CENTER, LLC | 201547519 - (OK) BAILEY MEDICAL CENTER LLC | OK | General Acute Care Hospital (282N00000X) |
United | 157 | $24665.66 | 1477809978 - RIPON MEDICAL CENTER | 391101287 - RIPON MEDICAL CENTER INC | WI | General Acute Care Hospital (282N00000X) |
United | 157 | $34276.14 | 1073799664 - THEDACARE MEDICAL CENTER, RIVERSIDE MEDICAL CENTER, INC. | 350983617 - COMMUNITY HEALTH NETWORK INC | WI | Critical Access Hospital (282NC0060X) |
United | 157 | $22640.08 | 1710109186 - ST. MARY MEDICAL CENTER, PROVIDENCE ST. MARY MEDICAL CENTER | 951914489 - (CA) ST MARY MEDICAL CENTER | CA | General Acute Care Hospital (282N00000X) |
United | 157 | $21417.42 | 1629170824 - ST CATHERINE HOSPITAL INC | 351738708 - (IN) ST CATHERINE HOSPITAL INC | IN | Psychiatric Hospital Unit (273R00000X) |
United | 157 | $26869.74 | 1972517365 - COVENANT MEDICAL CENTER | 822913146 - (TX) COVENANT MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 157 | $14612.24 | 1134172406 - COLUMBIA MEDICAL CENTER OF ARLINGTON SUBSIDIARY LP, MEDICAL CITY ARLINGTON | 621682201 - COLUMBIA MEDICAL CENTER OF ARLINGTON SUBSIDIARY LP | TX | General Acute Care Hospital (282N00000X) |
United | 157 | $32979.60 | 1043397177 - AURORA MEDICAL CENTER BAY AREA, INC | 391528430 - AURORA MEDICAL CENTER BAY AREA INC | WI | General Acute Care Hospital (282N00000X) |
United | 157 | $30935.65 | 1982600540 - UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC., PIEDMONT MCDUFFIE HOSPITAL | 454166209 - (GA) UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | 157 | $14715.17 | 1497708473 - NASON MEDICAL CENTER LLC, NASON HOSPITAL | 472546387 | PA | 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 157 vs. Other Diseases & Disorders of the Ear, Nose, Mouth & Throat Codes
The MS-DRG 157 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 157 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 |
|---|---|---|
| 156-MS-DRG | High | Other Ear, Nose, Mouth and Throat Diagnoses without CC/MCC |
| 157-MS-DRG | High | Dental and Oral Diseases with MCC |
| 158-MS-DRG | High | Dental and Oral Diseases with CC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 157. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 157 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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