MS-DRG 203 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 Respiratory System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 203 by major payers:
$8,191.45
$9,795.95
$11,088.20
$11,446.41
| 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 203 | ||||||
United | 203 | $4693.14 | 1346251543 - ST. LUKES EPISCOPAL-PRESBYTERIAN HOSPITAL, ST. LUKE'S HOSPITAL | 430652680 - ST LUKES EPISCOPAL-PRESBYTERIAN HOSPITAL | MO | General Acute Care Hospital (282N00000X) |
United | 203 | $20480.03 | 1316933609 - PHYSICIANS MEDICAL CENTER, LLC, TEXAS HEALTH CENTER FOR DIAGNOSTICS AND SURGERY PLANO | 481281376 - (TX) PHYSICIANS MEDICAL CENTER, LLC DBA TEXAS HEALTH CENTER FOR DIAGNOSTICS | TX | General Acute Care Hospital (282N00000X) |
United | 203 | $7266.93 | 1407990088 - PMC HOSPITAL, LLC, ST. LUKE'S PATIENTS MEDICAL CENTER | 273280598 - (TX) PMC HOSPITAL, LLC | TX | General Acute Care Hospital (282N00000X) |
United | 203 | $3720.00 | 1174601397 - PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA, JACKSON SOUTH COMMUNITY HOSPITAL | 591713947 - (FL) PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY FLORIDA | FL | General Acute Care Hospital (282N00000X) |
United | 203 | $16961.11 | 1831759794 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 203 | $16023.88 | 1437582400 - HIGHLAND HOSPITAL | 943302014 | CA | General Acute Care Hospital (282N00000X) |
United | 203 | $16023.88 | 1437582400 - HIGHLAND HOSPITAL | 943302014 | CA | General Acute Care Hospital (282N00000X) |
United | 203 | $15580.16 | 1912171323 - AURORA HEALTH CARE METRO, INC., AURORA ST. LUKE'S MEDICAL CENTER | 390806181 - AURORA HEALTH CARE INC | WI | Rehabilitation Hospital Unit (273Y00000X) |
United | 203 | $9513.46 | 1982625661 - NICHOLAS H. NOYES MEMORIAL HOSPITAL | 160743979 - (NY) NICHOLAS H NOYES MEMORIAL HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 203 | $10657.28 | 1891222410 - METHODIST GERMANTOWN | 620479367 - METHODIST HEALTHCARE-MEMPHIS | TN | General Acute Care Hospital (282N00000X) |
United | 203 | $7098.39 | 1942205166 - CLAIBORNE MEDICAL CENTER | 464420358 - (TN) CLAIBORNE MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | 203 | $10613.90 | 1073653523 - MONROE CLINIC, SSM HEALTH MONROE HOSPITAL | 390808509 - THE MONROE CLINIC INC | WI | General Acute Care Hospital (282N00000X) |
United | 203 | $11712.94 | 1417600909 - COLUMBIA ST. MARY'S HOSPITAL MILWAUKEE INC | 390806315 - COLUMBIA ST MARYS HOSPITAL MILWAUKEE INC | WI | Psychiatric Hospital Unit (273R00000X) |
United | 203 | $6621.00 | 1699738088 - JACKSON COUNTY SCHNECK MEMORIAL HOSPITAL, SCHNECK MEDICAL CENTER | 351163135 - JACKSON COUNTY SCHNECK MEMORIAL HOSPITAL | IN | General Acute Care Hospital (282N00000X) |
United | 203 | $6531.58 | 1154363406 - BOTSFORD GENERAL HOSPITAL, BEAUMONT HOSPITAL-FARMINGTON HILLS | 381426919 - (MI) BOTSFORD GENERAL HOSPITAL | MI | Rehabilitation Hospital Unit (273Y00000X) |
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 203 vs. Other Diseases & Disorders of the Respiratory System Codes
The MS-DRG 203 code is part of the Diseases & Disorders of the Respiratory 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 203 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 |
|---|---|---|
| 202-APR-DRG | Moderate | Open Craniotomy For Trauma |
| 202-MS-DRG | High | Bronchitis and Asthma with CC/MCC |
| 203-MS-DRG | High | Bronchitis and Asthma without CC/MCC |
| 204-APR-DRG | High | SYNCOPE & COLLAPSE |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 203. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 203 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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