MS-DRG 065 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 065 by major payers:
$12,925.12
$13,877.34
$17,113.30
$17,098.95
| 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 065 | ||||||
United | 065 | $30136.23 | 1073524690 - LINCOLN COUNTY PUBLIC HOSPITAL DISTRICT 1, ODESSA MEMORIAL HEALTHCARE CENTER | 916001722 - (WA) LINCOLN COUNTY PUBLIC HOSPITAL DISTRICT 1 | WA | Critical Access Hospital (282NC0060X) |
United | 065 | $16243.95 | 1225195464 - CANNON COUNTY HOSPITAL LLC, STONES RIVER HOSPITAL | 474063232 | TN | Rehabilitation Hospital Unit (273Y00000X) |
United | 065 | $8046.00 | 1205089026 - PRIME HEALTHCARE SERVICES | 263487583 | CA | General Acute Care Hospital (282N00000X) |
United | 065 | $20236.31 | 1053361642 - DEACONESS HOSPITAL, INC. | 350593390 - DEACONESS HOSPITAL INC | IN | General Acute Care Hospital (282N00000X) |
United | 065 | $9143.53 | 1033228168 - ST FRANCIS HEALTH LLC, ST FRANCIS HOSPITAL | 475259919 - (GA) ST FRANCIS HEALTH LLC | GA | General Acute Care Hospital (282N00000X) |
United | 065 | $11167.59 | 1124661897 - UOFL HEALTH-LOUISVILLE INC | 843178470 - UOFL HEALTH-LOUISVILLE INC | KY | Rehabilitation Hospital Unit (273Y00000X) |
United | 065 | $7772.16 | 1649794421 - POTTSTOWN HOSPITAL, LLC, POTTSTOWN HOSPITAL | 822132538 | PA | General Acute Care Hospital (282N00000X) |
United | 065 | $10543.12 | 1720037559 - EAST TEXAS MEDICAL CENTER PITTSBURG, ETMC PITTSBURG | 823953636 | TX | Critical Access Hospital (282NC0060X) |
United | 065 | $12005.71 | 1235256884 - EAST TEXAS MEDICAL CENTER | 823878395 | TX | General Acute Care Hospital (282N00000X) |
United | 065 | $12005.71 | 1235256884 - EAST TEXAS MEDICAL CENTER | 823878395 | TX | General Acute Care Hospital (282N00000X) |
United | 065 | $21130.96 | 1376899856 - ST. FRANCIS HOSPITAL, INC., BON SECOURS ST. FRANCIS SURGERY CENTER | 582504530 - (SC) ST FRANCIS HOSPITAL INC | SC | General Acute Care Hospital (282N00000X) |
United | 065 | $5526.00 | 1598756710 - PARADISE VALLEY HOSPITAL | 205837239 | CA | General Acute Care Hospital (282N00000X) |
United | 065 | $14996.21 | 1336440643 - RCHP, CLINTON MEMORIAL HOSPITAL | 273633811 | OH | Rehabilitation Hospital Unit (273Y00000X) |
United | 065 | $14996.21 | 1336440643 - RCHP, CLINTON MEMORIAL HOSPITAL | 273633811 | OH | Rehabilitation Hospital Unit (273Y00000X) |
United | 065 | $12522.11 | 1487607784 - NORTHWEST HOSPITAL LLC, NORTHWEST MEDICAL CENTER | 621762430 | AZ | 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 065 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 065 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 065 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 |
|---|---|---|
| 064-APR-DRG | Moderate | Pancreas Transplant |
| 064-MS-DRG | High | Intracranial Hemorrhage or Cerebral Infarction with MCC |
| 065-MS-DRG | High | Intracranial Hemorrhage or Cerebral Infarction with CC or TPA in 24 Hours |
| 066-APR-DRG | Moderate | Pancreas Transplant |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 065. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 065 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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