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 | $22756.17 | 1104957083 - INOVA HEALTH CARE SERVICES, INOVA MOUNT VERNON HOSPITAL | 540620889 - INOVA HEALTH CARE SERVICES | VA | Psychiatric Hospital Unit (273R00000X) |
United | 065 | $15852.45 | 1619916806 - ST JOSEPH MEDICAL CENTER, OSF SAINT JOSEPH MEDICAL CENTER | 370662576 | IL | General Acute Care Hospital (282N00000X) |
United | 065 | $16926.30 | 1528169125 - HONORHEALTH, HONORHEALTH DEER VALLEY MEDICAL CENTER | 860181654 - HONORHEALTH | AZ | General Acute Care Hospital (282N00000X) |
United | 065 | $4534.00 | 1013328681 - HUNTERDON MEDICAL CENTER, HUNTERDON MEDICAL SLEEP CENTER | 221537688 - HUNTERDON MEDICAL CENTER | NJ | General Acute Care Hospital (282N00000X) |
United | 065 | $15730.42 | 1023069028 - SOUTHCREST LLC, SOUTHCREST HOSPITAL | 452711804 | OK | General Acute Care Hospital (282N00000X) |
United | 065 | $6034.00 | 1144402819 - PRIME HEALTHCARE PARADISE VALLEY LLC, PARADISE VALLEY HOSPITAL | 205837239 | CA | Psychiatric Hospital Unit (273R00000X) |
United | 065 | $12449.87 | 1801908728 - RUSH UNIVERSITY MEDICAL CENTER | 362174823 - (IL) RUSH UNIVERSITY MEDICAL CENTER | IL | Children's Hospital (282NC2000X) |
United | 065 | $14996.21 | 1336440643 - RCHP, CLINTON MEMORIAL HOSPITAL | 273633811 | OH | Rehabilitation Hospital Unit (273Y00000X) |
United | 065 | $22378.26 | 1144236571 - INTEGRIS BASS BAPTIST HEALTH CENTER, INTEGRIS BASS BAPTIST HEALTH CENTER | 730612674 | OK | General Acute Care Hospital (282N00000X) |
United | 065 | $16420.58 | 1255585303 - WILKES BARRE HOSPITAL COMPANY LLC, WILKES BARRE GENERAL HOSPITAL | 263632648 | PA | General Acute Care Hospital (282N00000X) |
United | 065 | $15730.42 | 1023069028 - SOUTHCREST LLC, SOUTHCREST HOSPITAL | 452711804 | OK | General Acute Care Hospital (282N00000X) |
United | 065 | $31317.47 | 1629068531 - BEAUFORT COUNTY MEMORIAL HOSPITAL, BMH INPATIENT PSYCHIATRIC UNIT | 576000094 - BEAUFORT COUNTY MEMORIAL HOSPITAL | SC | Psychiatric Hospital Unit (273R00000X) |
United | 065 | $8008.89 | 1790729861 - CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY, CORYELL MEMORIAL HEALTHCARE SYSTEM SWINGBED | 741857100 | TX | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 065 | $16075.16 | 1972500452 - COMMUNITY HOSPITAL OF ANDERSON & MADISON COUNTY, INC | 351069822 - (IN) COMMUNITY HOSPITAL OF ANDERSON- MADISON COUNTY INC | IN | General Acute Care Hospital (282N00000X) |
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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