MS-DRG 068 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 068 by major payers:
$10,634.73
$11,879.41
$14,611.86
$14,773.63
| 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 068 | ||||||
United | 068 | $19203.00 | 1790297455 - HMH HOSPITALS CORPORATION, RARITAN BAY MEDICAL CENTER | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | General Acute Care Hospital (282N00000X) |
United | 068 | $9452.95 | 1710353339 - SMSJ TUCSON HOLDINGS LLC, ST. MARYS HOSPITAL | 474131755 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 068 | $7506.68 | 1518957950 - BOLIVAR GENERAL HOSPITAL, INC., WEST TENNESSEE HEALTHCARE BOLIVAR HOSPITAL | 621624171 - (TN) BOLIVAR GENERAL HOSPITAL INC | TN | Critical Access Hospital (282NC0060X) |
United | 068 | $13205.75 | 1043457583 - MEMORIAL HERMANN REHABILITATION HOSPITAL KATY, LLC, MEMORIAL HERMANN REHABILITATION HOSPITAL KATY | 263896170 | TX | Rehabilitation Hospital (283X00000X) |
United | 068 | $27476.08 | 1740724780 - DE CRAIG RANCH, LLC, DIGNITY HEALTH ST ROSE DOMINICAN WEST FLAMINGO CAMPUS | 364827272 - (NV) DE CRAIG RANCH LLC | NV | General Acute Care Hospital (282N00000X) |
United | 068 | $9229.30 | 1942205166 - CLAIBORNE MEDICAL CENTER | 464420358 - (TN) CLAIBORNE MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | 068 | $7262.68 | 1881970333 - ELLA E M BROWN CHARITABLE CIRCLE | 381368347 - ELLA E M BROWN CHARITABLE CIRCLE | MI | Psychiatric Hospital (283Q00000X) |
United | 068 | $3288.00 | 1457347239 - UHS-CORONA INC, CORONA REGIONAL MEDICAL CENTER | 432035443 | CA | General Acute Care Hospital (282N00000X) |
United | 068 | $5414.04 | 1629044961 - GREENWOOD COUNTY HOSPITAL, EUREKA CLINIC | 480616260 - (KS) GREENWOOD COUNTY HOSPITAL | KS | Critical Access Hospital (282NC0060X) |
United | 068 | $10359.38 | 1043336910 - MURRAY-CALLOWAY COUNTY PUBLIC HOSPITAL CORPORATION, MCCH IP REHAB | 610620567 | KY | Rehabilitation Hospital Unit (273Y00000X) |
United | 068 | $6868.06 | 1992759419 - HCA HEALTH SERVICES OF FLORIDA, INC., HCA FLORIDA BAYONET POINT HOSPITAL | 621113740 | FL | General Acute Care Hospital (282N00000X) |
United | 068 | $6400.25 | 1811939887 - MERCY HEALTH-ST RITAS MEDICAL CENTER LLC, MERCY HEALTH-ST RITA'S MEDICAL CENTER | 341105619 | OH | General Acute Care Hospital (282N00000X) |
United | 068 | $4350.00 | 1912063280 - SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC, MEMORIAL SPECIALTY HOSPITAL | 720551963 - (LA) SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC | LA | Long Term Care Hospital (282E00000X) |
United | 068 | $10403.00 | 1477166064 - THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO, GOOD SAMARITAN ENDOSCOPY CENTER NORTH | 310537486 - (OH) THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO DTD 01251995 | OH | General Acute Care Hospital (282N00000X) |
United | 068 | $16845.86 | 1689121188 - AGH MESA LLC, DIGNITY HEALTH ARIZONA GENERAL HOSPITAL | 383990879 - (AZ) AGH MESA LLC | 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 068 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 068 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 068 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 |
|---|---|---|
| 067-MS-DRG | High | Non-specific CVA and Precerebral Occlusion without Infarction with MCC |
| 068-MS-DRG | High | Non-specific CVA and Precerebral Occlusion without Infarction without MCC |
| 069-APR-DRG | Moderate | Pancreas Transplant |
| 069-MS-DRG | High | Transient Ischemia without Thrombolytic |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 068. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 068 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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