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 | $10359.38 | 1043336910 - MURRAY-CALLOWAY COUNTY PUBLIC HOSPITAL CORPORATION, MCCH IP REHAB | 610620567 | KY | Rehabilitation Hospital Unit (273Y00000X) |
United | 068 | $12209.66 | 1962472860 - ROPER HOSPITAL, INC | 570828733 - ROPER HOSPITAL INC | SC | General Acute Care Hospital (282N00000X) |
United | 068 | $8638.70 | 1730114703 - MAHNOMEN HEALTH CENTER | 416008946 - (MN) MAHNOMEN HEALTH CENTER | MN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 068 | $8324.88 | 1497708473 - NASON MEDICAL CENTER LLC, NASON HOSPITAL | 472546387 | PA | General Acute Care Hospital (282N00000X) |
United | 068 | $8324.88 | 1497708473 - NASON MEDICAL CENTER LLC, NASON HOSPITAL | 472546387 | PA | General Acute Care Hospital (282N00000X) |
United | 068 | $15360.13 | 1154321115 - FLOWER HOSPITAL, FLOWER MEMORIAL HOSPITAL | 344428256 - (OH) TOLEDO HOSPITAL | OH | Psychiatric Hospital Unit (273R00000X) |
United | 068 | $7363.16 | 1740413988 - MERCY HOSPITAL LEBANON, MERCY HOSPITAL LEBANON | 431767432 - MERCY HOSPITAL LEBANON | MO | General Acute Care Hospital (282N00000X) |
United | 068 | $6706.00 | 1588817225 - PARADISE VALLEY HOSPITAL | 205837239 | CA | General Acute Care Hospital (282N00000X) |
United | 068 | $6706.00 | 1588817225 - PARADISE VALLEY HOSPITAL | 205837239 | CA | General Acute Care Hospital (282N00000X) |
United | 068 | $14469.91 | 1326022732 - VHS ACQUISITION SUBSIDIARY NUMBER 1 INC, ABRAZO SCOTTSDALE CAMPUS | 621861138 - (AZ) VHS ACQUISITION SUBSIDIARY NUMBER 1 INC | AZ | 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 | 068 | $17630.00 | 1770560294 - EMORY UNIVERSITY, EMORY UNIVERSITY HOSPITAL AT WESLEY WOODS | 580566256 - (GA) EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | 068 | $13222.94 | 1326022765 - VHS OF ARROWHEAD, INC, ABRAZO ARROWHEAD CAMPUS | 621811285 | AZ | General Acute Care Hospital (282N00000X) |
United | 068 | $15927.82 | 1922085299 - FAIRVIEW HEALTH SERVICES, FAIRVIEW NORTHLAND REGIONAL HOSPITAL | 410991680 - FAIRVIEW HEALTH SERVICES | MN | General Acute Care Hospital (282N00000X) |
United | 068 | $10359.38 | 1043336910 - MURRAY-CALLOWAY COUNTY PUBLIC HOSPITAL CORPORATION, MCCH IP REHAB | 610620567 | KY | 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 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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