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MS-DRG 069 Fee Schedule

Last Verified: December 2025

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.

Transient Ischemia without Thrombolytic
Key FactDetail
Service Type

Diseases & Disorders of the Nervous System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Complexity LevelHigh

National average reimbursement for MS-DRG 069 by major payers:

bcbs

$9,362.23

uhc

$10,943.18

aetna

$13,532.93

cigna

$13,586.30

Preview provider-level rates for...
For billing codeMS-DRG 069
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for MS-DRG 069

United
069$18028.651053347955 - DELRAY MEDICAL CENTER, INC., DELRAY MEDICAL CENTER752922687FLPsychiatric Hospital Unit (273R00000X)
United
069$35228.391790969269 - THE NEW YORK AND PRESBYTERIAN HOSPITAL, NEW YORK-PRESBYTERIAN HOSPITAL133957095 - (NY) THE NEW YORK AND PRESBYTERIAN HOSPITALNYGeneral Acute Care Hospital (282N00000X)
United
069$8786.701881915585 - ADVOCATE ILLINOIS MASONIC MEDICAL CENTER363196629 - (IL) ADVOCATE NORTH SIDE HEALTH NETWORKILGeneral Acute Care Hospital (282N00000X)
United
069$11049.371831970532 - VHS SAN ANTONIO PARTNERS, LLC760714523TXGeneral Acute Care Hospital (282N00000X)
United
069$19082.391548716665 - UPSTATE AFFILIATE ORGANIZATION, GHS CANCER INST-ANDREWS811723202 - PRISMA HEALTH - UPSTATESCGeneral Acute Care Hospital (282N00000X)
United
069$9393.961689282147 - BAPTIST HEALTHCARE SYSTEM INC, BAPTIST HEALTH HARDIN610444707 - BAPTIST HEALTHCARE SYSTEM INCKYGeneral Acute Care Hospital (282N00000X)
United
069$18028.651053347955 - DELRAY MEDICAL CENTER, INC., DELRAY MEDICAL CENTER752922687FLPsychiatric Hospital Unit (273R00000X)
United
069$11399.821710039508 - THE METHODIST HOSPITALS, INC.350868133 - METHODIST HOSPITALS INCINRehabilitation Hospital Unit (273Y00000X)
United
069$20954.441396725677 - MARIN GENERAL HOSPITAL942823538 - (CA) MARIN GENERAL HOSPITALCAGeneral Acute Care Hospital (282N00000X)
United
069$13964.951255377149 - OHIOHEALTH CORPORATION, GRANT MEDICAL CENTER314394942 - OHIOHEALTH CORPORATION GRANT RIVERSIDE DOCTORS DUBLIN METOHGeneral Acute Care Hospital (282N00000X)
United
069$14617.801407803638 - ASCENSION NE WISCONSIN, INC, ASCENSION NE WISCONSIN-ST ELIZABETH CAMPUS390816818 - ASCENSION NE WISCONSIN INCWIGeneral Acute Care Hospital (282N00000X)
United
069$9918.691487253449 - VANDERBILT BEDFORD HOSPITAL, LLC, VANDERBILT BEDFORD HOSPITAL853419620TNGeneral Acute Care Hospital (282N00000X)
United
069$9918.691487253449 - VANDERBILT BEDFORD HOSPITAL, LLC, VANDERBILT BEDFORD HOSPITAL853419620TNGeneral Acute Care Hospital (282N00000X)
United
069$18768.191720011810 - BANNER DESERT MEDICAL CENTER900054201 - (AZ) BANNER DESERT MEDICAL CENTERAZGeneral Acute Care Hospital (282N00000X)
United
069$2683.001306876065 - ST DOMINIC-JACKSON MEMORIAL HOSPITAL640303091 - (MS) ST DOMINIC-JACKSON MEMORIAL HOSPITALMSGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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MS-DRG 069 vs. Other Diseases & Disorders of the Nervous System Codes

The MS-DRG 069 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 069 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.

CodeComplexityDescription
068-APR-DRGModeratePancreas Transplant
068-MS-DRGHighNon-specific CVA and Precerebral Occlusion without Infarction without MCC
069-MS-DRGHighTransient Ischemia without Thrombolytic
070-APR-DRGHighAllogeneic Bone Marrow 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 069. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 069 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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