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MS-DRG 078 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.

Hypertensive Encephalopathy with CC
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 078 by major payers:

bcbs

$11,640.21

uhc

$13,149.51

aetna

$15,801.16

cigna

$16,162.57

Preview provider-level rates for...
For billing codeMS-DRG 078
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for MS-DRG 078

United
078$9175.411275566200 - BANNER ESTRELLA MEDICAL CENTER900065118 - (AZ) BANNER ESTRELLA MEDICAL CENTERAZGeneral Acute Care Hospital (282N00000X)
United
078$10786.291518950674 - INDIANA REGIONAL MEDICAL CENTER250965404 - (PA) INDIANA REGIONAL MEDICAL CENTERPARehabilitation Hospital Unit (273Y00000X)
United
078$4606.641013993559 - SCCI HOSPITAL, KINDRED HOSPITAL EL PASO742983423 - (TX) SCCI HOSPITALTXLong Term Care Hospital (282E00000X)
United
078$16226.321851388961 - DAKOTA SPECIALTY INSTITUTE, INNOVIS HEALTH261175213 - INNOVIS HEALTH LLCNDGeneral Acute Care Hospital (282N00000X)
United
078$15112.091336184647 - JEWELL COUNTY HOSPITAL480764254KSCritical Access Hospital (282NC0060X)
United
078$15112.091336184647 - JEWELL COUNTY HOSPITAL480764254KSCritical Access Hospital (282NC0060X)
United
078$16028.131760464283 - BROWN COUNTY HOSPITAL470532256 - (NE) BROWN COUNTY HOSPITALNECritical Access Hospital (282NC0060X)
United
078$14684.041417951468 - MERCY HEALTH-LOURDES HOSPITAL LLC, LOURDES - REHAB610600313KYRehabilitation Hospital Unit (273Y00000X)
United
078$14684.041417951468 - MERCY HEALTH-LOURDES HOSPITAL LLC, LOURDES - REHAB610600313KYRehabilitation Hospital Unit (273Y00000X)
United
078$15806.001912925199 - STATEN ISLAND UNIVERSITY HOSPITAL112868878 - (NY) STATEN ISLAND UNIVERSITY HOSPITALNYPsychiatric Hospital Unit (273R00000X)
United
078$10125.691104375237 - STILLWATER MEDICAL CENTER AUTHORITY, STILLWATER MEDICAL - BLACKWELL730927647OKGeneral Acute Care Hospital (282N00000X)
United
078$10125.691104375237 - STILLWATER MEDICAL CENTER AUTHORITY, STILLWATER MEDICAL - BLACKWELL730927647OKGeneral Acute Care Hospital (282N00000X)
United
078$8440.241063422053 - VALLEY MEDICAL FACILITIES INC, VALLEY MEDICAL FACILITIES INC DBA HERITAGE VALLEY BEAVER251801532 - (PA) HERITAGE VALLEY HEALTH SYSTEMPAGeneral Acute Care Hospital (282N00000X)
United
078$20851.111790092633 - MEDICAL COLLEGE OF WISCONSIN396105970 - (WI) FROEDTERT MEMORIAL LUTHERAN HOSPITAL INCWIGeneral Acute Care Hospital (282N00000X)
United
078$22415.521710353339 - SMSJ TUCSON HOLDINGS LLC, ST. MARYS HOSPITAL474131755AZRehabilitation Hospital Unit (273Y00000X)
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 078 vs. Other Diseases & Disorders of the Nervous System Codes

The MS-DRG 078 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 078 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
077-MS-DRGHighHypertensive Encephalopathy with MCC
078-MS-DRGHighHypertensive Encephalopathy with CC
079-MS-DRGHighHypertensive Encephalopathy without CC/MCC

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 078. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 078 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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