MS-DRG 085 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 085 by major payers:
$24,723.06
$28,603.98
$35,506.80
$35,885.03
| 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 085 | ||||||
United | 085 | $4498.00 | 1184967523 - ST VINCENTS BLOUNT | 810935368 | AL | Critical Access Hospital (282NC0060X) |
United | 085 | $78229.11 | 1780196345 - THE NEW YORK AND PRESBYTERIAN HOSPITAL | 133957095 - (NY) THE NEW YORK AND PRESBYTERIAN HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 085 | $24543.05 | 1407800436 - OH MUHLENBERG, LLC, OWENSBORO HEALTH MUHLENBERG COMMUNITY HOSPITAL | 473944197 - (KY) OH MUHLENBERG LLC | KY | General Acute Care Hospital (282N00000X) |
United | 085 | $31724.00 | 1205816626 - BINGHAM MEMORIAL HOSPITAL | 205126945 - (ID) BMH INC | ID | Critical Access Hospital (282NC0060X) |
United | 085 | $17232.55 | 1487628145 - ENCOMPASS HEALTH METHODIST REHABILITATION HOSPITAL, LP, ENCOMPASS HEALTH REHABILITATION HOSPITAL OF NORTH MEMPHIS | 631107459 - (TN) ENCOMPASS HEALTH METHODIST REHABILITATION HOSPITAL LP | TN | Rehabilitation Hospital (283X00000X) |
United | 085 | $54923.30 | 1598755324 - ST. ANTHONY COMMUNITY HOSPITAL | 141340100 - (NY) BON SECOURS CHARITY HEALTH SYSTEM INC | NY | General Acute Care Hospital (282N00000X) |
United | 085 | $9246.90 | 1225339898 - SCREVEN COUNTY HOSPITAL, LLC, OPTIM MEDICAL CENTER - SCREVEN | 273100946 | GA | Critical Access Hospital (282NC0060X) |
United | 085 | $59560.35 | 1982800397 - PELHAM MEDICAL CENTER | 141996067 | SC | General Acute Care Hospital (282N00000X) |
United | 085 | $30930.90 | 1790945061 - RUSH UNIVERSITY MEDICAL CENTER | 362174823 - (IL) RUSH UNIVERSITY MEDICAL CENTER | IL | General Acute Care Hospital (282N00000X) |
United | 085 | $22727.98 | 1912473927 - RESILIENCE HEALTHCARE, LOUIS A. WEISS MEMORIAL HOSPITAL | 352637418 | IL | Psychiatric Hospital Unit (273R00000X) |
United | 085 | $8443.00 | 1043204316 - THE MERCY HOSPITAL INC, MERCY MEDICAL CENTER | 43398280 - (MA) THE MERCY HOSPITAL INC | MA | General Acute Care Hospital (282N00000X) |
United | 085 | $9859.00 | 1215398813 - CHILDREN'S HOSPITAL COLORADO, CHILDREN'S HOSPITAL COLORADO OUTPATIENT SPECIALTY CARE UPTOWN | 840166760 - CHILDRENS HOSPITAL COLORADO | CO | Children's Hospital (282NC2000X) |
United | 085 | $45320.00 | 1356328199 - EMORY UNIVERSITY, EMORY UNIVERSITY HOSPITAL | 463808276 | GA | Rehabilitation Hospital (283X00000X) |
United | 085 | $4498.00 | 1184967523 - ST VINCENTS BLOUNT | 810935368 | AL | Critical Access Hospital (282NC0060X) |
United | 085 | $45320.00 | 1356328199 - EMORY UNIVERSITY, EMORY UNIVERSITY HOSPITAL | 463808276 | GA | Rehabilitation Hospital (283X00000X) |
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 085 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 085 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 085 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 |
|---|---|---|
| 084-APR-DRG | Moderate | Autologous Bone Marrow Transplant |
| 084-MS-DRG | High | Traumatic Stupor and Coma >1 Hour without CC/MCC |
| 085-MS-DRG | High | Traumatic Stupor and Coma <1 Hour with MCC |
| 086-APR-DRG | Moderate | Autologous 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 085. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 085 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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