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 | $24209.93 | 1700901873 - EAST TEXAS MEDICAL CENTER REHABILITATION HOSPITAL | 824037220 | TX | Rehabilitation Hospital (283X00000X) |
United | 085 | $1518.00 | 1861449639 - MENA HOSPITAL COMMISSION, MENA REGIONAL HEALTH SYSTEM | 710708660 - (AR) MENA HOSPITAL COMMISSION | AR | General Acute Care Hospital (282N00000X) |
United | 085 | $6237.00 | 1457979908 - NATCHEZ HOSPITAL COMPANY LLC, MERIT HEALTH NATCHEZ | 371756496 | MS | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 085 | $23780.31 | 1801896915 - PROVIDENCE MEDICAL CENTER, INC | 462162669 | KS | General Acute Care Hospital (282N00000X) |
United | 085 | $17323.18 | 1497750244 - WEST TENNESSEE HEALTHCARE HENRY COUNTY | 626007078 | TN | 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 | $22727.98 | 1912473927 - RESILIENCE HEALTHCARE, LOUIS A. WEISS MEMORIAL HOSPITAL | 352637418 | IL | Psychiatric Hospital Unit (273R00000X) |
United | 085 | $54621.92 | 1629122171 - BANNER | 270036499 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 085 | $35551.26 | 1891712485 - NASSAU HEALTH CARE CORPORATION, NASSAU UNIVER MED CENTER - REHAB | 113465690 | NY | Rehabilitation Hospital Unit (273Y00000X) |
United | 085 | $35551.26 | 1891712485 - NASSAU HEALTH CARE CORPORATION, NASSAU UNIVER MED CENTER - REHAB | 113465690 | NY | Rehabilitation Hospital Unit (273Y00000X) |
United | 085 | $8299.00 | 1467797522 - MILLER CHILDREN'S HOSPITAL CENTER, LONG BEACH MEMORIAL MEDICAL CENTER | 953527031 - (CA) LONG BEACH MEMORIAL MEDICAL CENTER | CA | Children's Hospital (282NC2000X) |
United | 085 | $45320.00 | 1356328199 - EMORY UNIVERSITY, EMORY UNIVERSITY HOSPITAL | 463808276 | GA | Rehabilitation Hospital (283X00000X) |
United | 085 | $19478.00 | 1801955497 - CHIPPENHAM & JOHNSTON-WILLIS HOSPITALS, INC., CJW MEDICAL CENTER | 541779911 | VA | General Acute Care Hospital (282N00000X) |
United | 085 | $16633.08 | 1407364847 - TYLER REGIONAL HOSPITAL LLC | 823878395 | TX | General Acute Care Hospital (282N00000X) |
United | 085 | $31708.14 | 1699357368 - VHS ACQUISITION SUBSIDIARY NUMBER 1 INC, ABRAZO CAVE CREEK HOSPITAL | 621861138 - (AZ) VHS ACQUISITION SUBSIDIARY NUMBER 1 INC | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like MS-DRG 085) and we'll show you how you compare in 15 minutes or less.