MS-DRG 965 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 | • Multiple Significant Trauma |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 965 by major payers:
$12,003.26
$12,555.73
$14,512.75
$15,023.22
| 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 965 | ||||||
United | 965 | $16120.16 | 1417032673 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 965 | $44493.80 | 1780196345 - THE NEW YORK AND PRESBYTERIAN HOSPITAL | 133957095 - (NY) THE NEW YORK AND PRESBYTERIAN HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 965 | $17899.00 | 1568802288 - RAPIDES REGIONAL MEDICAL CENTER | 611267229 | LA | General Acute Care Hospital (282N00000X) |
United | 965 | $12010.67 | 1023472842 - THEDACARE REGIONAL MEDICAL CENTER, THEDA CLARK MEDICAL CENTER, INC. | 390830664 - (WI) THEDACARE REGIONAL MEDICAL CENTER - NEENAH INC | WI | General Acute Care Hospital (282N00000X) |
United | 965 | $16554.27 | 1669558771 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 965 | $26344.93 | 1982733655 - DIGNITY HEALTH, ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER | 721561134 - (AZ) ST JOSEPHS HOSPITAL AND MEDICAL CENTER | AZ | General Acute Care Hospital (282N00000X) |
United | 965 | $16177.65 | 1902844988 - PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA, PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER TORRANCE | 421672810 - (CA) UNITED STATES CATHLOC CONFERENCE | CA | General Acute Care Hospital (282N00000X) |
United | 965 | $27565.28 | 1104845015 - TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | 751438726 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | TX | General Acute Care Hospital (282N00000X) |
United | 965 | $10032.20 | 1154406254 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 965 | $28271.50 | 1851568836 - SAINT FRANCIS HOSPITAL, ST. FRANCIS HOSPITAL | 133964321 - (NY) PEO MID-HUDSON VALLEY STAFFCO | NY | General Acute Care Hospital (282N00000X) |
United | 965 | $35580.44 | 1548301112 - DESERT REGIONAL MEDICAL CENTER, INC., DESERT REGIONAL MEDICAL CENTER | 752694137 | CA | Psychiatric Hospital Unit (273R00000X) |
United | 965 | $82194.00 | 1114224151 - CHCA CLEAR LAKE LP, HCA HOUSTON HEALTHCARE CLEAR LAKE | 621801360 | TX | Psychiatric Hospital Unit (273R00000X) |
United | 965 | $20196.14 | 1073664116 - PRESBYTERIAN HOSPITAL OF PLANO | 752770738 - (TX) TEXAS HEALTH PRESBYTERIAN HOSPITAL PLANO | TX | Psychiatric Hospital Unit (273R00000X) |
United | 965 | $10381.95 | 1699726695 - NORTHWEST ARKANSAS HOSPITALS, LLC, NORTHWEST MEDICAL CENTER | 205896848 | AR | General Acute Care Hospital (282N00000X) |
United | 965 | $11144.66 | 1225083074 - OLEAN GENERAL HOSPITAL | 160743102 - OLEAN GENERAL HOSPITAL | NY | 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 |
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MS-DRG 965 vs. Other Multiple Significant Trauma Codes
The MS-DRG 965 code is part of the Multiple Significant Trauma 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 965 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 |
|---|---|---|
| 964-MS-DRG | High | Other Multiple Significant Trauma with CC |
| 965-MS-DRG | High | Other Multiple Significant Trauma 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 965. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 965 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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