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    v1.0.30
    OpenPayerBilling CodesDiseases and Disorders of the Nervous SystemDRG 021-intracranial-vascular-procedures-with-principal-diagnosis-hemorrhage-with-cc
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    Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage with CC: Inpatient Reimbursement Overview

    DRG 021 groups inpatient cases involving intracranial vascular procedures for patients with a principal diagnosis of hemorrhage and a Complication or Comorbidity, representing complex neurovascular surgical or endovascular care. Proper assignment matters for inpatient reimbursement because it reflects higher resource needs and influences Medicare payment for these high-acuity hospitalizations.

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    DRG 021 Overview

    DRG 021 covers inpatient admissions for intracranial vascular procedures performed with a principal diagnosis of hemorrhage and presence of a Complication or Comorbidity. This group captures high-acuity neurovascular surgical and endovascular interventions for patients presenting with intracranial bleeding, where additional diagnoses increase resource use. It matters for Medicare payment because case mix classification influences hospital payment rates and reflects the higher expected resource consumption for hemorrhagic neurovascular care with complications. Accurate coding of the principal diagnosis and Complication or Comorbidity is essential to assign this Diagnosis-Related Group correctly.

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    Clinical Trials

    • Acute endovascular intervention trials: studies focusing on timing, procedural techniques, and peri-procedural management for patients admitted with intracranial hemorrhage who undergo intracranial vascular procedures (for example, endovascular coiling, embolization, or clot evacuation). These trials enroll patients in the hyperacute to acute inpatient period and address questions such as optimal door-to-procedure intervals, blood pressure and anticoagulation management surrounding the procedure, and complication mitigation strategies. Results are directly relevant to surgeons, interventionalists, and hospital administrators because they affect in-hospital mortality, complication rates, length of stay, and resource utilization tied to this DRG.
    • Comparative effectiveness and safety studies of procedural strategies and adjunctive therapies: observational cohorts or randomized designs comparing different surgical or endovascular approaches, use of adjunctive devices or hemostatic agents, or variations in intensive care protocols among patients with intracranial hemorrhage who require vascular procedures. These studies typically stratify by hemorrhage location, size, and comorbidity burden (including CC-level clinical complexity) to identify which strategies produce better functional outcomes and fewer readmissions. Payors and providers value this evidence to guide care pathways that optimize outcomes while potentially reducing reoperation, complications, and downstream costs associated with the DRG.
    • Post-discharge outcomes and rehabilitation research: longitudinal studies examining neurological recovery, functional status, and healthcare utilization after hospital discharge for patients who underwent intracranial vascular procedures for hemorrhage, including investigation of predictors of readmission, long-term disability, and needs for downstream services. These studies may test transitional care models, timing and intensity of rehabilitation, and monitoring strategies to reduce preventable rehospitalizations and improve quality-of-life metrics. Findings inform discharge planning, case management, and coverage decisions by payers concerned with 30- and 90-day outcomes and total episode-of-care costs for this high-acuity DRG.

    Related Codes

    020-INTRACRANIAL-VASCULAR-PROCEDURES-WITH-PRINCIPAL-DIAGNOSIS-HEMORRHAGE-WITH-MCC

    Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage with MCC: Inpatient Reimbursement Overview

    022-INTRACRANIAL-VASCULAR-PROCEDURES-WITH-PRINCIPAL-DIAGNOSIS-HEMORRHAGE-WITHOUT-CC-MCC

    Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage without CC/MCC: Inpatient Reimbursement Overview

    023-CRANIOTOMY-WITH-MAJOR-DEVICE-IMPLANT-OR-ACUTE-COMPLEX-CNS-PRINCIPAL-DIAGNOSIS-WITH-MCC-OR-ANTINEOPLASTIC-IMPLANT-OR-EPILEPSY-WITH-NEUROSTIMULATOR

    Craniotomy with Major Device Implant or Complex CNS DRG 023: Inpatient Reimbursement Overview

    024-CRANIOTOMY-WITH-MAJOR-DEVICE-IMPLANT-OR-ACUTE-COMPLEX-CNS-PRINCIPAL-DIAGNOSIS-WITHOUT-MCC

    Craniotomy with Major Device Implant or Acute Complex CNS Principal Diagnosis without MCC: Inpatient Reimbursement Overview

    025-CRANIOTOMY-AND-ENDOVASCULAR-INTRACRANIAL-PROCEDURES-WITH-MCC

    Craniotomy and Endovascular Intracranial Procedures with MCC: Inpatient Reimbursement Overview

    026-CRANIOTOMY-AND-ENDOVASCULAR-INTRACRANIAL-PROCEDURES-WITH-CC

    Craniotomy and Endovascular Intracranial Procedures with CC: Inpatient Reimbursement Overview

    027-CRANIOTOMY-AND-ENDOVASCULAR-INTRACRANIAL-PROCEDURES-WITHOUT-CC-MCC

    Craniotomy and Endovascular Intracranial Procedures without CC/MCC: Inpatient Reimbursement Overview

    028-SPINAL-PROCEDURES-WITH-MCC

    Spinal Procedures with MCC: Inpatient Reimbursement Overview

    029-SPINAL-PROCEDURES-WITH-CC-OR-SPINAL-NEUROSTIMULATORS

    Spinal Procedures with CC or Spinal Neurostimulators: Inpatient Reimbursement Overview

    030-SPINAL-PROCEDURES-WITHOUT-CC-MCC

    Spinal Procedures without CC/MCC: Inpatient Reimbursement Overview

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    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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