Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.30
    OpenPayerBilling CodesDiseases and Disorders of the Nervous SystemDRG 023-craniotomy-with-major-device-implant-or-acute-complex-cns-principal-diagnosis-with-mcc-or-antineoplastic-implant-or-epilepsy-with-neurostimulator
    Ask Trek AI about this page

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

    DRG 023 addresses complex neurosurgical admissions involving major device implants or acute complex central nervous system diagnoses with Major Complication or Comorbidity, including antineoplastic implants and neurostimulator procedures; it captures high-resource inpatient care. This grouping matters for inpatient reimbursement because it aligns payment with the elevated procedural complexity, device-related costs, and intensive postoperative resources recognized by the Centers for Medicare & Medicaid Services.

    Customize your policy alerts

    Sign up for drg 023 policy alerts

    Get alerted when payer policies referencing 023 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    DRG 023 Overview

    DRG 023 covers hospitalizations for craniotomy with major device implant or acute complex central nervous system principal diagnosis with Major Complication or Comorbidity, as well as admissions for antineoplastic implant procedures or epilepsy treated with a neurostimulator. This Diagnosis-Related Group encompasses high-acuity neurosurgical interventions and device implantations that drive substantial resource use, extended operating room time, and specialized postoperative care. It matters for Medicare payment because cases grouped here typically receive higher inpatient reimbursement reflecting increased procedure complexity, device costs, and intensive care needs. Accurate clinical documentation of the procedures, device use, and comorbidities is key to appropriate grouping and payment under Centers for Medicare & Medicaid Services rules.

    Table of contents

    Progress1 / 3

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical Trials

    • Acute perioperative device-implant safety and efficacy studies: randomized or observational studies assessing short-term outcomes and complication rates associated with major intracranial device implantation (such as ventricular shunts, deep brain stimulators, tumor-seeding catheters, or neurostimulation leads placed at the time of craniotomy) in patients undergoing craniotomy for complex CNS pathology or epilepsy. These trials focus on intraoperative and immediate postoperative morbidity, infection, device-related neurological deficits, and device functionality in the high-risk period, studying patients with acute complex CNS diagnoses or refractory epilepsy requiring device therapy. Results inform surgeons and hospital administrators about expected complication profiles, length of stay drivers, and resource needs that directly affect inpatient coding, utilization review, and payer authorization for device-related care.
    • Comparative effectiveness and timing-of-intervention studies for acute complex CNS diagnoses: prospective cohort or randomized studies comparing strategies such as early aggressive surgical resection with device implantation versus staged procedures or conservative medical management in patients with malignant or life‑threatening CNS pathology (for example hemorrhagic or neoplastic processes presenting with mass effect or rapidly evolving deficits). These studies examine functional neurologic outcomes, need for reoperation, ICU utilization, and in-hospital mortality among adults with MCC-level acuity, addressing which approaches yield the best balance of short-term survival and complication burden. Evidence from these trials is relevant to payers and hospitals for DRG-related resource allocation, triage protocols, and to justify decisions about intensive perioperative care and reimbursement for high-cost acute interventions.
    • Post-discharge functional outcomes, readmission, and cost-effectiveness studies: longitudinal observational or registry-based research tracking patients after craniotomy with major device or antineoplastic implant to measure long-term seizure control, neurological function, device longevity, readmission rates, and total episode-of-care costs including rehabilitation and complications. These studies enroll survivors of high-acuity craniotomy with MCCs and evaluate predictors of readmission, durable benefit from implants, and downstream utilization such as home health, skilled nursing, and repeat operations. Findings help case managers, payers, and value-based care programs understand the longer-term economic impact of index admissions in this DRG and guide policy on bundled payments, follow-up care pathways, and approval of costly implants or adjunct therapies.

    Related Codes

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

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

    021-INTRACRANIAL-VASCULAR-PROCEDURES-WITH-PRINCIPAL-DIAGNOSIS-HEMORRHAGE-WITH-CC

    Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage with CC: 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

    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

    Showing 1–10 of 71

    • More pages

    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.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.