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    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Nervous SystemDRG 064-intracranial-hemorrhage-or-cerebral-infarction-with-mcc
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    Intracranial Hemorrhage or Cerebral Infarction with MCC: Inpatient Reimbursement Overview

    DRG 064 encompasses intracranial hemorrhage or cerebral infarction cases with a Major Complication or Comorbidity, representing high-acuity cerebrovascular admissions. This Diagnosis-Related Group designation significantly influences inpatient reimbursement under Medicare Severity Diagnosis-Related Group-based payment because added comorbidity severity increases expected resource use.

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    DRG 064 Overview

    DRG 064 covers hospital admissions for intracranial hemorrhage or cerebral infarction when a Major Complication or Comorbidity is present, reflecting cases with significantly increased resource use and clinical complexity. This Diagnosis-Related Group is focused on acute cerebrovascular events that require intensive inpatient management, such as neurosurgical interventions, advanced neurocritical care, or prolonged monitoring due to severe neurologic compromise. Because the presence of a Major Complication or Comorbidity elevates expected costs, DRG 064 has higher payment weightings within Medicare Severity Diagnosis-Related Group-based inpatient reimbursement. Accurate documentation and coding of the primary cerebrovascular diagnosis and any Major Complication or Comorbidity are central to assigning this Diagnosis-Related Group and determining Medicare payment.

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    Clinical Trials

    • Acute intervention randomized trials examining time-sensitive reperfusion or hemostatic strategies for patients presenting with intracerebral hemorrhage or large-vessel ischemic stroke with major complications. These studies enroll patients during the initial hospital presentation and compare immediate procedural or pharmacologic approaches (for example, endovascular clot retrieval windows, surgical hematoma evacuation timing, or agents to limit hematoma expansion) to standard acute care. Results directly affect inpatient resource utilization, complication rates, and short-term mortality, making findings highly relevant to clinicians determining acute management and to payers forecasting cost and length-of-stay implications for DRG 064 admissions.
    • Comparative effectiveness and safety studies of in-hospital management pathways for medically complex stroke patients with major complications, such as trials comparing intensive neurocritical care protocols versus stepdown stroke unit models. These pragmatic studies focus on populations with substantial comorbidity, hemodynamic instability, or secondary complications (seizures, infection, or need for ventilatory support) and evaluate outcomes like complication rates, functional recovery at discharge, and readmission. Evidence from these trials informs best practices for resource allocation, staffing models, and care bundles that influence DRG costs and quality metrics used by hospitals and payers.
    • Post-discharge transitional care and secondary prevention trials targeting patients discharged after intracranial hemorrhage or cerebral infarction with major complications, investigating interventions such as coordinated case-management, early outpatient rehabilitation initiation, or medication reconciliation programs to reduce recurrent events and readmissions. These studies enroll patients at hospital discharge and measure longer-term outcomes including functional status, recurrent stroke, medication adherence, and 30–90 day readmission rates. Findings are crucial for payers and providers seeking to improve long-term outcomes, reduce costly readmissions associated with DRG 064 index hospitalizations, and guide investment in post-acute services and care coordination.

    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

    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

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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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