Cranial and Peripheral Nerve Disorders without MCC: Inpatient Reimbursement Overview

DRG 074 groups inpatient stays for cranial and peripheral nerve disorders without Major Complication or Comorbidity, encompassing conditions like compressive neuropathies and select cranial nerve dysfunctions. This grouping matters for inpatient reimbursement because it determines case classification, relative resource use, and the Medicare payment weight applied to qualifying admissions.

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DRG 074 Overview

DRG 074 covers inpatient admissions for cranial and peripheral nerve disorders without a Major Complication or Comorbidity. It includes diagnoses such as nerve compressions, neuropathies, and certain cranial nerve disorders when the clinical course is uncomplicated. This Diagnosis-Related Group is used to classify cases for Medicare inpatient payment and influences base payment rates and resource expectations. Understanding this DRG helps clarify reimbursement implications for hospital stays that do not involve major complications.

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Cranial and Peripheral Nerve Disorders without MCC: Inpatient Reimbursement Overview

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Get alerted when payer policies referencing 074 are released or updated.

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DRG 074 Overview

National Payment Rates

Across featured payers the observed rate range runs roughly from $370 up to $35K, with the widest spread between Anthem (min $390, max $35K) and other payers reflecting a high dispersion. Commercial benchmarks show median payments clustered between about $9.3K and $18K depending on payer, while maximums extend into the high $20Ks to mid $30Ks. See the table and chart below for payer-specific quartiles and distributions.

The CMS 2023 data represents national Medicare fee-for-service inpatient payments as published in the CMS Provider Utilization and Payment Data program. The table below shows average total payment ($10.1k), average submitted covered charges ($51.3k), average Medicare payment amount ($7.8k), and total discharges (11.6k).

Average Total Payment	Average Submitted Charges	Average Medicare Payment	Total Discharges
$10K	$51K	$7.8K	12K

Patient Population

The DRG 074 population includes a mix of Medicare beneficiaries and commercially insured patients, reflecting both Medicare-age and working-age adults. Claims volumes indicate a meaningful Medicare share given the program’s large inpatient footprint, but private/commercial payers also represent a sizeable portion of cases. Overall the population skews toward a mixed-age group with a substantial Medicare component rather than being exclusively Medicare-age.

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

Alaska payer rates for DRG 074 span from 16K to 25K across the reported payers, with Blue Cross Blue Shield and Anthem at the low end (16K) and Cigna at the high end (25K). The Cigna mean notably exceeds the other in-state payers and sits above many national averages, creating the most pronounced deviation. Reference the table and chart below for payer-level detail.

Key Insights for Alaska

Highest payer: Cigna with a mean of 25K; Lowest payer(s): BCBS and Anthem, both with a mean of 16K.
Cigna’s mean (25K) in Alaska is meaningfully above the state’s other payers and above national means for several payers, indicating a notable upward deviation from national averages.

Clinical Trials

Acute neuromodulation and surgical intervention trials: studies in this area evaluate the safety and short-term efficacy of acute surgical or neuromodulatory procedures (for example, decompression, nerve repair, or intraoperative monitoring-guided interventions) for patients admitted with cranial nerve palsies, traumatic peripheral nerve injury, or compressive neuropathies causing hospital-level symptoms. These trials typically enroll patients during the index hospitalization or immediately post-injury to measure time-to-recovery, complication rates, and need for reoperation, addressing questions about optimal timing and technique. Results inform surgeons, hospitalists, and payers about procedure-related resource use, length of stay implications, and early outcomes that drive inpatient reimbursement and bundle payment considerations.
Comparative effectiveness and perioperative management studies: these trials compare different non-surgical or adjunctive inpatient therapies (such as corticosteroid regimens, anticoagulation strategies when vascular causes are suspected, or different anesthesia/monitoring approaches) for acute cranial and peripheral nerve disorders. They enroll heterogeneous inpatient populations—patients with Bell’s palsy variants, ischemic cranial neuropathies, or acute compressive neuropathies—to determine which management pathways shorten neurologic deficit duration, reduce complications, or lower readmission. Findings are relevant to clinicians and payers because they identify care pathways that optimize outcomes while potentially reducing length of stay, avoidable imaging or consultations, and overall inpatient costs.
Post-discharge functional outcomes and rehabilitation trials: these studies focus on subacute and longer-term recovery, testing timing and intensity of rehabilitation interventions (physical therapy, occupational therapy, specialized nerve rehabilitation programs) or care-coordination models for patients discharged after an acute cranial or peripheral nerve event. They target patients with residual motor or sensory deficits after hospital discharge and measure functional recovery, quality of life, and downstream health-care utilization such as outpatient therapy needs, readmissions, or durable medical equipment. Evidence from these trials helps payers and providers plan post-acute services, allocate rehabilitation resources, and predict long-term costs associated with incomplete recovery in this DRG.

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

Showing 1–10 of 71

References

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.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.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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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.

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National Payment Rates

Mean Rates by Payer — National — DRG 074

Average Total Payment	Average Submitted Charges	Average Medicare Payment	Total Discharges
$10K	$51K	$7.8K	12K

Patient Population

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

Mean Rates by Payer — Alaska — DRG 074

Key Insights for Alaska

Highest payer: Cigna with a mean of 25K; Lowest payer(s): BCBS and Anthem, both with a mean of 16K.
Cigna’s mean (25K) in Alaska is meaningfully above the state’s other payers and above national means for several payers, indicating a notable upward deviation from national averages.

Clinical Trials

Acute neuromodulation and surgical intervention trials: studies in this area evaluate the safety and short-term efficacy of acute surgical or neuromodulatory procedures (for example, decompression, nerve repair, or intraoperative monitoring-guided interventions) for patients admitted with cranial nerve palsies, traumatic peripheral nerve injury, or compressive neuropathies causing hospital-level symptoms. These trials typically enroll patients during the index hospitalization or immediately post-injury to measure time-to-recovery, complication rates, and need for reoperation, addressing questions about optimal timing and technique. Results inform surgeons, hospitalists, and payers about procedure-related resource use, length of stay implications, and early outcomes that drive inpatient reimbursement and bundle payment considerations.
Comparative effectiveness and perioperative management studies: these trials compare different non-surgical or adjunctive inpatient therapies (such as corticosteroid regimens, anticoagulation strategies when vascular causes are suspected, or different anesthesia/monitoring approaches) for acute cranial and peripheral nerve disorders. They enroll heterogeneous inpatient populations—patients with Bell’s palsy variants, ischemic cranial neuropathies, or acute compressive neuropathies—to determine which management pathways shorten neurologic deficit duration, reduce complications, or lower readmission. Findings are relevant to clinicians and payers because they identify care pathways that optimize outcomes while potentially reducing length of stay, avoidable imaging or consultations, and overall inpatient costs.
Post-discharge functional outcomes and rehabilitation trials: these studies focus on subacute and longer-term recovery, testing timing and intensity of rehabilitation interventions (physical therapy, occupational therapy, specialized nerve rehabilitation programs) or care-coordination models for patients discharged after an acute cranial or peripheral nerve event. They target patients with residual motor or sensory deficits after hospital discharge and measure functional recovery, quality of life, and downstream health-care utilization such as outpatient therapy needs, readmissions, or durable medical equipment. Evidence from these trials helps payers and providers plan post-acute services, allocate rehabilitation resources, and predict long-term costs associated with incomplete recovery in this DRG.

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

Showing 1–10 of 71

References

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

OpenPayer

Cranial and Peripheral Nerve Disorders without MCC: Inpatient Reimbursement Overview

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DRG 074 Overview

OpenPayer

Cranial and Peripheral Nerve Disorders without MCC: Inpatient Reimbursement Overview

Sign up for drg 074 policy alerts

DRG 074 Overview

National Payment Rates

Patient Population

State Payment Rates

Alaska Benchmarks

Key Insights for Alaska

Clinical Trials

Related Codes

References

National Payment Rates

Patient Population

State Payment Rates

Alaska Benchmarks

Key Insights for Alaska

Clinical Trials

Related Codes

References