MS-DRG 215 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 | • Diseases & Disorders of the Circulatory System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 215 by major payers:
$126,785.90
$126,220.80
$162,241.74
$170,883.06
| 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 215 | ||||||
United | 215 | $94446.03 | 1457323248 - CHHS HOSPITAL COMPANY LLC, CHESTNUT HILL HOSPITAL | 883577015 | PA | Psychiatric Hospital Unit (273R00000X) |
United | 215 | $165737.28 | 1063598886 - MERCY HEALTH, MERCY FRANCISCAN HOSPITAL-WESTERN HILLS(PSYCHIATRIC UNIT) | 311091597 | OH | Psychiatric Hospital Unit (273R00000X) |
United | 215 | $116468.64 | 1700961869 - CARONDELET HEALTH NETWORK, ST. MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 215 | $434588.09 | 1740252592 - VHS ACQUISITION SUBSIDIARY NUMBER 9 INC, METROWEST MEDICAL CENTER | 621861200 - (MA) VHS ACQUISITION SUBSIDIARY NUMBER 9 INC | MA | General Acute Care Hospital (282N00000X) |
United | 215 | $4158.00 | 1285685727 - DICKENSON COMMUNITY HOSPITAL, INC. | 770599553 - DICKENSON COMMUNITY HOSPITAL INC | VA | Critical Access Hospital (282NC0060X) |
United | 215 | $152522.73 | 1104192590 - EINSTEIN MEDICAL CENTER MONTGOMERY | 204193243 - (PA) ALBERT EINSTEIN HEALTHCARE NETWORK | PA | General Acute Care Hospital (282N00000X) |
United | 215 | $246180.76 | 1427024942 - ST. ANTHONYS HOSPITAL, INC., ST. ANTHONYS HOSPITAL | 592043026 - (FL) ST ANTHONYS HOSPITAL INC | FL | General Acute Care Hospital (282N00000X) |
United | 215 | $131947.64 | 1558531293 - HEALTH & HOSPITAL CORPORATION OF MARION COUNTY, WISHARD HEALTH SERVICES | 356005697 | IN | General Acute Care Hospital (282N00000X) |
United | 215 | $142998.20 | 1831798719 - VANDERBILT COFFEE HOSPITAL, LLC, VANDERBILT TULLAHOMA-HARTON HOSPITAL | 853420386 | TN | General Acute Care Hospital (282N00000X) |
United | 215 | $97983.42 | 1083778302 - WHITE COUNTY MEDICAL CENTER | 710772737 - WHITE COUNTY MEDICAL CENTER | AR | Psychiatric Hospital Unit (273R00000X) |
United | 215 | $8620.00 | 1942348354 - BAYLOR UNIVERSITY MEDICAL CENTER | 751837454 - (TX) BAYLOR UNIVERSITY MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 215 | $24125.57 | 1609287937 - QUILLEN REHABILITATION HOSPITAL OF JOHNSON CITY LLC, QUILLEN REHAB HOSP, A JV OF BALLAD HEALTH AND ENCOMPASS HEALTH | 465144209 - (TN) QUILLEN REHABILITATION HOSPITAL OF JOHNSON CITY LLC | TN | Rehabilitation Hospital (283X00000X) |
United | 215 | $31474.00 | 1518018191 - DIGNITY HEALTH, MERCY MEDICAL CENTER MERCED | 383738197 | CA | General Acute Care Hospital (282N00000X) |
United | 215 | $242351.87 | 1124341672 - BANNER IRONWOOD MEDICAL CENTER | 900412842 | AZ | General Acute Care Hospital (282N00000X) |
United | 215 | $51975.00 | 1205882396 - PULASKI COMMUNITY HOSPITAL INC, LEWISGALE HOSPITAL PULASKI | 540941129 | VA | 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 215 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 215 code is part of the Diseases & Disorders of the Circulatory System 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 215 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 |
|---|---|---|
| 212-APR-DRG | Moderate | Open Craniotomy Except Trauma |
| 212-MS-DRG | High | Concomitant Aortic and Mitral Valve Procedures |
| 215-MS-DRG | High | Other Heart Assist System Implant |
| 216-MS-DRG | High | Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with 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 215. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 215 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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