MS-DRG 217 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 217 by major payers:
$76,151.66
$79,289.12
$100,092.44
$102,762.89
| 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 217 | ||||||
United | 217 | $150055.76 | 1376529743 - MORTON PLANT HOSPITAL ASSOCIATION INC, MORTON PLANT HOSPITAL | 590624462 - (FL) MORTON PLANT HOSPITAL ASSOCIATION INC | FL | General Acute Care Hospital (282N00000X) |
United | 217 | $30045.67 | 1225038938 - BALLINGER MEMORIAL HOSPITAL DISTRICT, BALLINGER MEMORIAL HOSPITAL | 752312009 | TX | Critical Access Hospital (282NC0060X) |
United | 217 | $136631.15 | 1346519816 - ST. JOSEPH'S HOSPITAL, INC., ST. JOSEPH'S WOMEN'S HOSPITAL | 590774199 - (FL) ST JOSEPHS HOSPITAL INC | FL | General Acute Care Hospital (282N00000X) |
United | 217 | $75951.35 | 1275608457 - RIDGEVIEW MEDICAL CENTER | 311667875 - RIDGEVIEW MEDICAL CENTER | MN | General Acute Care Hospital (282N00000X) |
United | 217 | $127123.75 | 1699734665 - ST JOSEPH REGIONAL HEALTH NETWORK, PENN STATE HEALTH ST JOSEPH | 231352211 - (PA) ST JOSEPH REGIONAL HEALTH NETWORK | PA | General Acute Care Hospital (282N00000X) |
United | 217 | $141273.01 | 1215444054 - FLORIDA HOSPITAL DADE CITY INC, ADVENTHEALTH DADE CITY | 822567308 - (FL) FLORIDA HOSPITAL DADE CITY INC | FL | General Acute Care Hospital (282N00000X) |
United | 217 | $56651.17 | 1053320093 - GRAND VIEW HOSPITAL | 231352181 - (PA) GRAND VIEW HOSPITAL | PA | Psychiatric Hospital Unit (273R00000X) |
United | 217 | $106193.71 | 1225130412 - MUNSTER MEDICAL RESEARCH FOUNDATION INC, COMMUNITY HOSPITAL | 351107009 - (IN) MUNSTER MEDICAL RESEARCH FOUNDATION INC | IN | General Acute Care Hospital (282N00000X) |
United | 217 | $79748.60 | 1518957174 - ROANE MEDICAL CENTER | 680673354 - (TN) ROANE COUNTY MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | 217 | $135972.25 | 1992747125 - MEMORIAL HERMANN HEALTH SYSTEM, MEMORIAL HERMANN HOSPITAL REHABILITATION UNIT | 741152597 - (TX) MEMORIAL HERMANN HEALTH SYSTEM | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 217 | $121300.79 | 1437119310 - SENTARA HOSPITALS, SENTARA NORFOLK GENERAL HOSPITAL | 541547408 - SENTARA HOSPITALS | VA | General Acute Care Hospital (282N00000X) |
United | 217 | $79283.78 | 1477583334 - NEW MEDICAL HORIZONS II, LTD., CYPRESS FAIRBANKS MEDICAL CENTER HOSPITAL | 742129954 - (TX) NEW MEDICAL HORIZONS II LTD | TX | General Acute Care Hospital (282N00000X) |
United | 217 | $149336.46 | 1013130145 - BANNER HEALTH | 900412842 | AZ | General Acute Care Hospital (282N00000X) |
United | 217 | $97223.59 | 1073653523 - MONROE CLINIC, SSM HEALTH MONROE HOSPITAL | 390808509 - THE MONROE CLINIC INC | WI | General Acute Care Hospital (282N00000X) |
United | 217 | $197871.71 | 1417919531 - ANMED HEALTH, ANMED | 570359174 - ANMED HEALTH | SC | 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 217 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 217 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 217 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 |
|---|---|---|
| 216-MS-DRG | High | Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with MCC |
| 217-MS-DRG | High | Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with CC |
| 218-MS-DRG | High | Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization without CC/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 217. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 217 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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