MS-DRG 218 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 218 by major payers:
$69,978.23
$72,908.01
$93,434.72
$94,740.51
| 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 218 | ||||||
United | 218 | $102846.40 | 1427133883 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 218 | $232516.48 | 1497106843 - KECK MEDICAL CENTER | 851644866 - (CA) KECK MEDICAL CENTER OF USC | CA | General Acute Care Hospital (282N00000X) |
United | 218 | $174909.42 | 1902047376 - FLOWER MOUND HOSPITAL PARTNERS, LLC, TEXAS HEALTH PRESBYTERIAN HOSPITAL FLOWER MOUND | 260684968 - (TX) FLOWER MOUND HOSPITAL PARTNERS, LLC DBA TEXAS HEALTH PRESBYTERIAN HOSP | TX | General Acute Care Hospital (282N00000X) |
United | 218 | $117034.63 | 1134223878 - PROVIDENCE EVERETT MEDICAL CENTER, INPATIENT REHABILITATION FACILITY | 352346161 | WA | Rehabilitation Hospital Unit (273Y00000X) |
United | 218 | $116142.24 | 1225289895 - PROVIDENCE HEALTH & SERVICES, PROVIDENCE HOLY FAMILY HOSPITAL | 352345508 | WA | General Acute Care Hospital (282N00000X) |
United | 218 | $60954.82 | 1578529954 - AURELIA OSBORN FOX MEMORIAL HOSPITAL SOCIETY, A.O. FOX MEMORIAL HOSPITAL | 150539039 - (NY) AURELIA OSBORN FOX MEMORIAL HOSPITAL SOCIETY | NY | General Acute Care Hospital (282N00000X) |
United | 218 | $135114.32 | 1528028396 - SENTARA PRINCESS ANNE HOSPITAL, SENTARA HOSPITALS | 273208969 - (VA) SENTARA PRINCESS ANNE HOSPITAL | VA | General Acute Care Hospital (282N00000X) |
United | 218 | $158911.75 | 1619967494 - COBB HOSPITAL, INC, WELLSTAR COBB HOSPITAL INPATIENT REHAB UNIT | 580968382 - COBB HOSPITAL | GA | Rehabilitation Hospital Unit (273Y00000X) |
United | 218 | $109438.35 | 1700037801 - PROVIDENCE HEALTH & SERVICES-WA | 352346161 | WA | General Acute Care Hospital (282N00000X) |
United | 218 | $114110.60 | 1891842308 - BON SECOURS COMMUNITY HOSPITAL | 141347717 - BON SECOURS CHARITY HEALTH SYSTEM INC | NY | Psychiatric Hospital Unit (273R00000X) |
United | 218 | $7419.00 | 1710138094 - SAINT PETERS UNIVERSITY HOSPTIAL | 221487330 - (NJ) SAINT PETERS UNIVERSITY HOSPITAL | NJ | General Acute Care Hospital (282N00000X) |
United | 218 | $125357.70 | 1134794506 - FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC, FROEDTERT COMMUNITY HOSPITAL | 843381796 | WI | General Acute Care Hospital (282N00000X) |
United | 218 | $76763.03 | 1013332014 - PROSPECT CHARTERCARE RWMC, LLC, ROGER WILLIAMS MEDICAL CENTER | 464648465 | RI | General Acute Care Hospital (282N00000X) |
United | 218 | $5196.00 | 1336673250 - STEWARD SHARON REGIONAL HEALTH SYSTEM, INC. | 815457135 | PA | Rehabilitation Hospital Unit (273Y00000X) |
United | 218 | $152653.09 | 1437582400 - HIGHLAND HOSPITAL | 943302014 | CA | 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 218 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 218 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 218 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 |
|---|---|---|
| 217-APR-DRG | Moderate | Open Craniotomy Except Trauma |
| 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 |
| 219-APR-DRG | Moderate | Open Craniotomy Except Trauma |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 218. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 218 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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