MS-DRG 219 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 219 by major payers:
$91,093.08
$92,606.04
$113,507.01
$119,684.71
| 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 219 | ||||||
United | 219 | $60233.32 | 1689747552 - UNM HOSPITAL | 856003005 | NM | General Acute Care Hospital (282N00000X) |
United | 219 | $99701.00 | 1306126974 - TOMBALL TEXAS HOSPITAL COMPANY LLC, TOMBALL REGIONAL MEDICAL CENTER | 821349955 | TX | General Acute Care Hospital (282N00000X) |
United | 219 | $64061.00 | 1104981661 - DIGNITY HEALTH, MERCY HOSPITAL | 870692237 - (CA) DIGNITY HEALTH | CA | General Acute Care Hospital (282N00000X) |
United | 219 | $45502.00 | 1043343304 - STAFFORD HOSPITAL, LLC, STAFFORD HOSPITAL | 134316364 - (VA) STAFFORD HOSPITAL LLC | VA | General Acute Care Hospital (282N00000X) |
United | 219 | $3891.00 | 1609984954 - MOUNTAIN STATES HEALTH ALLIANCE, JAMES H. & CECILE C. QUILLEN REHABILITATION HOSPITAL | 620476282 - MOUNTAIN STATES HEALTH ALLIANCE | TN | Rehabilitation Hospital Unit (273Y00000X) |
United | 219 | $69637.50 | 1649607268 - OUR LADY OF THE ANGELS HOSPITAL, INC., OUR LADY OF THE ANGELS HOPSITAL - PSYCH | 463123178 - (LA) OUR LADY OF THE ANGELS HOSPITAL INC | LA | Psychiatric Hospital Unit (273R00000X) |
United | 219 | $250370.03 | 1033325378 - ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC, QUEEN OF THE VALLEY HOSPITAL | 814791043 - (CA) ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC | CA | General Acute Care Hospital (282N00000X) |
United | 219 | $177889.67 | 1033186093 - MOUNT SINAI HOSPITAL | 131624096 - MOUNT SINAI HOSPITAL | NY | Psychiatric Hospital (283Q00000X) |
United | 219 | $60233.32 | 1689747552 - UNM HOSPITAL | 856003005 | NM | General Acute Care Hospital (282N00000X) |
United | 219 | $199907.40 | 1316396377 - MCLEOD HEALTH CLARENDON | 812772554 - MCLEOD HEALTH CLARENDON | SC | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 219 | $60066.16 | 1770573586 - MCALLEN HOSPITALS L P, SOUTH TEXAS HEALTH SYSTEM | 233069260 | TX | General Acute Care Hospital (282N00000X) |
United | 219 | $5855.00 | 1568899391 - HILLCREST BAPTIST MEDICAL CENTER, BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | 741161944 - (TX) HILLCREST BAPTIST MEDICAL CENTER | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 219 | $40869.35 | 1124061882 - JACKSON COUNTY HOSPITAL DISTRICT, JACKSON HEALTHCARE CENTER | 741738475 - (TX) JACKSON COUNTY HOSPITAL DISTRICT | TX | Critical Access Hospital (282NC0060X) |
United | 219 | $11052.00 | 1952762551 - CHILDREN'S HOSPITAL COLORADO, CHILDREN'S HOSPITAL COLORADO OUTPATIENT SPECIALTY CARE PARKER | 840166760 - CHILDRENS HOSPITAL COLORADO | CO | Children's Hospital (282NC2000X) |
United | 219 | $97425.79 | 1942294939 - ST JOSEPH REGIONAL HEALTH CENTER, ST JOSEPH AMBULATORY SURGERY | 741282696 - ST JOSEPH REGIONAL HEALTH CENTER | TX | 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 219 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 219 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 219 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 |
|---|---|---|
| 218-MS-DRG | High | Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization without CC/MCC |
| 219-MS-DRG | High | Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization with MCC |
| 220-APR-DRG | High | MAJOR STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES |
| 220-MS-DRG | High | Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization with CC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 219. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 219 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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