MS-DRG 220 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 220 by major payers:
$63,536.05
$65,775.43
$83,391.18
$84,614.85
| 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 220 | ||||||
United | 220 | $65900.00 | 1114216850 - DIGNITY HEALTH, MERCY SOUTHWEST HOSPITAL | 870692237 - (CA) DIGNITY HEALTH | CA | General Acute Care Hospital (282N00000X) |
United | 220 | $10403.00 | 1851904445 - THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO, GOOD SAMARITAN HAND SURGERY CENTER | 310537486 - (OH) THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO DTD 01251995 | OH | General Acute Care Hospital (282N00000X) |
United | 220 | $79858.00 | 1720058027 - RENOWN SOUTH MEADOWS MEDICAL CENTER | 460517825 - (NV) RENOWN SOUTH MEADOWS MEDICAL CENTER | NV | General Acute Care Hospital (282N00000X) |
United | 220 | $77961.07 | 1619911104 - JOHNSTON HEALTH SERVICES CORPORATION, JOHNSTON HEALTH | 463176429 - (NC) JOHNSTON HEALTH SERVICES CORPORATION | NC | General Acute Care Hospital (282N00000X) |
United | 220 | $274093.62 | 1164458196 - COASTAL CAROLINA MEDICAL CENTER, INC., COASTAL CAROLINA HOSPITAL-SWING BED UNIT | 934580630 | SC | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 220 | $78295.82 | 1659523132 - THE METHODIST HOSPITAL, THE METHODIST HOSPITAL | 350868133 - METHODIST HOSPITALS INC | IN | General Acute Care Hospital (282N00000X) |
United | 220 | $64710.76 | 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 | 220 | $9793.00 | 1265772362 - SCOTT & WHITE HOSPITAL, BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | 274434451 - (TX) SCOTT & WHITE HOSPITAL - COLLEGE STATION | TX | General Acute Care Hospital (282N00000X) |
United | 220 | $4708.00 | 1922003730 - RUSSELL COUNTY MEDICAL CENTER, INC, RUSSELL COUNTY MEDICAL CENTER | 620476282 - MOUNTAIN STATES HEALTH ALLIANCE | VA | General Acute Care Hospital (282N00000X) |
United | 220 | $79768.29 | 1881758126 - KISHWAUKEE COMMUNITY HOSPITAL, NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL | 237087041 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | General Acute Care Hospital (282N00000X) |
United | 220 | $56521.05 | 1396835138 - CARONDELET HEALTH NETWORK, ST. MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 220 | $54402.23 | 1801975107 - EAST TEXAS MEDICAL CENTER CARTHAGE, ETMC CARTHAGE | 824005981 | TX | General Acute Care Hospital (282N00000X) |
United | 220 | $74937.71 | 1598795502 - BLADEN COUNTY HOSPITAL | 800164702 | NC | Critical Access Hospital (282NC0060X) |
United | 220 | $50175.08 | 1710931985 - JEFFERSON HOSPITAL ASSOCIATION INC, JEFFERSON REGIONAL MEDICAL CENTER | 710329353 - (AR) JEFFERSON HOSPITAL ASSN INC | AR | General Acute Care Hospital (282N00000X) |
United | 220 | $95255.56 | 1760408801 - AMISUB (SFH), INC., ST. FRANCIS HOSPITAL | 752522262 | TN | Rehabilitation Hospital Unit (273Y00000X) |
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 220 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 220 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 220 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 |
|---|---|---|
| 219-APR-DRG | Moderate | Open Craniotomy Except Trauma |
| 219-MS-DRG | High | Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization with MCC |
| 220-MS-DRG | High | Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization with CC |
| 221-APR-DRG | High | Major Small & Large Bowel Procedures |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 220. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 220 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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