MS-DRG 221 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 221 by major payers:
$56,378.12
$58,235.53
$74,928.46
$74,626.27
| 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 221 | ||||||
United | 221 | $58679.64 | 1073568754 - MOORESVILLE HOSPITAL MANAGEMENT ASSOCIATES LLC, LAKE NORMAN REGIONAL MEDICAL CENTER | 332476324 | NC | General Acute Care Hospital (282N00000X) |
United | 221 | $41169.64 | 1326485749 - SOUTHERN REGIONAL MEDICAL CORPORATION, LEONARD J. CHABERT MEDICAL CENTER | 462743282 | LA | General Acute Care Hospital (282N00000X) |
United | 221 | $31343.26 | 1245274950 - MERCY HEALTH-REGIONAL MEDICAL CENTER LLC, MERCY HEALTH LORAIN HOSPITAL | 340714704 | OH | General Acute Care Hospital (282N00000X) |
United | 221 | $1000.00 | 1962626770 - LAWRENCE MEMORIAL HEALTH FOUNDATION INC., LAWRENCE MEMORIAL PHYSICIAN GROUP | 731547175 - (AR) LAWRENCE MEMORIAL HEALTH FOUNDATION | AR | Critical Access Hospital (282NC0060X) |
United | 221 | $101455.70 | 1417290958 - CARONDELET HEALTH NETWORK, O'RIELLY TRANSITIONS INTENSIVE OUTPATIENT PROGRAM | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 221 | $49382.07 | 1982247649 - UOFL HEALTH-LOUISVILLE INC | 843178470 - UOFL HEALTH-LOUISVILLE INC | IN | Rehabilitation Hospital Unit (273Y00000X) |
United | 221 | $56116.98 | 1356718787 - PRIME HEALTHCARE SERVICES-SUBURBAN HOSPITAL LLC | 472819044 | PA | Psychiatric Hospital Unit (273R00000X) |
United | 221 | $91349.64 | 1619351160 - UCHEALTH GRANDVIEW HOSPITAL, UCHEALTH COLORADO SPRINGS HOSPITAL LLC | 473455146 - (CO) UCHEALTH GRANDVIEW HOSPITAL | CO | General Acute Care Hospital (282N00000X) |
United | 221 | $88448.88 | 1386749893 - FRANCISCAN HEALTH INDIANAPOLIS & MOORESVILLE, FRANCISCAN HEALTH - INDIANAPOLIS | 350913537 | IN | General Acute Care Hospital (282N00000X) |
United | 221 | $103834.09 | 1760299093 - ADVENTHEALTH PORT CHARLOTTE INC | 332257010 | FL | General Acute Care Hospital (282N00000X) |
United | 221 | $74388.00 | 1184722167 - UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, UCSF MEDICAL CENTER | 943281657 | CA | General Acute Care Hospital (282N00000X) |
United | 221 | $73245.17 | 1225289499 - LUBBOCK HERITAGE HOSPITAL, LLC., GRACE SURGICAL HOSPITAL | 264021016 - (TX) LUBBOCK HERITAGE HOSPITAL LLC | TX | General Acute Care Hospital (282N00000X) |
United | 221 | $84898.79 | 1396317137 - STEWARD HH. INC. | 995053647 | FL | General Acute Care Hospital (282N00000X) |
United | 221 | $29712.03 | 1033536727 - SELECT SPECIALTY HOSPITAL | 463235750 - (FL) SELECT SPECIALTY HOSPITAL | FL | Long Term Care Hospital (282E00000X) |
United | 221 | $129497.53 | 1033681630 - SPARTANBURG MEDICAL CENTER | 576000934 | SC | Psychiatric Hospital Unit (273R00000X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
MS-DRG 221 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 221 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 221 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 |
|---|---|---|
| 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 |
| 221-MS-DRG | High | Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization without CC/MCC |
| 228-APR-DRG | High | INGUINAL, FEMORAL & UMBILICAL HERNIA 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 221. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 221 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like MS-DRG 221) and we'll show you how you compare in 15 minutes or less.