MS-DRG 228 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 228 by major payers:
$65,964.81
$63,511.11
$81,061.50
$80,400.22
| 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 228 | ||||||
United | 228 | $21081.91 | 1295716637 - HOSPITAL SERVICE DIST. NO. 1 OF THE PARISH OF ST. CHARLES, STATE OF LA, ST. CHARLES PARISH HOSPITAL | 726014606 | LA | General Acute Care Hospital (282N00000X) |
United | 228 | $51803.00 | 1821042870 - DOCTORS HOSPITAL OF AUGUSTA, LLC, DOCTORS HOSPITAL (AUGUSTA) | 581162801 - (GA) DOCTORS HOSPITAL OF AUGUSTA LLC | GA | Rehabilitation Hospital Unit (273Y00000X) |
United | 228 | $50281.50 | 1205834694 - FRESNO SURGERY CENTER LP | 770011624 - (CA) FRESNO SURGICAL CENTER, LP DBA FRESNO SURGICAL HOSPITAL | CA | General Acute Care Hospital (282N00000X) |
United | 228 | $160023.73 | 1508998394 - ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC, PROVIDENCE ST. JOSEPH HOSPITAL | 814791043 - (CA) ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC | CA | Rehabilitation Hospital Unit (273Y00000X) |
United | 228 | $61573.64 | 1457448037 - BAPTIST HEALTH CARE, INC. | 590657322 - BAPTIST HEALTH CARE INC | FL | Psychiatric Hospital Unit (273R00000X) |
United | 228 | $126874.82 | 1548716665 - UPSTATE AFFILIATE ORGANIZATION, GHS CANCER INST-ANDREWS | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 228 | $51188.14 | 1083041917 - STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER, UNIVERSITY OF MISSISSIPPI CENTER - GRENADA PSYCH | 646008520 | MS | Psychiatric Hospital (283Q00000X) |
United | 228 | $99665.00 | 1841221017 - NORTHSHORE REGIONAL MEDICAL CENTER, LLC, NORTHSHORE REGIONAL MEDICAL CENTER | 271770321 | LA | General Acute Care Hospital (282N00000X) |
United | 228 | $58563.73 | 1518182070 - MURRAY-CALLOWAY COUNTY PUBLIC HOSPITAL CORPORATION | 610620567 | KY | General Acute Care Hospital (282N00000X) |
United | 228 | $1787.00 | 1215979190 - VANDERBILT UNIVERSITY MEDICAL CENTER, VANDERBILT WILSON COUNTY HOSPITAL | 200248060 | TN | Rehabilitation Hospital Unit (273Y00000X) |
United | 228 | $121996.17 | 1679525919 - THE CLEVELAND CLINIC FOUNDATION | 340714585 - THE CLEVELAND CLINIC FOUNDATION | OH | General Acute Care Hospital (282N00000X) |
United | 228 | $102396.46 | 1053972760 - ADVENTHEALTH POLK SOUTH INC, ADVENTHEALTH LAKE WALES | 834672945 | FL | General Acute Care Hospital (282N00000X) |
United | 228 | $47834.69 | 1326037607 - HAMILTON COUNTY HOSPITAL DISTRICT, HAMILTON GENERAL HOSPITAL | 742570068 | TX | Critical Access Hospital (282NC0060X) |
United | 228 | $24125.57 | 1376538231 - GILA RIVER HEALTH CARE CORPORATION, KOMATKE HEALTH CENTER | 860810876 - (AZ) GILA RIVER HEALTH CARE CORPORATION | AZ | Critical Access Hospital (282NC0060X) |
United | 228 | $32515.00 | 1700824398 - MIAMI COUNTY MEDICAL CENTER INC, MIAMI COUNTY MEDICAL CENTER | 481155548 - (KS) MIAMI COUNTY MEDICAL CENTER INC | KS | 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 228 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 228 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 228 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 |
|---|---|---|
| 221-APR-DRG | High | Major Small & Large Bowel Procedures |
| 221-MS-DRG | High | Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization without CC/MCC |
| 228-MS-DRG | High | Other Cardiothoracic Procedures with MCC |
| 229-APR-DRG | High | OTHER DIGESTIVE SYSTEM & ABDOMINAL 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 228. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 228 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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