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See a sample rate comparisonMS-DRG 228 Fee Schedule
Last Verified: October 2026
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.
OTHER CARDIOTHORACIC PROCEDURES WITH MCC
| 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
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MS-DRG 228
5 of 25 sample ratesHigher to lower in this preview
St. Joseph Health Northern California, LLC, Providence St. Joseph Hospital
St Joseph Health Northern California LLC
$160,023.73Published rateSt. Vincent Heart Center Of Indiana, LLC, Ascension St. Vincent Heart Center
St. Vincent Heart Center Of Indiana
$93,436.88Published rateTerrebonne Parish Hospital Service District #1, Terrebone General Rehabilitation Unit
Terrebonne Hospital Service District No 1
$53,540.57Published rateClallam County Public Hospital District No 1, Forks Community Hospital
$36,422.19Published rateVanderbilt University Medical Center, Vanderbilt Wilson County Hospital
$1,787.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-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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