MS-DRG 235 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 235 by major payers:
$67,017.02
$71,440.50
$89,254.31
$92,025.69
| 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 235 | ||||||
United | 235 | $135354.25 | 1669673463 - ALAMEDA HEALTH SYSTEM, HIGHLAND GENERAL HOSPITAL | 943302014 | CA | General Acute Care Hospital (282N00000X) |
United | 235 | $10123.00 | 1801826839 - BAYLOR SCOTT & WHITE MEDICAL CENTER | 824052186 - (TX) BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | TX | General Acute Care Hospital (282N00000X) |
United | 235 | $72871.00 | 1336244474 - UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, UCSF MEDICAL CENTER | 943281657 | CA | General Acute Care Hospital (282N00000X) |
United | 235 | $88508.24 | 1619975331 - UNION HOSPITAL INC. | 350876396 - UNION HOSPITAL INC | IN | General Acute Care Hospital (282N00000X) |
United | 235 | $146104.68 | 1104845015 - TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | 751438726 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | TX | General Acute Care Hospital (282N00000X) |
United | 235 | $3949.00 | 1902280050 - JOHNSTON MEMORIAL HOSPITAL, INC, JOHNSTON MEMORIAL HOSPITAL REHABILITATION | 540544705 - JOHNSTON MEMORIAL HOSPITAL INC | VA | General Acute Care Hospital (282N00000X) |
United | 235 | $159099.62 | 1922542968 - DE CRAIG RANCH, LLC, DIGNITY HEALTH-ST. ROSE DOMINICAN BLUE DIAMOND CAMPUS | 364827272 - (NV) DE CRAIG RANCH LLC | NV | General Acute Care Hospital (282N00000X) |
United | 235 | $64614.12 | 1942241955 - SARTORI MEMORIAL HOSPITAL INC, MERCYONE CEDAR FALLS MEDICAL CENTER | 420758901 - (IA) SARTORI MEMORIAL HOSPITAL INC | IA | General Acute Care Hospital (282N00000X) |
United | 235 | $72871.00 | 1336244474 - UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, UCSF MEDICAL CENTER | 943281657 | CA | General Acute Care Hospital (282N00000X) |
United | 235 | $24125.57 | 1760892657 - ROOSEVELT WARM SPRINGS REHABILITATION & SPECIALTY HOSPITALS, INC., ROOSEVELT WARM SPRINGS REHABILITATION HOSPITAL | 464824043 - (GA) ROOSEVELT WARM SPRINGS REHABILITATION & SPECIALTY HOSPITA | GA | Rehabilitation Hospital (283X00000X) |
United | 235 | $58930.26 | 1881792547 - MERCY HOSPITALS EAST COMMUNITIES, MERCY HOSPITAL ST LOUIS | 430653493 - MERCY HOSPITALS EAST COMMUNITIES | MO | Psychiatric Hospital Unit (273R00000X) |
United | 235 | $135130.65 | 1104845015 - TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | 751438726 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | TX | General Acute Care Hospital (282N00000X) |
United | 235 | $85167.09 | 1114931342 - INTEGRIS MIAMI HOSPITAL, INTEGRIS MIAMI HOSPITAL | 730584411 | OK | General Acute Care Hospital (282N00000X) |
United | 235 | $73616.50 | 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 | 235 | $11248.00 | 1801826839 - BAYLOR SCOTT & WHITE MEDICAL CENTER | 824052186 - (TX) BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | 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 235 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 235 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 235 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 |
|---|---|---|
| 234-APR-DRG | High | APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS |
| 234-MS-DRG | High | Coronary Bypass with Cardiac Catheterization or Open Ablation without MCC |
| 235-MS-DRG | High | Coronary Bypass without Cardiac Catheterization with MCC |
| 236-APR-DRG | Moderate | Spinal 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 235. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 235 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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