MS-DRG 239 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 239 by major payers:
$55,172.95
$65,396.49
$78,257.64
$80,399.66
| 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 239 | ||||||
United | 239 | $87118.21 | 1982799375 - LOVELACE HEALTH SYSTEM, LLC, LOVELACE WOMEN'S HOSPITAL | 850327237 | NM | General Acute Care Hospital (282N00000X) |
United | 239 | $153518.40 | 1386871788 - EMANUEL MEDICAL CENTER, INC., EMANUEL FAMILY PRACTICE - MONTE VISTA | 752918774 | CA | General Acute Care Hospital (282N00000X) |
United | 239 | $83597.42 | 1710097936 - OCHSNER MEDICAL CENTER | 205432782 | LA | General Acute Care Hospital (282N00000X) |
United | 239 | $31964.46 | 1205837770 - NORTH RUNNELS COUNTY HOSPITAL, NORTH RUNNELS HOSPITAL | 751306626 | TX | Critical Access Hospital (282NC0060X) |
United | 239 | $33273.76 | 1407304256 - KANSAS MEDICAL CENTER, LLC, KMC PHYSICIANS PART A | 201853760 - (KS) KANSAS MEDICAL CENTER, LLC | KS | General Acute Care Hospital (282N00000X) |
United | 239 | $83597.42 | 1710097936 - OCHSNER MEDICAL CENTER | 205432782 | LA | General Acute Care Hospital (282N00000X) |
United | 239 | $65276.33 | 1962498733 - CENTRAL MONTGOMERY MEDICAL CENTER L L C | 263359979 - (PA) LANSDALE HOSPITAL CORPORATION | PA | General Acute Care Hospital (282N00000X) |
United | 239 | $117037.40 | 1437135811 - MORTON PLANT HOSPITAL ASSOCIATION INC, MORTON PLANT NORTH BAY HOSPITAL | 590624462 - (FL) MORTON PLANT HOSPITAL ASSOCIATION INC | FL | General Acute Care Hospital (282N00000X) |
United | 239 | $59334.67 | 1316279003 - METROSOUTH MEDICAL CENTER, HOSPITAL | 510382045 | IL | General Acute Care Hospital (282N00000X) |
United | 239 | $144448.21 | 1528101284 - DIGNITY HEALTH, ST. ROSE DOMINICAN HOSPITAL, SAN MARTIN CAMPUS | 880059427 - (NV) DIGNITY HEALTH | NV | General Acute Care Hospital (282N00000X) |
United | 239 | $54433.78 | 1093171860 - ST VINCENTS CHILTON LLC, ASCENSION ST. VINCENT'S CHILTON | 810935368 | AL | General Acute Care Hospital (282N00000X) |
United | 239 | $101360.99 | 1164481529 - ST. CHARLES HOSPITAL | 111871039 - (NY) ST CHARLES HOSPITAL CORP | NY | General Acute Care Hospital (282N00000X) |
United | 239 | $102677.21 | 1366536963 - PROVIDENCE HEALTH & SERVICES OREGON, PROVIDENCE MILWAUKIE HOSPITAL | 930924302 - (OR) PROVIDENCE HEALTH & SERVICES OREGON | OR | General Acute Care Hospital (282N00000X) |
United | 239 | $1350.00 | 1982864526 - FORREST COUNTY GENERAL HOSPITAL, PERRY COUNTY GENERAL HOSPITAL SNF | 646001587 - FORREST COUNTY GENERAL HOSPITAL | MS | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 239 | $44576.57 | 1134222565 - LAFAYETTE SURGICAL HOSPITAL LLC, LAFAYETTE SURGICAL SPECIALTY HOSPITAL | 900021727 - (LA) LAFAYETTE SURGICAL SPECIALTY HOSPITAL | LA | 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 239 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 239 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 239 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 |
|---|---|---|
| 236-APR-DRG | Moderate | Spinal Procedures |
| 236-MS-DRG | High | Coronary Bypass without Cardiac Catheterization without MCC |
| 239-MS-DRG | High | Amputation for Circulatory System Disorders except Upper Limb and Toe with MCC |
| 240-APR-DRG | High | DIGESTIVE MALIGNANCY |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 239. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 239 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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