MS-DRG 240 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 240 by major payers:
$33,525.44
$38,982.87
$45,571.26
$46,857.07
| 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 240 | ||||||
United | 240 | $38148.94 | 1396998183 - LANSDALE HOSPITAL CORPORATION, LANSDALE HOSPITAL | 263359979 - (PA) LANSDALE HOSPITAL CORPORATION | PA | Rehabilitation Hospital Unit (273Y00000X) |
United | 240 | $59365.19 | 1114015971 - PROVIDENCE HEALTH & SERVICES OREGON, PROVIDENCE ST VINCENT MEDICAL CENTER | 930386929 - (OR) PROVIDENCE HEALTH & SERVICES OREGON | OR | General Acute Care Hospital (282N00000X) |
United | 240 | $63978.12 | 1598375271 - ASPIRUS WAUSAU HOSPITAL, INC., ASPIRUS PLOVER HOSPITAL | 391138241 - ASPIRUS WAUSAU HOSPITAL INC | WI | General Acute Care Hospital (282N00000X) |
United | 240 | $59455.48 | 1184647620 - LEGACY MERIDIAN PARK HOSPITAL | 930618975 - LEGACY MERIDIAN PARK HOSPITAL | OR | General Acute Care Hospital (282N00000X) |
United | 240 | $66878.67 | 1639533623 - TEXAS HEALTH PRESBYTERIAN HOSPITAL ALLEN, TEXAS HEALTH BEHAVIORAL HEALTH HOSPITAL ALLEN | 752890358 - (TX) TEXAS HEALTH PRESBYTERIAN HOSPITAL ALLEN | TX | Psychiatric Hospital Unit (273R00000X) |
United | 240 | $19466.88 | 1952427874 - JACKSON MEDICAL CENTER, LLC | 208057478 - (AL) JACKSON MEDICAL CENTER, L.L.C. | AL | Rural Acute Care Hospital (282NR1301X) |
United | 240 | $66316.61 | 1073610473 - METROPOLITAN HOSPITAL CENTER | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | General Acute Care Hospital (282N00000X) |
United | 240 | $36249.92 | 1831123942 - MONROE HOSPITAL, LLC | 472105584 | IN | General Acute Care Hospital (282N00000X) |
United | 240 | $40799.85 | 1669405072 - ST LUKES QUAKERTOWN HOSPITAL | 844475996 - (PA) ST LUKES HOSPITAL-EASTON CAMPUS | PA | General Acute Care Hospital (282N00000X) |
United | 240 | $50207.26 | 1225289895 - PROVIDENCE HEALTH & SERVICES, PROVIDENCE HOLY FAMILY HOSPITAL | 352345508 | WA | General Acute Care Hospital (282N00000X) |
United | 240 | $21130.00 | 1871953802 - FREEDOM HOSPITAL OF MAGNOLIA, LLC, BEACHAM MEMORIAL HOSPITAL | 811097331 | MS | Rural Acute Care Hospital (282NR1301X) |
United | 240 | $25095.49 | 1679617963 - CHESTNUT HILL REHAB HOSPITAL, LLC, MONTGOMERY REHAB HOSPITAL OF CHESTNUT HILL | 822108660 | PA | Rehabilitation Hospital (283X00000X) |
United | 240 | $19636.31 | 1801104732 - NOT-FOR-PROFIT HOSPITAL CORPORATION, UNITED MEDICAL CENTER | 261335878 - (DC) UNITED MEDICAL CENTER | DC | General Acute Care Hospital (282N00000X) |
United | 240 | $47590.82 | 1669752234 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL | 452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 240 | $9736.00 | 1902901333 - CLARA MAASS MEDICAL CENTER | 221500556 | NJ | 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 240 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 240 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 240 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 |
|---|---|---|
| 239-MS-DRG | High | Amputation for Circulatory System Disorders except Upper Limb and Toe with MCC |
| 240-MS-DRG | High | Amputation for Circulatory System Disorders except Upper Limb and Toe with CC |
| 241-APR-DRG | High | PEPTIC ULCER & GASTRITIS |
| 241-MS-DRG | High | Amputation for Circulatory System Disorders except Upper Limb and Toe without CC/MCC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 240. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 240 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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