MS-DRG 245 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 245 by major payers:
$57,312.62
$60,724.77
$73,810.74
$75,321.25
| 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 245 | ||||||
United | 245 | $82855.68 | 1215903018 - COMMUNITY MEMORIAL HEALTH SYSTEM, COMMUNITY MEMORIAL HOSPITAL OF SAN BUENA VENTURA | 951683892 - COMMUNITY MEMORIAL HEALTH SYSTEM | CA | General Acute Care Hospital (282N00000X) |
United | 245 | $97856.43 | 1972652063 - COMMUNITY MEDICAL CENTER | 240862246 - (PA) COMMUNITY MEDICAL CENTER | PA | General Acute Care Hospital (282N00000X) |
United | 245 | $72213.56 | 1427360700 - VHS HARPER-HUTZEL HOSPITAL INC, HARPER UNIVERSITY HOSPITAL | 272844767 | MI | General Acute Care Hospital (282N00000X) |
United | 245 | $43746.62 | 1679535637 - SWEDISH COVENANT HEALTH, SWEDISH HOSPITAL | 362179813 - (IL) SWEDISH COVENANT HEALTH | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 245 | $105496.24 | 1508810565 - REDMOND PARK HOSPITAL, LLC, REDMOND REGIONAL MEDICAL CENTER | 581123037 - (GA) REDMOND PARK HOSPITAL LLC | GA | General Acute Care Hospital (282N00000X) |
United | 245 | $72129.17 | 1023251923 - CLAIBORNE COUNTY HOSPITAL CLAIBORNE COUNTY AMBULANCE, CLAIBORNE COUNTY HOSPITAL | 464420358 - (TN) CLAIBORNE MEDICAL CENTER | TN | Rural Acute Care Hospital (282NR1301X) |
United | 245 | $14902.00 | 1043354111 - REDLANDS COMMUNITY HOSPITAL | 951643347 - (CA) REDLANDS COMMUNITY HOSPITAL | CA | General Acute Care Hospital (282N00000X) |
United | 245 | $46400.17 | 1689606220 - TENET HEALTHSYSTEM HOSPITALS DALLAS, INC., RHD MEMORIAL MEDICAL CENTER | 271459658 - (TX) DALLAS MEDICAL CENTER, LLC | TX | General Acute Care Hospital (282N00000X) |
United | 245 | $76689.40 | 1902844988 - PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA, PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER TORRANCE | 421672810 - (CA) UNITED STATES CATHLOC CONFERENCE | CA | General Acute Care Hospital (282N00000X) |
United | 245 | $42502.21 | 1497708929 - MEXIA PRINCIPAL HEALTHCARE LIMITED PARTNERSHIP, PARKVIEW REGIONAL HOSPITAL | 621692446 | TX | General Acute Care Hospital (282N00000X) |
United | 245 | $39363.00 | 1689769911 - DIGNITY HEALTH, ST. BERNARDINE MEDICAL CENTER | 870692261 | CA | General Acute Care Hospital (282N00000X) |
United | 245 | $95971.86 | 1447500111 - FAIRVIEW CLEVELAND CLINIC HOSPITAL | 340714618 - FAIRVIEW HOSPITAL | OH | General Acute Care Hospital (282N00000X) |
United | 245 | $53754.80 | 1205203775 - PLANO SURGICAL HOSPITAL | 843385649 | TX | General Acute Care Hospital (282N00000X) |
United | 245 | $61563.91 | 1851798342 - PRIME HEALTHCARE SERVICES LOWER BUCKS LLC, LOWER BUCKS HOSPITAL | 460750728 - (PA) PRIME HEALTHCARE SERVICES LOWER BUCKS, LLC | PA | General Acute Care Hospital (282N00000X) |
United | 245 | $56090.00 | 1659321198 - PARKRIDGE MEDICAL CENTER, INC., PARKRIDGE EAST HOSPITAL | 620840204 | TN | 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 245 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 245 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 245 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 |
|---|---|---|
| 244-APR-DRG | High | DIVERTICULITIS & DIVERTICULOSIS |
| 244-MS-DRG | High | Permanent Cardiac Pacer Implant without CC/MCC |
| 245-MS-DRG | High | AICD Generator Procedures |
| 250-MS-DRG | High | Percutaneous Cardiovascular Procedures without Intraluminal Device with 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 245. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 245 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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