MS-DRG 251 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 251 by major payers:
$20,341.87
$22,234.01
$26,925.87
$26,022.76
| 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 251 | ||||||
United | 251 | $9273.00 | 1972071991 - GAINESVILLE COMMUNITY HOSPITAL, INC., NORTH TEXAS MEDICAL CENTER | 831683025 - (TX) GAINESVILLE COMMUNITY HOSPITAL INC | TX | General Acute Care Hospital (282N00000X) |
United | 251 | $2060.00 | 1033159173 - GREENWOOD LEFLORE HOSPITAL, REHAB UNIT | 646000400 - (MS) GREENWOOD LEFLORE HOSPITAL | MS | Rehabilitation Hospital Unit (273Y00000X) |
United | 251 | $30530.00 | 1063495836 - SOUTH BROWARD HOSPITAL DISTRICT, MEMORIAL HOSPITAL PEMBROKE | 596014973 - (FL) SOUTH BROWARD HOSPITAL DISTRICT | FL | General Acute Care Hospital (282N00000X) |
United | 251 | $65087.00 | 1811055098 - SUTTER WEST BAY HOSPITALS, CALIFORNIA PACIFIC MEDICAL CENTER | 940562680 - (CA) SUTTER BAY HOSPITALS | CA | General Acute Care Hospital (282N00000X) |
United | 251 | $39190.00 | 1285681908 - CENTRAL FLORIDA REGIONAL HOSPITAL, INC, HCA FLORIDA LAKE MONROE HOSPITAL | 591978725 - (FL) CENTRAL FLORIDA REGIONAL HOSPITAL INC | FL | General Acute Care Hospital (282N00000X) |
United | 251 | $34033.42 | 1013589738 - STEWARD PGH, INC., PSYCH | 862724926 | FL | Psychiatric Hospital (283Q00000X) |
United | 251 | $3036.00 | 1073517058 - ROOSEVELT COUNTY SPECIAL HOSPITAL DISTRICT, ROOSEVELT GENERAL HOSPITAL | 850458844 - (NM) ROOSEVELT COUNTY SPECIAL HOSPITAL DISTRICT | NM | General Acute Care Hospital (282N00000X) |
United | 251 | $30498.83 | 1144286352 - COMMUNITY MERCY HEALTH PARTNERS, MERCY HEALTH - URBANA HOSPITAL | 310785684 - COMMUNITY MERCY HEALTH PARTNERS | OH | Critical Access Hospital (282NC0060X) |
United | 251 | $22471.75 | 1891222410 - METHODIST GERMANTOWN | 620479367 - METHODIST HEALTHCARE-MEMPHIS | TN | General Acute Care Hospital (282N00000X) |
United | 251 | $2626.00 | 1558391045 - WELLMONT HEALTH SYSTEM, BRISTOL REGIONAL MEDICAL CENTER PSYCHIATRIC UNIT | 621636465 - WELLMONT HEALTH SYSTEM | TN | Psychiatric Hospital Unit (273R00000X) |
United | 251 | $15440.04 | 1801141759 - OAKWOOD HOSPITAL AND MEDICAL CENTER | 381405141 - (MI) OAKWOOD HEALTHCARE INC | MI | General Acute Care Hospital (282N00000X) |
United | 251 | $72871.00 | 1548421837 - UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER | 943281657 | CA | General Acute Care Hospital (282N00000X) |
United | 251 | $33594.33 | 1073608139 - VANDERBILT UNIV. MEDICAL CENTER, TVHS | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | 251 | $32588.01 | 1427607464 - SAINT JOSEPH HOSPITAL, INC | 840417134 - (CO) SAINT JOSEPH HOSPITAL | CO | General Acute Care Hospital (282N00000X) |
United | 251 | $26144.58 | 1609251891 - JEWISH HOSPITAL LLC, THE JEWISH HOSPITAL - MERCY HEALTH | 271408630 - (OH) JEWISH HOSPITAL LLC | OH | Rehabilitation Hospital Unit (273Y00000X) |
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 251 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 251 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 251 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 |
|---|---|---|
| 250-MS-DRG | High | Percutaneous Cardiovascular Procedures without Intraluminal Device with MCC |
| 251-MS-DRG | High | Percutaneous Cardiovascular Procedures without Intraluminal Device without MCC |
| 252-APR-DRG | High | MALFUNCTION, REACTION & COMPLICATION OF GI DEVICE OR PROCEDURE |
| 252-MS-DRG | High | Other Vascular Procedures 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 251. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 251 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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