MS-DRG 252 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 252 by major payers:
$40,054.47
$43,629.00
$53,792.10
$55,232.03
| 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 252 | ||||||
United | 252 | $24668.00 | 1568463701 - JERSEY COMMUNITY HOSPITAL DISTRICT, JERSEY COMMUNITY HOSPITAL | 376013958 | IL | General Acute Care Hospital (282N00000X) |
United | 252 | $68933.89 | 1902355654 - SWEDISH HEALTH SERVICES, SWEDISH MEDICAL CENTER-BALLARD PSYCH | 910433740 - (WA) SWEDISH HEALTH SERVICES | WA | Psychiatric Hospital Unit (273R00000X) |
United | 252 | $52413.07 | 1417946377 - OUR LADY OF LOURDES REGIONAL MEDICAL CENTER INC | 720423635 - OUR LADY OF LOURDES REGIONAL MEDICAL CENTER INC | LA | Rehabilitation Hospital (283X00000X) |
United | 252 | $101073.31 | 1700998697 - HOLY FAMILY MEMORIAL INC, FROEDTERT HOLY FAMILY MEMORIAL HOSPITAL | 390806395 - HOLY FAMILY MEMORIAL INC | WI | General Acute Care Hospital (282N00000X) |
United | 252 | $30303.66 | 1578932869 - NORTHWEST COMMUNITY HOSPITAL, NCH BREAST CENTER AT ARLINGTON HEIGHTS ROAD | 362340313 - NORTHWEST COMMUNITY HOSPITAL | IL | General Acute Care Hospital (282N00000X) |
United | 252 | $5761.00 | 1043641749 - CR EMERGENCY ROOM, LLC, BAYLOR SCOTT & WHITE EMERGENCY HOSPITAL COLLEYVILLE | 262978009 | TX | General Acute Care Hospital (282N00000X) |
United | 252 | $4158.00 | 1891801734 - MOUNTAIN STATES HEALTH ALLIANCE, SYCAMORE SHOALS HOSPITAL | 620476282 - MOUNTAIN STATES HEALTH ALLIANCE | TN | General Acute Care Hospital (282N00000X) |
United | 252 | $5761.00 | 1043641749 - CR EMERGENCY ROOM, LLC, BAYLOR SCOTT & WHITE EMERGENCY HOSPITAL COLLEYVILLE | 262978009 | TX | General Acute Care Hospital (282N00000X) |
United | 252 | $63514.00 | 1811930555 - SEQUOIA HEALTH SERVICES, SEQUOIA HOSPITAL | 943246947 | CA | Psychiatric Hospital Unit (273R00000X) |
United | 252 | $40169.98 | 1962451195 - BROOKDALE HOSPITAL MEDICAL CENTER, BROOKDALE EMERGENCY PHYSICIANS ASSOCIATES | 111631746 - BROOKDALE HOSPITAL MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 252 | $48025.60 | 1225202195 - CLARION HOSPITAL, INPATIENT REHAB UNIT | 251010039 - (PA) CLARION HOSPITAL | PA | Rehabilitation Hospital Unit (273Y00000X) |
United | 252 | $47724.57 | 1194741181 - NASSAU HEALTH CARE CORPORATION, NUMC DEPARTMENT OF PEDIATRICS, FPP | 113465690 | NY | General Acute Care Hospital (282N00000X) |
United | 252 | $38005.39 | 1104019215 - HOLYOKE MEDICAL CENTER, INC. | 222520073 - (MA) HOLYOKE MEDICAL CENTER INC | MA | Hospitalist Physician (208M00000X) |
United | 252 | $84628.00 | 1538114434 - HENDERSONVILLE HOSPITAL CORPORATION, TRISTAR HENDERSONVILLE MEDICAL CENTER | 621321255 - (TN) HENDERSONVILLE HOSPITAL CORPORATION | TN | General Acute Care Hospital (282N00000X) |
United | 252 | $53198.58 | 1912932336 - PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA, JACKSON NORTH MEDICAL CENTER REHAB | 591713947 - (FL) PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY FLORIDA | FL | 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 252 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 252 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 252 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 |
|---|---|---|
| 251-APR-DRG | High | ABDOMINAL PAIN |
| 251-MS-DRG | High | Percutaneous Cardiovascular Procedures without Intraluminal Device without MCC |
| 252-MS-DRG | High | Other Vascular Procedures with MCC |
| 253-APR-DRG | High | OTHER & UNSPECIFIED GASTROINTESTINAL HEMORRHAGE |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 252. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 252 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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