MS-DRG 253 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 253 by major payers:
$31,456.99
$33,571.01
$40,835.87
$41,760.62
| 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 253 | ||||||
United | 253 | $32502.47 | 1235256884 - EAST TEXAS MEDICAL CENTER | 823878395 | TX | General Acute Care Hospital (282N00000X) |
United | 253 | $55221.39 | 1306871223 - SOUTHCOAST HOSPITALS GROUP, INC, CHARLTON MEMORIAL HOSPITAL | 222592333 - SOUTHCOAST HOSPITALS GROUP INC | MA | General Acute Care Hospital (282N00000X) |
United | 253 | $36026.80 | 1740661305 - SAINT THOMAS DEKALB HOSPITAL, LLC, ASCENSION SAINT THOMAS DEKALB | 474063289 - (TN) SAINT THOMAS DEKALB HOSPITAL LLC | TN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 253 | $86454.78 | 1407016793 - DOCTORS MEDICAL CENTER, DOCTORS BEHAVIORAL HEALTH | 752918774 | CA | Psychiatric Hospital (283Q00000X) |
United | 253 | $57390.00 | 1457629974 - ST MARY MEDICAL CENTER | 870692255 | CA | General Acute Care Hospital (282N00000X) |
United | 253 | $42718.17 | 1255354700 - LEGACY MOUNT HOOD MEDICAL CENTER | 930591528 - (OR) LEGACY MOUNT HOOD MEDICAL CENTER | OR | General Acute Care Hospital (282N00000X) |
United | 253 | $35217.94 | 1235417288 - SOUTHEASTERN REGIONAL MEDICAL CENTER, INC., SOUTHEASTERN REGIONAL MEDICAL CENTER, LLC | 264572436 - (GA) SOUTHEASTERN REGIONAL MEDICAL CENTER LLC | GA | General Acute Care Hospital (282N00000X) |
United | 253 | $32218.85 | 1730451899 - PRIME HEALTHCARE SERVICES ROXBOROUGH LLC, ROXBOROUGH MEMORIAL HOSPITAL | 454246163 - (PA) PRIME HEALTHCARE SERVICES ROXBOROUGH, LLC | PA | Rehabilitation Hospital Unit (273Y00000X) |
United | 253 | $29992.64 | 1063764371 - EAST LIVERPOOL CITY HOSPITAL | 340714583 - (OH) CITY HOSPITAL ASSOCIATION | OH | General Acute Care Hospital (282N00000X) |
United | 253 | $37332.80 | 1932489713 - AHS CLAREMORE REGIONAL HOSPITAL LLC, HILLCREST HOSPITAL CLAREMORE | 452652006 | OK | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 253 | $44238.62 | 1598719346 - CLEVELAND CLINIC HEALTH SYSTEM, EUCLID HOSPITAL | 340714593 - CLEVELAND CLINIC HEALTH SYSTEM EAST REGION | OH | General Acute Care Hospital (282N00000X) |
United | 253 | $65144.89 | 1215969787 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 253 | $54866.51 | 1942267869 - MARIN GENERAL HOSPITAL | 942823538 - (CA) MARIN GENERAL HOSPITAL | CA | Psychiatric Hospital Unit (273R00000X) |
United | 253 | $14707.00 | 1619969540 - SOUTHFIELD REHABILITATION COMPANY, SURGEONS CHOICE MACOMB CENTER | 383162435 - (MI) SURGEONS CHOICE MEDICAL CENTER | MI | General Acute Care Hospital (282N00000X) |
United | 253 | $63291.42 | 1780313775 - NAPLES HMA LLC | 204401957 | 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 253 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 253 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 253 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 |
|---|---|---|
| 252-APR-DRG | High | MALFUNCTION, REACTION & COMPLICATION OF GI DEVICE OR PROCEDURE |
| 252-MS-DRG | High | Other Vascular Procedures with MCC |
| 253-MS-DRG | High | Other Vascular Procedures with CC |
| 254-APR-DRG | High | OTHER DIGESTIVE SYSTEM DIAGNOSES |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 253. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 253 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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