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See a sample rate comparisonMS-DRG 254 Fee Schedule
Last Verified: October 2026
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.
OTHER VASCULAR PROCEDURES WITHOUT CC/MCC
| 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 254 by major payers:
$21,884.77
$24,424.46
$29,144.22
$29,574.55
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MS-DRG 254
5 of 25 sample ratesHigher to lower in this preview
The New York And Presbyterian Hospital, New York-Presbyterian Hospital
The New York And Presbyterian Hospital
$77,026.07Published rateFroedtert Memorial Lutheran Hospital, Inc., Froedtert Bluemound Rehabilitation Hospital
Community Memorial Hospital Of Menomonee Falls Inc
$30,698.68Published rateFrye Regional Medical Center, Inc., Frye Regional Medical Center -Alexander Campus
$26,345.96Published rateCumberland County Hospital System Inc, Highsmith-Rainey Speciality Hospital
Cumberland County Hospital System Inc
$10,979.44Published rateWellmont Health System, Holston Valley Medical Center
Wellmont Health System
$2,954.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 254 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 254 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 254 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 |
|---|---|---|
| 253-APR-DRG | High | OTHER & UNSPECIFIED GASTROINTESTINAL HEMORRHAGE |
| 253-MS-DRG | High | OTHER VASCULAR PROCEDURES WITH CC |
| 254-MS-DRG | High | OTHER VASCULAR PROCEDURES WITHOUT CC/MCC |
| 255-MS-DRG | High | UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS 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 254. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 254 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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