MS-DRG 254 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 254 by major payers:
$21,884.77
$24,424.46
$29,144.22
$29,574.55
| 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 254 | ||||||
United | 254 | $77026.07 | 1790969269 - THE NEW YORK AND PRESBYTERIAN HOSPITAL, NEW YORK-PRESBYTERIAN HOSPITAL | 133957095 - (NY) THE NEW YORK AND PRESBYTERIAN HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 254 | $33849.14 | 1427447697 - VANDERBILT UNIVERSITY HOSPITAL | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | 254 | $20249.31 | 1659603975 - METROPOLITAN HOSPITAL, METRO HEALTH HOSPITAL | 380593405 - METROPOLITAN HOSPITAL | MI | General Acute Care Hospital (282N00000X) |
United | 254 | $10979.44 | 1982607115 - CUMBERLAND COUNTY HOSPITAL SYSTEM INC, HIGHSMITH-RAINEY SPECIALITY HOSPITAL | 560845796 - CUMBERLAND COUNTY HOSPITAL SYSTEM INC | NC | Special Hospital (284300000X) |
United | 254 | $37145.00 | 1629023502 - HCA HEALTHONE LLC, SWEDISH MEDICAL CENTER | 841321373 | CO | Rehabilitation Hospital Unit (273Y00000X) |
United | 254 | $27433.66 | 1598781486 - NUMC DEPARTMENT OF NEPHROLOGY, FPP | 113465690 | NY | General Acute Care Hospital (282N00000X) |
United | 254 | $7536.00 | 1104857119 - PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA, JACKSON NORTH MEDICAL CENTER | 591713947 - (FL) PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY FLORIDA | FL | General Acute Care Hospital (282N00000X) |
United | 254 | $17626.88 | 1083041917 - STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER, UNIVERSITY OF MISSISSIPPI CENTER - GRENADA PSYCH | 646008520 | MS | Psychiatric Hospital (283Q00000X) |
United | 254 | $6900.00 | 1356675003 - LAKE HOSPITAL SYSTEM, INC, LAKE HEALTH | 341425870 - (OH) UNIVERSITY HOSPITALS HEALTH SYSTEM INC | OH | General Acute Care Hospital (282N00000X) |
United | 254 | $30698.68 | 1003819475 - FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC., FROEDTERT BLUEMOUND REHABILITATION HOSPITAL | 390987025 - (WI) COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INC | WI | Rehabilitation Hospital Unit (273Y00000X) |
United | 254 | $26177.44 | 1417194184 - EMORY UNIVERSITY HOSPITAL | 580566256 - (GA) EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | 254 | $27537.21 | 1851305619 - FRYE REGIONAL MEDICAL CENTER, INC., FRYE REGIONAL MEDICAL CENTER -ALEXANDER CAMPUS | 352547114 | NC | General Acute Care Hospital (282N00000X) |
United | 254 | $26345.96 | 1851305619 - FRYE REGIONAL MEDICAL CENTER, INC., FRYE REGIONAL MEDICAL CENTER -ALEXANDER CAMPUS | 352547114 | NC | General Acute Care Hospital (282N00000X) |
United | 254 | $30618.23 | 1336162874 - LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER | 930386793 - LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER PAYROLL DEPT | OR | Psychiatric Hospital Unit (273R00000X) |
United | 254 | $10907.86 | 1114962842 - POST ACUTE MEDICAL AT LULING LLC, PAM SPECIALTY HOSPITAL OF LULING | 383743549 - (TX) POST ACUTE MEDICAL AT LULING LLC | TX | Rehabilitation Hospital (283X00000X) |
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 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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