MS-DRG 257 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 257 by major payers:
$14,025.38
$12,564.96
$14,375.48
$15,151.45
| 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 257 | ||||||
United | 257 | $15914.01 | 1578526695 - ST. JOHN'S RIVERSIDE HOSPITAL | 131740126 - (NY) ST JOHNS RIVERSIDE HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 257 | $9804.66 | 1417032145 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 257 | $17162.14 | 1538174347 - LCMC HEALTH HOLDINGS INC, EAST JEFFERSON GENERAL HOSPITAL | 621596506 | LA | General Acute Care Hospital (282N00000X) |
United | 257 | $14923.00 | 1891712485 - NASSAU HEALTH CARE CORPORATION, NASSAU UNIVER MED CENTER - REHAB | 113465690 | NY | Rehabilitation Hospital Unit (273Y00000X) |
United | 257 | $14766.29 | 1609869916 - APPALACHIAN REGIONAL HEALTHCARE, INC., HAZARD ARH REGIONAL MEDICAL CENTER | 520795508 - APPALACHIAN REGIONAL HEALTHCARE INC | KY | General Acute Care Hospital (282N00000X) |
United | 257 | $7989.64 | 1992776405 - HCA HEALTH SERVICES OF TENNESSEE, INC., TRISTAR STONECREST MEDICAL CENTER | 621113737 - HCA HEALTH SERVICES OF TENNESSEE INC | TN | General Acute Care Hospital (282N00000X) |
United | 257 | $12707.79 | 1396015251 - THE METHODIST HOSPITALS, INC | 350868133 - METHODIST HOSPITALS INC | IN | Psychiatric Hospital Unit (273R00000X) |
United | 257 | $14171.08 | 1467129700 - VHS SAN ANTONIO PARTNERS, LLC, NORTHEAST BAPTIST HOSPITAL | 760714523 | TX | General Acute Care Hospital (282N00000X) |
United | 257 | $12961.92 | 1083112023 - PIPELINE EAST DALLAS, LLC, WHITE ROCK MEDICAL CENTER | 823626083 - (TX) PIPELINE EAST DALLAS, LLC | TX | General Acute Care Hospital (282N00000X) |
United | 257 | $6972.58 | 1164420329 - SALINA SURGICAL CENTER, LLC, SALINA SURGICAL HOSPITAL | 481199515 - (KS) SALINA SURGICAL CENTER, LLC DBA SALINA SURGICAL HOSPITAL | KS | Special Hospital (284300000X) |
United | 257 | $13899.37 | 1629025648 - SAINT THOMAS WEST HOSPITAL, ASCENSION SAINT THOMAS HOSPITAL | 620347580 - (TN) SAINT THOMAS WEST HOSPITAL | TN | General Acute Care Hospital (282N00000X) |
United | 257 | $6893.02 | 1477939296 - SELECT SPECIALTY HOSPITAL | 352498003 | GA | Special Hospital (284300000X) |
United | 257 | $19921.48 | 1033167051 - SOUTHWESTERN MEDICAL CENTER, LLC, SOUTHWESTERN MEDICAL CENTER | 621757662 | OK | Rehabilitation Hospital Unit (273Y00000X) |
United | 257 | $29846.53 | 1003854688 - SCRIPPS HEALTH, SCRIPPS MEMORIAL HOSPITAL ENCINITAS REHAB UNIT | 951684089 - SCRIPPS HEALTH | CA | Rehabilitation Hospital Unit (273Y00000X) |
United | 257 | $25640.33 | 1619467412 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY, UCHEALTH EMERGENCY ROOM - AURORA CENTRAL | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
MS-DRG 257 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 257 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 257 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 |
|---|---|---|
| 256-MS-DRG | High | Upper Limb and Toe Amputation for Circulatory System Disorders with CC |
| 257-MS-DRG | High | Upper Limb and Toe Amputation for Circulatory System Disorders without CC/MCC |
| 258-MS-DRG | High | Cardiac Pacer Device Replacement 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 257. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 257 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like MS-DRG 257) and we'll show you how you compare in 15 minutes or less.