MS-DRG 260 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 260 by major payers:
$40,272.86
$42,296.77
$48,549.22
$53,098.82
| 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 260 | ||||||
United | 260 | $74388.00 | 1700981131 - UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER, UCSF MEDICAL CENTER | 943281657 | CA | General Acute Care Hospital (282N00000X) |
United | 260 | $132800.93 | 1912938788 - DESERT REGIONAL MEDICAL CENTER, INC., DESERT REGIONAL MEDICAL CENTER | 752694137 | CA | Rehabilitation Hospital Unit (273Y00000X) |
United | 260 | $57023.19 | 1447898622 - VHS OF ARROWHEAD, INC., ABRAZO SURPRISE HOSPITAL | 621811285 | AZ | General Acute Care Hospital (282N00000X) |
United | 260 | $40125.03 | 1174706576 - LUTHERAN MUSCULOSKELETAL CENTER LLC, THE ORTHOPAEDIC HOSPITAL OF LUTHERAN HEALTH NETWORK | 261483076 - (IN) LUTHERAN MUSCULOSKELETAL CENTER LLC | IN | General Acute Care Hospital (282N00000X) |
United | 260 | $26484.78 | 1124272547 - ADVOCATE CONDELL MEDICAL CENTER | 262525968 - (IL) ADVOCATE HEALTH CARE NETWORK | IL | General Acute Care Hospital (282N00000X) |
United | 260 | $92387.53 | 1174768071 - BETH ISRAEL MEDICAL CENTER, KINGS HIGHWAY DIVISION | 135564934 - (NY) BETH ISRAEL MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 260 | $23362.00 | 1831112895 - HOUSTON NORTHWEST PARTNERS, LTD., HOUSTON NORTHWEST MEDICAL CENTER | 261512163 | TX | General Acute Care Hospital (282N00000X) |
United | 260 | $23522.00 | 1841562709 - HH KILLEEN HEALTH SYSTEM LLC, SETON MEDICAL CENTER HARKER HEIGHTS | 272814378 - (TX) HH KILLEEN HEALTH SYSTEM LLC | TX | General Acute Care Hospital (282N00000X) |
United | 260 | $35675.78 | 1679628838 - GENESIS MEDICAL CENTER | 421418847 - GENESIS HEALTH SYSTEM | IA | General Acute Care Hospital (282N00000X) |
United | 260 | $8941.00 | 1023062098 - HCA HEALTHONE LLC, ROSE MEDICAL CENTER | 841321373 | CO | General Acute Care Hospital (282N00000X) |
United | 260 | $29487.47 | 1942276423 - MEADVILLE MEDICAL CENTER | 251512436 - (PA) MEADVILLE MEDICAL CENTER | PA | General Acute Care Hospital (282N00000X) |
United | 260 | $500.00 | 1851642540 - HOUSTON COUNTY COMMUNITY HOSPITAL | 462490116 | TN | General Acute Care Hospital (282N00000X) |
United | 260 | $25338.07 | 1427021625 - POTTSTOWN HOSPITAL COMPANY LLC, POTTSTOWN MEMORIAL MEDICAL CENTER | 822132538 | PA | Psychiatric Hospital Unit (273R00000X) |
United | 260 | $108705.00 | 1528292596 - WESTCHESTER COUNTY HEALTHCARE CORP, ACT PROGRAM | 133964321 - (NY) PEO MID-HUDSON VALLEY STAFFCO | NY | General Acute Care Hospital (282N00000X) |
United | 260 | $45220.71 | 1710051941 - FRANCISCAN HEALTH MICHIGAN CITY, FRANCISCAN ST. ANTHONY HEALTH - MICHIGAN CITY | 350876394 - (IN) FRANCISCAN HEALTH MICHIGAN CITY | IN | 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 |
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MS-DRG 260 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 260 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 260 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 |
|---|---|---|
| 259-MS-DRG | High | Cardiac Pacer Device Replacement without MCC |
| 260-MS-DRG | High | Cardiac Pacer Revision except Device Replacement with MCC |
| 261-APR-DRG | High | MAJOR BILIARY TRACT PROCEDURES |
| 261-MS-DRG | High | Cardiac Pacer Revision except Device Replacement with CC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 260. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 260 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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