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See a sample rate comparisonMS-DRG 266 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.
ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH 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 266 by major payers:
$80,995.58
$74,019.98
$98,309.41
$97,404.94
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MS-DRG 266
5 of 25 sample ratesHigher to lower in this preview
Mount Sinai Hospital, Mount Sinai Of Queens
Mount Sinai Hospital
$203,765.07Published rateAurora Health Care Inc
$116,825.78Published rateDaviess County Hospital Swing Bed, Daviess Community Hospital Swing Bed
Daviess County Hospital
$87,465.67Published ratePhysicians Medical Center LLC
Physicians Medical Center, LLC
$48,369.71Published rateHillcrest Baptist Medical Center, Baylor Scott & White Medical Center Hillcrest
Scott & White Memorial Hospital
$9,137.00Published rate
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See a sample payer proposalMS-DRG 266 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 266 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 266 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 |
|---|---|---|
| 265-MS-DRG | High | AICD LEAD PROCEDURES |
| 266-MS-DRG | High | ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC |
| 267-APR-DRG | Moderate | Other Nervous System And Related Procedures |
| 267-MS-DRG | High | ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT 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 266. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 266 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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