MS-DRG 267 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 267 by major payers:
$63,283.82
$59,264.04
$78,755.19
$77,509.98
| 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 267 | ||||||
United | 267 | $201986.89 | 1790969509 - HARBORVIEW MEDICAL CENTER | 911631806 | WA | Chronic Disease Hospital (281P00000X) |
United | 267 | $78808.42 | 1184691610 - CAPE CANAVERAL HOSPITAL, INC. | 592477479 - (FL) CAPE CANAVERAL HOSPITAL INC | FL | General Acute Care Hospital (282N00000X) |
United | 267 | $115772.97 | 1700495389 - NAPLES HMA LLC, PHYSICIANS REGIONAL MEDICAL CENTER | 204401957 | FL | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 267 | $52623.46 | 1972542264 - GENESIS HEALTH SYSTEM, GENESIS MEDICAL CENTER DAVENPORT | 421418847 - GENESIS HEALTH SYSTEM | IA | General Acute Care Hospital (282N00000X) |
United | 267 | $81933.67 | 1437105624 - | 390987025 - (WI) COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INC | WI | Psychiatric Hospital Unit (273R00000X) |
United | 267 | $3778.46 | 1477585958 - KEARNEY CO HEALTH SERVICES, KEARNEY COUNTY HEALTH SERVICES | 476014070 - KEARNEY CO HEALTH SERVICES | NE | Critical Access Hospital (282NC0060X) |
United | 267 | $54522.76 | 1619002284 - ADVOCATE LUTHERAN GENERAL HOSPITAL | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | General Acute Care Hospital (282N00000X) |
United | 267 | $47540.00 | 1427536325 - UNIVERSITY HEALTH SHREVEPORT LLC, OCHSNER LSU HEALTH SHREVEPORT | 831173631 | LA | General Acute Care Hospital (282N00000X) |
United | 267 | $56498.25 | 1891728192 - O'CONNOR HOSPITAL | 161540394 - (NY) OCONNOR HOSPITAL | NY | Critical Access Hospital (282NC0060X) |
United | 267 | $2928.39 | 1932211851 - SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER, LAWRENCE COUNTY HOSPITAL | 640468873 | MS | Critical Access Hospital (282NC0060X) |
United | 267 | $68469.21 | 1912921198 - MARIAN HEALTH CENTER, MERCYONE SIOUXLAND MEDICAL CENTER | 311407377 | IA | Rehabilitation Hospital Unit (273Y00000X) |
United | 267 | $79768.18 | 1992876767 - COMMUNITY MEMORIAL HEALTH SYSTEM, OJAI VALLEY COMMUNITY HOSPITAL | 951683892 - COMMUNITY MEMORIAL HEALTH SYSTEM | CA | Critical Access Hospital (282NC0060X) |
United | 267 | $59450.10 | 1275523912 - NORTH ARKANSAS REGIONAL MEDICAL CENTER, NORTH ARKANSAS MEDICAL CENTER, BOONE COUNTY HOSPITAL | 710787860 - (AR) NORTH ARKANSAS REGIONAL MEDICAL CENTER | AR | General Acute Care Hospital (282N00000X) |
United | 267 | $78953.00 | 1528596889 - NORTH HOUSTON, HCA HOUSTON HEALTHCARE TOMBALL | 821349955 | TX | Psychiatric Hospital Unit (273R00000X) |
United | 267 | $119115.92 | 1366932162 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY, UCHEALTH EMERGENCY ROOM - THORNTON | 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 |
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MS-DRG 267 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 267 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 267 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 |
|---|---|---|
| 266-MS-DRG | High | Endovascular Cardiac Valve Replacement and Supplement Procedures with MCC |
| 267-MS-DRG | High | Endovascular Cardiac Valve Replacement and Supplement Procedures without MCC |
| 268-APR-DRG | Moderate | Other Nervous System And Related Procedures |
| 268-MS-DRG | High | Aortic and Heart Assist Procedures except Pulsation Balloon 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 267. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 267 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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