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See a sample rate comparisonMS-DRG 268 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.
AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON 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 268 by major payers:
$75,650.06
$80,579.80
$98,264.30
$104,175.75
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MS-DRG 268
5 of 25 sample ratesHigher to lower in this preview
Saint Francis Hospital, St. Francis Hospital
Peo Mid-Hudson Valley Staffco
$278,525.65Published rateThe Presbyterian Hospital, Novant Health Huntersville Medical Center
Presbyterian Hospital
$136,985.84Published rateSteward Sebastian River Medical Center, Inc.
$100,434.06Published rateSt. Vincent'S Birmingham, Ascension St. Vincent'S Birmingham
St Vincents Birmingham
$69,180.32Published rateMurphy Medical Center Inc, Erlanger Murphy Medical Center
Murphy Medical Center Inc
$15,193.25Published rate
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See a sample payer proposalMS-DRG 268 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 268 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 268 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 |
|---|---|---|
| 267-APR-DRG | Moderate | Other Nervous System And Related Procedures |
| 267-MS-DRG | High | ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC |
| 268-MS-DRG | High | AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC |
| 269-APR-DRG | Moderate | Other Nervous System And Related Procedures |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 268. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 268 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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