MS-DRG 269 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 269 by major payers:
$48,221.44
$51,231.42
$66,039.98
$67,079.38
| 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 269 | ||||||
United | 269 | $49489.62 | 1518945799 - FORT SANDERS REGIONAL MEDICAL CENTER, PATRICIA NEAL REHABILITATION CENTER | 620528340 - (TN) FORT SANDERS REGIONAL MEDICAL CENTER | TN | Rehabilitation Hospital Unit (273Y00000X) |
United | 269 | $8620.00 | 1104822915 - BAYLOR MEDICAL CENTER AT IRVING, BAYLOR SCOTT & WHITE MEDICAL CENTER - IRVING | 752586857 - (TX) BAYLOR MEDICAL CENTER AT IRVING | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 269 | $72871.00 | 1285725440 - UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER, UCSF MEDICAL CENTER | 943281657 | CA | General Acute Care Hospital (282N00000X) |
United | 269 | $18024.50 | 1174523815 - VICTORIA HEALTHCARE INC, SELECT SPECIALTY HOSPITAL - MIAMI | 251897325 - (FL) VICTORIA HEALTHCARE INC | FL | Long Term Care Hospital (282E00000X) |
United | 269 | $74056.96 | 1982789046 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 269 | $4158.00 | 1568649697 - MOUNTAIN STATES HEALTH ALLIANCE, RUSSELL COUNTY PSYCHIATRIC UNIT | 620476282 - MOUNTAIN STATES HEALTH ALLIANCE | VA | Psychiatric Hospital Unit (273R00000X) |
United | 269 | $3949.00 | 1871599308 - RUSSELL COUNTY MEDICAL CENTER, INC, RUSSELL COUNTY MEDICAL CENTER | 620476282 - MOUNTAIN STATES HEALTH ALLIANCE | VA | Psychiatric Hospital Unit (273R00000X) |
United | 269 | $131436.51 | 1659787554 - BANNER HEALTH, BANNER FORT COLLINS MEDICAL CENTER | 450233470 - BANNER HEALTH | CO | General Acute Care Hospital (282N00000X) |
United | 269 | $44278.17 | 1265549646 - NORTH MISSISSIPPI MEDICAL CENTER, INC., NORTH MS MED PSYCH UNIT | 640662976 - NORTH MISSISSIPPI MEDICAL CENTER INC | MS | Psychiatric Hospital Unit (273R00000X) |
United | 269 | $38856.78 | 1063900975 - MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC., MCCURTAIN MEMORIAL HOSPITAL | 736617937 - (OK) MCCURTAIN MEMORIAL MEDICAL MANAGEMENT INC | OK | Critical Access Hospital (282NC0060X) |
United | 269 | $2500.00 | 1073516019 - DREW COUNTY MEMORIAL HOSPITAL | 352414105 - (AR) DREW MEMORIAL HOSPITAL INC | AR | General Acute Care Hospital (282N00000X) |
United | 269 | $72603.02 | 1801262423 - SMSJ TUCSON HOLDINGS LLC, ST. JOSEPHS HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 269 | $29703.77 | 1528301900 - PRIME HEALTHCARE SERVICES, PROVIDENCE MEDICAL CENTER | 462162669 | KS | General Acute Care Hospital (282N00000X) |
United | 269 | $47648.33 | 1518513340 - OCHSNER MORGAN CITY LLC, OCHSNER ST. MARY | 842237042 | LA | Rehabilitation Hospital Unit (273Y00000X) |
United | 269 | $31800.23 | 1649794421 - POTTSTOWN HOSPITAL, LLC, POTTSTOWN HOSPITAL | 822132538 | PA | 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 269 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 269 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 269 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 |
|---|---|---|
| 268-APR-DRG | Moderate | Other Nervous System And Related Procedures |
| 268-MS-DRG | High | Aortic and Heart Assist Procedures except Pulsation Balloon with MCC |
| 269-MS-DRG | High | Aortic and Heart Assist Procedures except Pulsation Balloon without MCC |
| 270-APR-DRG | Moderate | Other Open Craniotomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 269. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 269 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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