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See a sample rate comparisonMS-DRG 269 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 WITHOUT 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 269 by major payers:
$48,221.44
$51,231.42
$66,039.98
$67,079.38
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MS-DRG 269
5 of 25 sample ratesHigher to lower in this preview
NYU Hospitals Center
NYU Langone Hospitals
$138,892.48Published rateCarondelet Health Network, St Mary'S Hospital
$74,056.96Published rateOchsner Morgan City LLC, Ochsner St. Mary
$47,648.33Published ratePrime Healthcare Services, Providence Medical Center
$29,703.77Published rateDrew County Memorial Hospital
Drew Memorial Hospital Inc
$2,500.00Published rate
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See a sample payer proposalMS-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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