MS-DRG 278 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 278 by major payers:
$51,417.83
$68,990.71
$76,111.26
$80,837.84
| 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 278 | ||||||
United | 278 | $58279.58 | 1215043112 - INTEGRIS MIAMI HOSPITAL, INTEGRIS MIAMI HOSPITAL GENERATIONS PSYCH UNIT | 730584411 | OK | Psychiatric Hospital Unit (273R00000X) |
United | 278 | $69795.46 | 1992159370 - BBH BMC, LLC, BROOKWOOD MEDICAL CENTER | 474757851 | AL | Rehabilitation Hospital Unit (273Y00000X) |
United | 278 | $33206.89 | 1225146400 - METHODIST HOSPITAL LEVELLAND, COVENANT HOSPITAL LEVELLAND | 752246348 - (TX) METHODIST HOSPITAL LEVELLAND | TX | General Acute Care Hospital (282N00000X) |
United | 278 | $92526.03 | 1043394745 - MOUNT ST. MARY'S HOSPITAL OF NIAGARA FALLS, MOUNT ST. MARY'S HOSPITAL AND HEALTH CENTER | 161523353 - (NY) MOUNT ST MARYS HOSPITAL OF NIAGARA FALLS | NY | General Acute Care Hospital (282N00000X) |
United | 278 | $134369.54 | 1043402050 - CENTRAL SUFFOLK HOSPITAL, PECONIC BAY MEDICAL CENTER PROFESSIONAL GROUP PRACTICE | 111661359 - (NY) CENTRAL SUFFOLK HOSPITAL | NY | Hospitalist Physician (208M00000X) |
United | 278 | $5185.00 | 1346570710 - ARLINGTON ORTHOPEDIC AND SPINE HOSPITAL, LLC, BAYLOR SCOTT & WHITE ORTHOPEDIC AND SPINE HOSPITAL | 261578178 - (TX) ARLINGTON ORTHOPEDIC AND SPINE HOSPITAL LLC | TX | General Acute Care Hospital (282N00000X) |
United | 278 | $89674.14 | 1528442357 - UCHEALTH BROOMFIELD HOSPITAL | 473393862 - (CO) UCHEALTH BROOMFIELD HOSPITAL | CO | General Acute Care Hospital (282N00000X) |
United | 278 | $74954.43 | 1669414884 - MEMORIAL HERMANN HEALTH SYSTEM, MEMORIAL HERMANN HOSPITAL SYSTEM REHABILITATION UNIT | 741152597 - (TX) MEMORIAL HERMANN HEALTH SYSTEM | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 278 | $63583.00 | 1699777458 - SAINT MICHAEL'S MEDICAL CENTER, INC., SAINT MICHAEL'S MEDICAL CENTER | 463487442 | NJ | General Acute Care Hospital (282N00000X) |
United | 278 | $101366.85 | 1912925199 - STATEN ISLAND UNIVERSITY HOSPITAL | 112868878 - (NY) STATEN ISLAND UNIVERSITY HOSPITAL | NY | Psychiatric Hospital Unit (273R00000X) |
United | 278 | $53455.26 | 1700901873 - EAST TEXAS MEDICAL CENTER REHABILITATION HOSPITAL | 824037220 | TX | Rehabilitation Hospital (283X00000X) |
United | 278 | $91430.29 | 1073608139 - VANDERBILT UNIV. MEDICAL CENTER, TVHS | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | 278 | $55036.30 | 1194730382 - FARMERS UNION HOSPITAL ASSOCIATION, GREAT PLAINS REGIONAL MEDICAL CENTER - PSYCHIATRIC UNIT | 730579295 - (OK) FARMERS UNION HOSPITAL ASSOCIATION | OK | Psychiatric Hospital Unit (273R00000X) |
United | 278 | $128624.54 | 1033120423 - TEXAS HEALTH HUGULEY, INC., TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH | 452694620 - (TX) TEXAS HEALTH HUGULEY INC | TX | General Acute Care Hospital (282N00000X) |
United | 278 | $53455.26 | 1700901873 - EAST TEXAS MEDICAL CENTER REHABILITATION HOSPITAL | 824037220 | TX | Rehabilitation Hospital (283X00000X) |
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 278 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 278 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 278 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 |
|---|---|---|
| 277-APR-DRG | Moderate | Other Open Craniotomy |
| 277-MS-DRG | High | Cardiac Defibrillator Implant without MCC |
| 278-MS-DRG | High | Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures with MCC |
| 279-APR-DRG | High | HEPATIC COMA & OTHER MAJOR ACUTE LIVER DISORDERS |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 278. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 278 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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