MS-DRG 279 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 279 by major payers:
$35,996.11
$46,779.81
$49,851.25
$52,119.39
| 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 279 | ||||||
United | 279 | $42866.82 | 1013233741 - RCHP OTTUMWA LLC, OTTUMWA REGIONAL HEALTH CENTER | 272200283 | IA | General Acute Care Hospital (282N00000X) |
United | 279 | $34051.17 | 1013382860 - LARKIN COMMUNITY HOSPITAL PALM SPRINGS CAMPUS, LLC | 475625607 | FL | General Acute Care Hospital (282N00000X) |
United | 279 | $68867.31 | 1538239397 - NEW HANOVER REGIONAL MEDICAL CENTER | 853777599 | NC | Psychiatric Hospital (283Q00000X) |
United | 279 | $75915.00 | 1194731935 - SEVENTH-DAY ADVENTISTS LOMA LINDA UNIVERSITY MEDICAL CENTER, LOMA LINDA UNIVERSITY MEDICAL CENTER | 953522679 - SEVENTH-DAY ADVENTISTS LOMA LINDA UNIVERSITY MEDICAL CENTER INC | CA | General Acute Care Hospital (282N00000X) |
United | 279 | $25970.00 | 1144778556 - TEXAS HEALTH SEAY BEHAVIORAL HEALTH HOSPITAL | 752771569 - (TX) MOTHER FRANCES HOSPITAL-WINNSBORO | TX | Psychiatric Hospital (283Q00000X) |
United | 279 | $42866.82 | 1013233741 - RCHP OTTUMWA LLC, OTTUMWA REGIONAL HEALTH CENTER | 272200283 | IA | General Acute Care Hospital (282N00000X) |
United | 279 | $57112.01 | 1699726695 - NORTHWEST ARKANSAS HOSPITALS, LLC, NORTHWEST MEDICAL CENTER | 205896848 | AR | General Acute Care Hospital (282N00000X) |
United | 279 | $68606.20 | 1891354726 - UCH-MHS, MEMORIAL HEALTH SYSTEM | 460796114 - (CO) UCH-MHS | CO | General Acute Care Hospital (282N00000X) |
United | 279 | $34051.17 | 1013382860 - LARKIN COMMUNITY HOSPITAL PALM SPRINGS CAMPUS, LLC | 475625607 | FL | General Acute Care Hospital (282N00000X) |
United | 279 | $23712.56 | 1538233549 - WINNER REGIONAL HEALTHCARE CENTER | 460274380 - (SD) WINNER REGIONAL HEALTHCARE CENTER | SD | Critical Access Hospital (282NC0060X) |
United | 279 | $58345.71 | 1073172201 - UCH-MHS, MEMORIAL HEALTH SYSTEM | 460796114 - (CO) UCH-MHS | CO | General Acute Care Hospital (282N00000X) |
United | 279 | $41674.00 | 1124074273 - METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO, LTD., L.L.P., METHODIST HOSPITAL | 742730328 | TX | General Acute Care Hospital (282N00000X) |
United | 279 | $35264.00 | 1659525236 - METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO LTD LLP, METHODIST HOSPITAL STONE OAK | 742730328 | TX | General Acute Care Hospital (282N00000X) |
United | 279 | $133857.40 | 1306013388 - SAINT FRANCIS HOSPITAL, ST. FRANCIS HOSPITAL | 133964321 - (NY) PEO MID-HUDSON VALLEY STAFFCO | NY | General Acute Care Hospital (282N00000X) |
United | 279 | $36911.48 | 1043307580 - INGALLS MEMORIAL HOSPITAL, THE INGALLS MEMORIAL HOSPITAL | 362170866 - (IL) INGALLS MEMORIAL HOSPITAL | IL | Psychiatric Hospital Unit (273R00000X) |
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 279 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 279 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 279 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 |
|---|---|---|
| 278-MS-DRG | High | Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures with MCC |
| 279-MS-DRG | High | Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures without MCC |
| 280-APR-DRG | High | ALCOHOLIC LIVER DISEASE |
| 280-MS-DRG | High | Acute Myocardial Infarction, Discharged Alive 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 279. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 279 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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