MS-DRG 285 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 285 by major payers:
$7,939.68
$8,808.86
$9,253.04
$9,529.07
| 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 285 | ||||||
United | 285 | $1800.00 | 1669403192 - NACOGDOCHES COUNTY HOSPITAL DISTRICT, NACOGDOCHES MEMORIAL HOSPITAL | 871142127 - (TX) LION STAR NACOGDOCHES HOSPITAL, LLC DBA NACOGDOCHES MEMORIAL HOSPITAL | TX | Rural Acute Care Hospital (282NR1301X) |
United | 285 | $9950.16 | 1003260480 - BBH BMC, LLC, BROOKWOOD MEDICAL CENTER | 474757851 | AL | General Acute Care Hospital (282N00000X) |
United | 285 | $3505.70 | 1326339862 - VALLEY MEDICAL FACILITIES, INC, HERITAGE VALLEY KENNEDY | 251801532 - (PA) HERITAGE VALLEY HEALTH SYSTEM | PA | Psychiatric Hospital Unit (273R00000X) |
United | 285 | $6935.14 | 1790767812 - SAINT LUKES SOUTH HOSPITAL, INC. | 481203262 - SAINT LUKES SOUTH HOSPITAL INC | KS | Rehabilitation Hospital Unit (273Y00000X) |
United | 285 | $5326.00 | 1497910012 - HUMC OPCO LLC, HOBOKEN UNIVERSITY MEDICAL CENTER | 452147328 - (NJ) HUMC OPCO LLC (D/B/A CAREPOINT HEALTH - HOBOKEN UNIVERSITY MED CENTER) | NJ | Rehabilitation Hospital Unit (273Y00000X) |
United | 285 | $13421.38 | 1629637608 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 285 | $7749.37 | 1144490160 - JORDAN VALLEY MEDICAL CENTER LP | 820588653 | UT | Rehabilitation Hospital Unit (273Y00000X) |
United | 285 | $6897.66 | 1679504955 - CUYAHOGA FALLS GENERAL HOSPITAL | 263536780 - (OH) WESTERN RESERVE HOSPITAL, LLC | OH | General Acute Care Hospital (282N00000X) |
United | 285 | $6721.79 | 1053375576 - BAPTIST MEMORIAL HOSPITAL NORTH MISSISSIPPI, INC | 640772726 - BAPTIST MEMORIAL HOSPITAL-NORTH MISSISSIPPI INC | MS | General Acute Care Hospital (282N00000X) |
United | 285 | $5684.56 | 1427069632 - EDWARD HOSPITAL | 363297173 - (IL) EDWARD HOSPITAL | IL | General Acute Care Hospital (282N00000X) |
United | 285 | $5043.66 | 1437175734 - VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY, VCU MEDICAL CENTER | 541848065 | VA | General Acute Care Hospital (282N00000X) |
United | 285 | $12124.94 | 1811929151 - SAINT FRANCIS HOSPITAL, ST. FRANCIS HOSPITAL-BARTLETT | 752804737 - (TN) SAINT FRANCIS HOSPITAL | TN | General Acute Care Hospital (282N00000X) |
United | 285 | $1320.32 | 1427128404 - ST. VINCENT WILLIAMSPORT HOSPITAL, ASCENSION ST. VINCENT WILLIAMSPORT | 350784551 - (IN) ST VINCENT WILLIAMSPORT HOSPITAL INC | IN | Critical Access Hospital (282NC0060X) |
United | 285 | $10280.91 | 1720078041 - BAY COUNTY HEALTH SYSTEM, LLC, ASCENSION SACRED HEART BAY | 900799724 | FL | General Acute Care Hospital (282N00000X) |
United | 285 | $24012.58 | 1952332801 - THE NEW YORK AND PRESBYTERIAN HOSPITAL, NEW YORK-PRESBYTERIAN HOSPITAL | 133957095 - (NY) THE NEW YORK AND PRESBYTERIAN HOSPITAL | NY | 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 285 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 285 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 285 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 |
|---|---|---|
| 284-APR-DRG | High | DISORDERS OF GALLBLADDER & BILIARY TRACT |
| 284-MS-DRG | High | Acute Myocardial Infarction, Expired with CC |
| 285-MS-DRG | High | Acute Myocardial Infarction, Expired without CC/MCC |
| 286-MS-DRG | High | Circulatory Disorders except AMI, With Cardiac Catheterization 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 285. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 285 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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