MS-DRG 286 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 286 by major payers:
$24,942.96
$27,203.87
$31,572.56
$33,321.57
| 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 286 | ||||||
United | 286 | $24149.71 | 1891728192 - O'CONNOR HOSPITAL | 161540394 - (NY) OCONNOR HOSPITAL | NY | Critical Access Hospital (282NC0060X) |
United | 286 | $1200.00 | 1649262791 - SABINE MEDICAL CENTER INC, SABINE MEDICAL CENTER | 262074318 | LA | General Acute Care Hospital (282N00000X) |
United | 286 | $32484.89 | 1225195464 - CANNON COUNTY HOSPITAL LLC, STONES RIVER HOSPITAL | 474063232 | TN | Rehabilitation Hospital Unit (273Y00000X) |
United | 286 | $13798.00 | 1356987630 - HCA-HEALTHONE, LLC | 841321373 | CO | General Acute Care Hospital (282N00000X) |
United | 286 | $36631.78 | 1255640819 - VHS OF ARROWHEAD, INC., ABRAZO ARIZONA HEART HOSPITAL | 621811285 | AZ | General Acute Care Hospital (282N00000X) |
United | 286 | $16713.48 | 1740413988 - MERCY HOSPITAL LEBANON, MERCY HOSPITAL LEBANON | 431767432 - MERCY HOSPITAL LEBANON | MO | General Acute Care Hospital (282N00000X) |
United | 286 | $14986.95 | 1215960315 - HENDRY COUNTY HOSPITAL AUTHORITY, HENDRY REGIONAL MEDICAL CENTER | 596002318 - (FL) HENDRY COUNTY HOSPITAL AUTHORITY | FL | Critical Access Hospital (282NC0060X) |
United | 286 | $19073.18 | 1295789907 - CAROLINAS MEDICAL CENTER | 561398929 | NC | General Acute Care Hospital (282N00000X) |
United | 286 | $16775.40 | 1073988994 - THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY, ATRIUM HEALTH STANLY | 560529945 | NC | General Acute Care Hospital (282N00000X) |
United | 286 | $48169.03 | 1558521070 - BANNER BOSWELL MEDICAL CENTER | 900389314 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 286 | $48169.03 | 1558521070 - BANNER BOSWELL MEDICAL CENTER | 900389314 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 286 | $49874.50 | 1619176997 - PROVIDENCE HEALTH & SERVICES WASHINGTON | 910567732 | WA | General Acute Care Hospital (282N00000X) |
United | 286 | $5761.00 | 1386647717 - MSH PARTNERS, LLC, BAYLOR SCOTT & WHITE MEDICAL CENTER - UPTOWN | 752829613 | TX | General Acute Care Hospital (282N00000X) |
United | 286 | $87618.50 | 1396818209 - COASTAL CAROLINA MEDICAL CENTER, INC., COASTAL CAROLINA HOSPITAL- REHABILITATION UNIT | 300151925 - (SC) COASTAL CAROLINA MEDICAL CENTER INC | SC | Rehabilitation Hospital Unit (273Y00000X) |
United | 286 | $23329.00 | 1275570376 - MONTGOMERY REGIONAL HOSPITAL INC, LEWISGALE HOSPITAL MONTGOMERY | 540889154 | VA | 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 286 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 286 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 286 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 |
|---|---|---|
| 285-MS-DRG | High | Acute Myocardial Infarction, Expired without CC/MCC |
| 286-MS-DRG | High | Circulatory Disorders except AMI, With Cardiac Catheterization with MCC |
| 287-MS-DRG | High | Circulatory Disorders except AMI, With Cardiac Catheterization without 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 286. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 286 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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