MS-DRG 291 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 291 by major payers:
$15,677.63
$17,750.87
$21,277.43
$20,987.42
| 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 291 | ||||||
United | 291 | $19700.00 | 1184682874 - S P ACQUISITION CORP., GRANDVIEW MEDICAL CENTER | 620840204 | TN | General Acute Care Hospital (282N00000X) |
United | 291 | $21755.32 | 1770673535 - PRINCETON BAPTIST MEDICAL CENTER, PRINCETON BAPTIST MEDICAL CENTER | 474775351 | AL | Psychiatric Hospital Unit (273R00000X) |
United | 291 | $16310.00 | 1770671182 - NEWARK WAYNE COMMUNITY HOSPITAL | 150584188 - NEWARK WAYNE COMMUNITY HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 291 | $48726.00 | 1104913367 - CLEVELAND CLINIC FOUNDATION | 340714585 - THE CLEVELAND CLINIC FOUNDATION | OH | Chronic Disease Hospital (281P00000X) |
United | 291 | $19598.73 | 1851378038 - FAIRVIEW HEALTH SERVICES, FAIRVIEW ACUTE REHABILITATION CENTER | 410991680 - FAIRVIEW HEALTH SERVICES | MN | Rehabilitation Hospital Unit (273Y00000X) |
United | 291 | $36905.58 | 1710011382 - TEXAS HEALTH HARRIS METHODIST HOSPITAL STEPHENVILLE | 751752253 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL STEPHENVILLE | TX | Chronic Disease Hospital (281P00000X) |
United | 291 | $2859.00 | 1164403861 - HOUSTON COUNTY HEALTHCARE AUTHORITY, SOUTHEAST HEALTH MEDICAL CENTER | 636004476 | AL | General Acute Care Hospital (282N00000X) |
United | 291 | $11833.03 | 1083615587 - EPHRATA COMMUNITY HOSPITAL, WELLSPAN EPHRATA COMMUNITY HOSPITAL | 883577015 | PA | General Acute Care Hospital (282N00000X) |
United | 291 | $19506.75 | 1457458556 - FATHER FLANAGAN'S BOYS' HOME, BOYS TOWN NATIONAL RESEARCH HOSPITAL | 470376606 - (NE) FATHER FLANAGANS BOYS HOME | NE | Children's Hospital (282NC2000X) |
United | 291 | $39359.23 | 1538588389 - , MARICOPA INTEGRATED HEALTH | 860830701 | AZ | General Acute Care Hospital (282N00000X) |
United | 291 | $3593.00 | 1053340158 - WELLMONT HEALTH SYSTEM, HANCOCK COUNTY HOSPITAL | 621636465 - WELLMONT HEALTH SYSTEM | TN | Critical Access Hospital (282NC0060X) |
United | 291 | $12025.04 | 1134130289 - VALLEY MEDICAL FACILITIES, INC., VALLEY MEDICAL FACILITIES, HERITAGE VALLEY BEAVER | 251801532 - (PA) HERITAGE VALLEY HEALTH SYSTEM | PA | Psychiatric Hospital Unit (273R00000X) |
United | 291 | $36905.58 | 1205960903 - HARRIS METHODIST FORT WORTH | 756001743 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 291 | $26478.31 | 1821019514 - PROVIDENCE HEALTH SYSTEM, PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER SAN PEDRO | 421672806 | CA | Rehabilitation Hospital Unit (273Y00000X) |
United | 291 | $11833.03 | 1083615587 - EPHRATA COMMUNITY HOSPITAL, WELLSPAN EPHRATA COMMUNITY HOSPITAL | 883577015 | PA | 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 291 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 291 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 291 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 |
|---|---|---|
| 290-MS-DRG | High | Acute and Subacute Endocarditis without CC/MCC |
| 291-MS-DRG | High | Heart Failure and Shock with MCC |
| 292-APR-DRG | Moderate | Other Percutaneous Intracranial Procedures |
| 292-MS-DRG | High | Heart Failure and Shock with CC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 291. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 291 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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