MS-DRG 295 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 295 by major payers:
$9,981.05
$17,212.04
$12,561.63
$12,892.43
| 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 295 | ||||||
United | 295 | $9281.73 | 1053434829 - MURRAY-CALLOWAY COUNTY PUBLIC HOSPITAL CORPORATION | 610620567 | KY | General Acute Care Hospital (282N00000X) |
United | 295 | $11296.50 | 1396036695 - JORDAN VALLEY MEDICAL CENTER LP, JORDAN VALLEY MEDICAL CENTER | 820588653 | UT | Psychiatric Hospital Unit (273R00000X) |
United | 295 | $8885.33 | 1356334510 - INDIANA REGIONAL MEDICAL CENTER | 250965404 - (PA) INDIANA REGIONAL MEDICAL CENTER | PA | Rural Acute Care Hospital (282NR1301X) |
United | 295 | $83250.71 | 1891879680 - CLALLAM COUNTY PUBLIC HOSPITAL DISTRICT NO 1, FORKS COMMUNITY HOSPITAL | 916001732 | WA | Critical Access Hospital (282NC0060X) |
United | 295 | $12616.26 | 1114972007 - CANNON COUNTY HOSPITAL LLC, STONES RIVER HOSPITAL | 474063232 | TN | General Acute Care Hospital (282N00000X) |
United | 295 | $9477.00 | 1760580757 - VCU HEALTH TAPPAHANNOCK HOSPITAL | 541489410 - (VA) VCU HEALTH TAPPAHANNOCK HOSPITAL | VA | Rural Acute Care Hospital (282NR1301X) |
United | 295 | $12217.41 | 1003347279 - AHS PRYOR HOSPITAL, LLC, HILLCREST HOSPITAL PRYOR | 820651263 | OK | General Acute Care Hospital (282N00000X) |
United | 295 | $12616.26 | 1164590386 - SAINT THOMAS RUTHERFORD HOSPITAL, ASCENSION SAINT THOMAS RUTHERFORD | 620475842 - SAINT THOMAS RUTHERFORD HOSPITAL | TN | General Acute Care Hospital (282N00000X) |
United | 295 | $20463.72 | 1487220307 - MEDICAL UNIVERSITY HOSPITAL AUTHORITY, MUSC HEALTH KERSHAW MEDICAL CENTER | 571098556 - (SC) MEDICAL UNIVERSITY HOSPITAL AUTHORITY | SC | General Acute Care Hospital (282N00000X) |
United | 295 | $25423.13 | 1477807436 - UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS | 753175630 | TX | General Acute Care Hospital (282N00000X) |
United | 295 | $12455.15 | 1285295899 - AHN EMERUS WESTMORELAND LLC, AHN MCCANDLESS NEIGHBORHOOD HOSPITAL | 823697883 - (PA) AHN EMERUS WESTMORELAND LLC | PA | General Acute Care Hospital (282N00000X) |
United | 295 | $3308.00 | 1083616221 - OKMULGEE MEMORIAL HOSPITAL, INC, OKMULGEE MEMORIAL HOSPITAL | 731357965 - MUSCOGEE (CREEK) NATION DEPARTMENT OF HEALTH | OK | General Acute Care Hospital (282N00000X) |
United | 295 | $13347.50 | 1255712766 - SAINT THOMAS STONES RIVER HOSPITAL, LLC, ASCENSION SAINT THOMAS STONES RIVER | 474063232 | TN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 295 | $9407.37 | 1982629630 - MERCY HOSPITAL SOUTH, MERCY HOSPITAL SOUTH | 430980256 - (MO) MERCY HOSPITAL SOUTH | MO | Rehabilitation Hospital Unit (273Y00000X) |
United | 295 | $17777.60 | 1417105107 - ENUMCLAW REGIONAL HOSPITAL ASSOCIATION, ST ELIZABETH HOSPTIAL | 910715805 - (WA) ENUMCLAW REGIONAL HOSPITAL ASSOCIATION | WA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
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 295 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 295 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 295 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 |
|---|---|---|
| 294-APR-DRG | Moderate | Other Percutaneous Intracranial Procedures |
| 294-MS-DRG | High | Deep Ven Thrombophlebitis with CC/MCC |
| 295-MS-DRG | High | Deep Ven Thrombophlebitis without CC/MCC |
| 296-APR-DRG | Moderate | Other Percutaneous Intracranial Procedures |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 295. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 295 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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