MS-DRG 296 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 296 by major payers:
$19,355.99
$20,670.49
$25,626.88
$26,115.64
| 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 296 | ||||||
United | 296 | $37646.98 | 1942784715 - IACC/EHI NW, LLC, INTEGRIS COMMUNITY HOSPITAL - DEL CITY | 352635546 - (OK) IACCEHI NW LLC | OK | General Acute Care Hospital (282N00000X) |
United | 296 | $10629.21 | 1588631311 - SURGICAL SPECIALTY CENTER OF BATON ROUGE, LLC, SURGICAL SPECIALTY CENTER OF BATON ROUGE | 263120962 - (LA) SURGICAL SPECIALTY CENTER OF BATON ROUGE, LLC | LA | General Acute Care Hospital (282N00000X) |
United | 296 | $54827.42 | 1700829199 - SCRIPPS HEALTH, SCRIPPS MEMORIAL HOSPITAL ENCINITAS | 951684089 - SCRIPPS HEALTH | CA | General Acute Care Hospital (282N00000X) |
United | 296 | $18842.41 | 1376596569 - WOMENS CENTER OF NORTHWEST ARKANSAS LLC, WILLOW CREEK WOMEN'S HOSPITAL | 205896848 | AR | General Acute Care Hospital (282N00000X) |
United | 296 | $37688.12 | 1396764353 - ALAMEDA HEALTH SYSTEM, HIGHLAND GENERAL HOSPITAL | 943302014 | CA | General Acute Care Hospital (282N00000X) |
United | 296 | $11843.95 | 1447303227 - GULF HEALTH HOSPITALS, INC, THOMAS HOSPITAL | 630891904 - (AL) GULF HEALTH HOSPITALS INC | AL | General Acute Care Hospital (282N00000X) |
United | 296 | $27033.59 | 1164445250 - AVERA MCKENNAN, AVERA MCKENNAN BEHAVIORAL HEALTH SERVICES | 460224743 - AVERA MCKENNAN | SD | Psychiatric Hospital Unit (273R00000X) |
United | 296 | $18993.85 | 1679628838 - GENESIS MEDICAL CENTER | 421418847 - GENESIS HEALTH SYSTEM | IA | General Acute Care Hospital (282N00000X) |
United | 296 | $42707.19 | 1477807436 - UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS | 753175630 | TX | General Acute Care Hospital (282N00000X) |
United | 296 | $18842.41 | 1376596569 - WOMENS CENTER OF NORTHWEST ARKANSAS LLC, WILLOW CREEK WOMEN'S HOSPITAL | 205896848 | AR | General Acute Care Hospital (282N00000X) |
United | 296 | $20144.13 | 1235250663 - ERLANGER MEDICAL CENTER | 883616696 - ERLANGER HEALTH | TN | Critical Access Hospital (282NC0060X) |
United | 296 | $39305.21 | 1275732661 - PROVIDENCE HEALTH & SERVICES WASHINGTON, PROVIDENCE CENTRALIA HOSPITAL | 352346161 | WA | General Acute Care Hospital (282N00000X) |
United | 296 | $19340.13 | 1639351935 - SOUTHEAST HOSPITAL, SOUTHEAST MISSOURI HOSPITAL ASSOCIATION | 430654874 - (MO) SOUTHEAST HOSPITAL | MO | Psychiatric Hospital Unit (273R00000X) |
United | 296 | $32230.60 | 1649615220 - PROVIDENCE HEALTH & SERVICES-WA, PROVIDENCE REGIONAL MEDICAL CENTER EVERETT | 352346161 | WA | Hospitalist Physician (208M00000X) |
United | 296 | $63877.94 | 1548301112 - DESERT REGIONAL MEDICAL CENTER, INC., DESERT REGIONAL MEDICAL CENTER | 752694137 | CA | 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 296 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 296 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 296 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 |
|---|---|---|
| 295-MS-DRG | High | Deep Ven Thrombophlebitis without CC/MCC |
| 296-MS-DRG | High | Cardiac Arrest, Unexplained with MCC |
| 297-MS-DRG | High | Cardiac Arrest, Unexplained 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 296. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 296 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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