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See a sample rate comparisonMS-DRG 296 Fee Schedule
Last Verified: October 2026
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.
CARDIAC ARREST, UNEXPLAINED WITH MCC
| 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
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MS-DRG 296
5 of 25 sample ratesHigher to lower in this preview
Desert Regional Medical Center, Inc., Desert Regional Medical Center
$63,877.94Published rateProvidence Health & Services Washington, Providence Centralia Hospital
$39,305.21Published rateCannon County Hospital LLC, Stones River Hospital
$26,171.80Published rateWomens Center Of Northwest Arkansas LLC, Willow Creek Women'S Hospital
$18,842.41Published ratePublic Health Trust Of Miami Dade County Florida, Jackson North Medical Center Psy
Public Health Trust Of Miami-Dade County Florida
$3,640.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-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 |
|---|---|---|
| 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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