MS-DRG 297 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 297 by major payers:
$9,678.08
$9,416.42
$11,251.82
$11,640.93
| 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 297 | ||||||
United | 297 | $7275.00 | 1780747097 - FREEMAN-OAK HILL HEALTH SYSTEM | 431704371 - FREEMAN HEALTH SYSTEM | MO | General Acute Care Hospital (282N00000X) |
United | 297 | $22863.47 | 1770768202 - THE NEW YORK AND PRESBYTERIAN HOSPITAL, NEWYORK-PRESBYTERIAN HOSPITAL | 133957095 - (NY) THE NEW YORK AND PRESBYTERIAN HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 297 | $2805.00 | 1346379534 - TAKOMA REGIONAL HOSPITAL,INC, GREENEVILLE COMMUNITY HOSPITAL REHABILITATION | 510603966 - TAKOMA REGIONAL HOSPITAL INC | TN | Rehabilitation Hospital Unit (273Y00000X) |
United | 297 | $14123.30 | 1255412789 - TEXAS HEALTH PRESBYTERIAN HOSPITAL DALLAS | 751047527 - (TX) TEXAS HEALTH PRESBYTERIAN HOSPITAL DALLAS | TX | Psychiatric Hospital Unit (273R00000X) |
United | 297 | $12719.16 | 1467537506 - CARONDELET HEALTH NETWORK, ST. MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 297 | $13213.13 | 1669461281 - INTERMOUNTAIN FRONT RANGE, INC. | 841103606 - (CO) SCL HEALTH - FRONT RANGE INC | CO | General Acute Care Hospital (282N00000X) |
United | 297 | $23395.00 | 1720379092 - CLEVELAND CLINIC | 340714585 - THE CLEVELAND CLINIC FOUNDATION | OH | Special Hospital (284300000X) |
United | 297 | $5574.50 | 1447230388 - OPELOUSAS GENERAL HOSPITAL AUTHORITY | 720708111 | LA | General Acute Care Hospital (282N00000X) |
United | 297 | $4424.50 | 1396394961 - CLHG-ACADIAN, LLC, ACADIAN MEDICAL CENTER | 825359949 | LA | General Acute Care Hospital (282N00000X) |
United | 297 | $8406.79 | 1942541248 - PHOENIXVILLE HOSPITAL COMPANY LLC, REGIONAL REHAB CENTER AT PHOENIXVILLE HOSPITAL | 822062413 | PA | Rehabilitation Hospital Unit (273Y00000X) |
United | 297 | $4424.50 | 1396394961 - CLHG-ACADIAN, LLC, ACADIAN MEDICAL CENTER | 825359949 | LA | General Acute Care Hospital (282N00000X) |
United | 297 | $7804.04 | 1104019215 - HOLYOKE MEDICAL CENTER, INC. | 222520073 - (MA) HOLYOKE MEDICAL CENTER INC | MA | Hospitalist Physician (208M00000X) |
United | 297 | $16367.44 | 1316096266 - WINTER HAVEN HOSPITAL INC, MID FLORIDA MEDICAL SERVIES | 590724462 - (FL) WINTER HAVEN HOSPITAL INC | FL | Rehabilitation Hospital Unit (273Y00000X) |
United | 297 | $21823.75 | 1598864118 - NYU HOSPITALS CENTER | 133971298 - NYU LANGONE HOSPITALS | NY | General Acute Care Hospital (282N00000X) |
United | 297 | $17998.38 | 1164648945 - LINCOLN HOSPITAL | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | 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 297 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 297 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 297 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-APR-DRG | Moderate | Other Percutaneous Intracranial Procedures |
| 296-MS-DRG | High | Cardiac Arrest, Unexplained with MCC |
| 297-MS-DRG | High | Cardiac Arrest, Unexplained with CC |
| 298-MS-DRG | High | Cardiac Arrest, Unexplained without CC/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 297. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 297 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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