MS-DRG 312 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 312 by major payers:
$9,744.49
$11,715.58
$13,810.25
$14,168.67
| 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 312 | ||||||
United | 312 | $22791.00 | 1043267727 - SAMARITAN HOSPITAL OF TROY, NEW YORK, SAMARITAN BEHAVIORAL HEALTH SERVICES | 141338544 - SAMARITAN HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 312 | $14013.12 | 1316975626 - SAINT VINCENT HEALTH CENTER | 250965547 - (PA) HIGHMARK HEALTH | PA | Psychiatric Hospital Unit (273R00000X) |
United | 312 | $18400.41 | 1821216391 - DELRAY MEDICAL CENTER, INC., PINECREST REHABILITATION HOSPITAL | 752922687 | FL | Rehabilitation Hospital Unit (273Y00000X) |
United | 312 | $15787.95 | 1679707087 - UNIVERSITY OF WASHINGTON MEDICAL CENTER | 916001537 | WA | General Acute Care Hospital (282N00000X) |
United | 312 | $18400.41 | 1821216391 - DELRAY MEDICAL CENTER, INC., PINECREST REHABILITATION HOSPITAL | 752922687 | FL | Rehabilitation Hospital Unit (273Y00000X) |
United | 312 | $16131.04 | 1063071033 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 312 | $2000.00 | 1811213366 - DEQUINCY MEMORIAL HOSPITAL INC | 364911029 - (LA) CLHGDEQUINCY LLC | LA | Psychiatric Hospital Unit (273R00000X) |
United | 312 | $12375.95 | 1396109500 - GOTTLIEB MEMORIAL HOSPITAL | 362379649 - (IL) GOTTLIEB MEMORIAL HOSPITAL | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 312 | $15390.63 | 1053496026 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 312 | $17913.92 | 1912085184 - ALEGENT HEALTH IMMANUEL MEDICAL CENTER, CHI HEALTH IMMANUEL | 470376615 - ALEGENT HEALTH-IMMANUEL MEDICAL CENTER | NE | General Acute Care Hospital (282N00000X) |
United | 312 | $21439.21 | 1376890020 - PENINUSLA EMERGENCY PHYSICIAN | 541547408 - SENTARA HOSPITALS | VA | General Acute Care Hospital (282N00000X) |
United | 312 | $6926.83 | 1730134123 - RIVERVIEW REGIONAL MEDICAL CENTER LLC, RIVERVIEW REGIONAL MEDICAL CENTER | 472228529 | AL | General Acute Care Hospital (282N00000X) |
United | 312 | $12168.87 | 1568416311 - ASCENSION BORGESS HOSPITAL | 381360526 - (MI) ASCENSION BORGESS HOSPITAL | MI | General Acute Care Hospital (282N00000X) |
United | 312 | $15173.79 | 1932654704 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH SURGERY/ORTHOPEDICS CLINIC | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 312 | $6102.14 | 1285742536 - GREELEY COUNTY HEALTH SERVICES, INC., GREELEY COUNTY HOSPITAL | 300078435 - (KS) GREELEY COUNTY HEALTH SERVICES INC | KS | Critical Access Hospital (282NC0060X) |
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 312 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 312 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 312 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 |
|---|---|---|
| 311-MS-DRG | High | Angina Pectoris |
| 312-MS-DRG | High | Syncope and Collapse |
| 313-APR-DRG | High | KNEE & LOWER LEG PROCEDURES EXCEPT FOOT |
| 313-MS-DRG | High | Chest Pain |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 312. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 312 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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