MS-DRG 313 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 313 by major payers:
$8,486.85
$9,549.60
$11,756.33
$11,743.48
| 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 313 | ||||||
United | 313 | $6975.31 | 1902818883 - GRANT COUNTY PUBLIC HOSPITAL DISTRICT 1, SAMARITAN HEALTHCARE | 916001698 | WA | General Acute Care Hospital (282N00000X) |
United | 313 | $9689.00 | 1538166061 - DUKE UNIVERSITY HEALTH SYSTEM, INC., DUKE UNIVERSITY HOSPITAL | 562070036 - DUKE UNIVERSITY HEALTH SYSTEM INC | NC | Rehabilitation Hospital Unit (273Y00000X) |
United | 313 | $16061.03 | 1356960132 - TEXAS HEALTH HOSPITAL MANSFIELD | 831869297 - (TX) TEXAS HEALTH HOSPITAL MANSFIELD | TX | General Acute Care Hospital (282N00000X) |
United | 313 | $11753.08 | 1821002007 - UNIVERSITY OF CALIFORNIA IRVINE, UCI HEALTH - FOUNTAIN VALLEY | 952768729 | CA | General Acute Care Hospital (282N00000X) |
United | 313 | $12861.17 | 1568668754 - MEMORIAL HEALTH SYSTEM, MEMORIAL HOSPITAL PHYS GROUP | 460796114 - (CO) UCH-MHS | CO | General Acute Care Hospital (282N00000X) |
United | 313 | $2761.29 | 1750314720 - MORRIS COUNTY HOSPITAL | 486075497 - (KS) MORRIS COUNTY HOSPITAL | KS | Critical Access Hospital (282NC0060X) |
United | 313 | $3473.28 | 1003192311 - EL CAMPO MEMORIAL HOSPITAL | 452750258 - (TX) EL CAMPO MEMORIAL HOSPITAL | TX | General Acute Care Hospital (282N00000X) |
United | 313 | $3693.00 | 1992159925 - HOSPITAL SERVICE DISTRICT NO 1 OF IBERIA PARISH, IBERIA MEDICAL CENTER | 726014963 | LA | Rehabilitation Hospital Unit (273Y00000X) |
United | 313 | $9557.55 | 1750805552 - PHOENIXVILLE HOSPITAL, LLC, PHOENIXVILLE HOSPITAL | 822062413 | PA | General Acute Care Hospital (282N00000X) |
United | 313 | $6688.56 | 1083615587 - EPHRATA COMMUNITY HOSPITAL, WELLSPAN EPHRATA COMMUNITY HOSPITAL | 883577015 | PA | General Acute Care Hospital (282N00000X) |
United | 313 | $9362.66 | 1780763284 - SSM HEALTH CARE ST. LOUIS, SSM HEALTH ST. MARY'S HOSPITAL - ST. LOUIS | 431343281 - SSM HEALTH CARE ST LOUIS | MO | Psychiatric Hospital Unit (273R00000X) |
United | 313 | $7798.24 | 1154406254 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 313 | $9171.00 | 1578652434 - NEWPORT HOSPITAL, NEWPORT HOSPITAL REHAB UNIT | 50258914 - (RI) NEWPORT HOSPITAL | RI | Rehabilitation Hospital Unit (273Y00000X) |
United | 313 | $27581.47 | 1821484262 - HDMC HOLDINGS, LLC, HI-DESERT MEDICAL CENTER | 473550779 | CA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 313 | $12702.79 | 1720454341 - SMSJ TUCSON HOLDINGS LLC, BRIDGES GEROPSYCHIATRIC PROGRAM AT ST. MARYS HOSPITAL | 474131755 | AZ | 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 313 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 313 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 313 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 |
|---|---|---|
| 312-APR-DRG | High | SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL & CONNECTIVE TISSUE DIAGNOSES |
| 312-MS-DRG | High | Syncope and Collapse |
| 313-MS-DRG | High | Chest Pain |
| 314-APR-DRG | High | FOOT & TOE 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 313. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 313 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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