MS-DRG 315 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 315 by major payers:
$12,146.33
$13,276.86
$15,344.44
$15,640.76
| 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 315 | ||||||
United | 315 | $21642.09 | 1558521070 - BANNER BOSWELL MEDICAL CENTER | 900389314 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 315 | $18812.05 | 1902831621 - LAKEWOOD REGIONAL MEDICAL CENTER, INC., LAKEWOOD REGIONAL MEDICAL CENTER | 752919841 - (CA) LAKEWOOD REGIONAL MEDICAL CENTER INC | CA | Psychiatric Hospital Unit (273R00000X) |
United | 315 | $19334.52 | 1104113380 - PROVIDENCE HEALTH & SERVICES, PROVIDENCE PORTLAND MEDICAL CENTER - CHILD & ADOLESCENT PSYCHIATRIC | 930386906 | OR | Psychiatric Hospital Unit (273R00000X) |
United | 315 | $12841.87 | 1144675745 - THEDACARE MEDICAL CENTER, NEW LONDON FAMILY MEDICAL CENTER, INC | 390869788 - (WI) THEDACARE MEDICAL CENTER NEW LONDON INC | WI | Critical Access Hospital (282NC0060X) |
United | 315 | $11494.00 | 1326401951 - BAYLOR REGIONAL MEDICAL CENTER AT GRAPEVINE, BAYLOR SCOTT & WHITE MEDICAL CENTER - GRAPEVINE | 751777119 - (TX) BAYLOR REGIONAL MEDICAL CENTER AT GRAPEVINE | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 315 | $19946.25 | 1134223878 - PROVIDENCE EVERETT MEDICAL CENTER, INPATIENT REHABILITATION FACILITY | 352346161 | WA | Rehabilitation Hospital Unit (273Y00000X) |
United | 315 | $10578.55 | 1801262423 - SMSJ TUCSON HOLDINGS LLC, ST. JOSEPHS HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 315 | $3350.00 | 1811023823 - BATON ROUGE GENERAL MEDICAL CENTER | 721025017 - (LA) BATON ROUGE GENERAL MEDICAL CENTER | LA | Rehabilitation Hospital Unit (273Y00000X) |
United | 315 | $11741.01 | 1548306343 - ELMHURST MEMORIAL HOSPITAL | 362167784 - (IL) ELMHURST MEMORIAL HEALTHCARE | IL | General Acute Care Hospital (282N00000X) |
United | 315 | $18838.94 | 1962723684 - PROVIDENCE SACRED HEART MEDICAL CENTER | 364640211 | WA | General Acute Care Hospital (282N00000X) |
United | 315 | $31874.30 | 1770502635 - THE NEW YORK AND PRESBYTERIAN HOSPITAL, NEW YORK-PRESBYTERIAN HOSPITAL | 133957095 - (NY) THE NEW YORK AND PRESBYTERIAN HOSPITAL | NY | Psychiatric Hospital (283Q00000X) |
United | 315 | $4120.00 | 1902280050 - JOHNSTON MEMORIAL HOSPITAL, INC, JOHNSTON MEMORIAL HOSPITAL REHABILITATION | 540544705 - JOHNSTON MEMORIAL HOSPITAL INC | VA | General Acute Care Hospital (282N00000X) |
United | 315 | $18594.23 | 1023194271 - PROVIDENCE HEALTH & SERVICES OREGON, PROVIDENCE PORTLAND MEDICAL CENTER | 930386906 | OR | Psychiatric Hospital Unit (273R00000X) |
United | 315 | $6211.37 | 1043389034 - THC, KINDRED HOSPITAL (HOUSTON NW) | 752504884 - (TX) THC | TX | Long Term Care Hospital (282E00000X) |
United | 315 | $19946.25 | 1134223878 - PROVIDENCE EVERETT MEDICAL CENTER, INPATIENT REHABILITATION FACILITY | 352346161 | WA | Rehabilitation Hospital Unit (273Y00000X) |
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 315 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 315 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 315 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 |
|---|---|---|
| 314-APR-DRG | High | FOOT & TOE PROCEDURES |
| 314-MS-DRG | High | Other Circulatory System Diagnoses with MCC |
| 315-MS-DRG | High | Other Circulatory System Diagnoses with CC |
| 316-APR-DRG | High | HAND & WRIST 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 315. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 315 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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