MS-DRG 316 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 316 by major payers:
$8,744.26
$9,704.45
$10,952.30
$11,295.71
| 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 316 | ||||||
United | 316 | $4238.64 | 1477757151 - TAYLOR COUNTY HOSPITAL DISTRICT HEALTH FACILITIES CORPORATION | 610676546 - (KY) TAYLOR COUNTY HOSPITAL DISTRICT HEALTH FACILITIES CORP | KY | General Acute Care Hospital (282N00000X) |
United | 316 | $4498.00 | 1013365824 - ST VINCENTS CHILTON LLC, ST VINCENTS CHILTON SWING BEDS | 810935368 | AL | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 316 | $14237.70 | 1669461281 - INTERMOUNTAIN FRONT RANGE, INC. | 841103606 - (CO) SCL HEALTH - FRONT RANGE INC | CO | General Acute Care Hospital (282N00000X) |
United | 316 | $6644.04 | 1255317822 - UPMC JAMESON, UPMC JAMESON PSYCHIATRIC UNIT | 250965406 - (PA) UPMC | PA | Psychiatric Hospital Unit (273R00000X) |
United | 316 | $8959.75 | 1407076631 - ST. MARY'S HEALTH CENTER | 431343281 - SSM HEALTH CARE ST LOUIS | MO | Critical Access Hospital (282NC0060X) |
United | 316 | $15223.53 | 1053972760 - ADVENTHEALTH POLK SOUTH INC, ADVENTHEALTH LAKE WALES | 834672945 | FL | General Acute Care Hospital (282N00000X) |
United | 316 | $13802.15 | 1649288085 - UPPER VALLEY MEDICAL CENTER, SUB PROVIDER REHAB | 310537095 - (OH) UPPER VALLEY MEDICAL CENTER | OH | Rehabilitation Hospital Unit (273Y00000X) |
United | 316 | $7345.00 | 1558493726 - THE HOSPITAL AUTHORITY OF HABERSHAM COUNTY | 922451946 | GA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 316 | $12885.28 | 1265532915 - FRANCISCAN HEALTH INDIANAPOLIS & MOORESVILLE, FRANCISCAN HEALTH - INPATIENT REHAB UNIT | 350913537 | IN | Rehabilitation Hospital Unit (273Y00000X) |
United | 316 | $10535.96 | 1043269566 - LUCY WEBB HAYES NATIONAL TRAINING SCHOOL FOR DEACONESSES & MISSIONARIE, SIBLEY MEMORIAL HOSPITAL | 530196602 - (DC) LUCY WEBB HAYNES NATIONAL TRAINING SCHOOL FOR DEACONESSES AND MISSION | DC | Psychiatric Hospital Unit (273R00000X) |
United | 316 | $6871.08 | 1518178268 - J C BLAIR MEMORIAL HOSPITAL, PENN HIGHLANDS HUNTINGDON | 231352159 - (PA) J C BLAIR MEMORIAL HOSPITAL | PA | Psychiatric Hospital Unit (273R00000X) |
United | 316 | $8467.53 | 1235567504 - MERCY HOSPITAL BOONEVILLE | 463851119 - MERCY HOSPITAL BOONEVILLE | AR | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 316 | $8169.68 | 1609830173 - BAPTIST MEMORIAL HOSPITAL | 621519754 - (MS) BAPTIST MEMORIAL HOSPITAL-GOLDEN TRIANGLE INC | MS | General Acute Care Hospital (282N00000X) |
United | 316 | $11836.79 | 1578670543 - ADVOCATE HEALTH AND HOSPITALS CORPORATION, ADVOCATE GOOD SAMARITAN HOSPITAL | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | General Acute Care Hospital (282N00000X) |
United | 316 | $15023.74 | 1588243117 - INTEGRIS HEALTH EDMOND, INC, INTEGRIS HEALTH JIM THORPE REHABILITATION HOSPITAL EDMOND | 451027361 - (OK) INTEGRIS HEALTH EDMOND INC | OK | 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 316 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 316 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 316 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 |
|---|---|---|
| 315-APR-DRG | High | SHOULDER, UPPER ARM & FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT |
| 315-MS-DRG | High | Other Circulatory System Diagnoses with CC |
| 316-MS-DRG | High | Other Circulatory System Diagnoses without CC/MCC |
| 317-APR-DRG | High | TENDON, MUSCLE & OTHER SOFT TISSUE 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 316. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 316 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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