MS-DRG 319 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 319 by major payers:
$49,834.56
$55,981.32
$71,466.39
$69,865.65
| 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 319 | ||||||
United | 319 | $55171.00 | 1134166069 - METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO, LTD., L.L.P., METHODIST HOSPITAL | 742730328 | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 319 | $48290.05 | 1437234580 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 319 | $31714.19 | 1114998911 - GRANBURY HOSPITAL CORPORATION, LAKE GRANBURY MEDICAL CENTER | 752682017 - (TX) GRANBURY HOSPITAL CORPORATION | TX | General Acute Care Hospital (282N00000X) |
United | 319 | $46335.25 | 1770675431 - NORTHWEST IOWA HOSPITAL CORPORATION, ST LUKES REGIONAL MEDICAL CENTER | 421019872 - (IA) NORTHWEST IOWA HOSPITAL CORPORATION | IA | Rehabilitation Hospital Unit (273Y00000X) |
United | 319 | $63399.00 | 1437121142 - PASADENA HOSPITAL ASSOCIATION, LTD., HUNTINGTON HOSPITAL | 951644036 - PASADENA HOSPITAL ASSOCIATION LTD | CA | Psychiatric Hospital Unit (273R00000X) |
United | 319 | $18872.00 | 1013912633 - THE VALLEY HOSPITAL INC. | 221487307 - (NJ) VALLEY HOSPITAL INC | NJ | General Acute Care Hospital (282N00000X) |
United | 319 | $50846.66 | 1902865355 - GOOD SAMARITAN HOSPITAL MEDICAL CENTER | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 319 | $3593.00 | 1881613909 - TAKOMA HOSPITAL & SANITARIUM TRAINING SCHOOL, INC., TAKOMA ADVENTIST HOSPITAL | 510603966 - TAKOMA REGIONAL HOSPITAL INC | TN | Rural Acute Care Hospital (282NR1301X) |
United | 319 | $95589.28 | 1609927748 - TEXAS HEALTH PRESBYTERIAN HOSPITAL PLANO | 752770738 - (TX) TEXAS HEALTH PRESBYTERIAN HOSPITAL PLANO | TX | General Acute Care Hospital (282N00000X) |
United | 319 | $56623.19 | 1790785996 - VIRGINIA HOSPITAL CENTER ARLINGTON HEALTH SYSTEM | 540505989 - (VA) VIRGINIA HOSPITAL CENTER ARLINGTON HEALTH SYSTEM | VA | General Acute Care Hospital (282N00000X) |
United | 319 | $49500.05 | 1871512855 - DUBOIS REGIONAL MEDICAL CENTER, PENN HIGHLANDS DUBOIS | 251490707 - DUBOIS REGIONAL MEDICAL CENTER | PA | General Acute Care Hospital (282N00000X) |
United | 319 | $55171.00 | 1134166069 - METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO, LTD., L.L.P., METHODIST HOSPITAL | 742730328 | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 319 | $39475.19 | 1295882561 - COPLEY MEMORIAL HOSPITAL, INC. | 362170840 - (IL) COPLEY MEMORIAL HOSPITAL INC | IL | General Acute Care Hospital (282N00000X) |
United | 319 | $33368.53 | 1962662379 - BROADLAWNS MEDICAL CENTER | 426005830 - (IA) BROADLAWNS MEDICAL CENTER | IA | Psychiatric Hospital Unit (273R00000X) |
United | 319 | $85510.24 | 1053365361 - CLEVELAND CLINIC HEALTH SYSTEM, SOUTH POINTE HOSPITAL | 340714593 - CLEVELAND CLINIC HEALTH SYSTEM EAST REGION | OH | 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 319 vs. Other Diseases & Disorders of the Circulatory System Codes
The MS-DRG 319 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 319 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 |
|---|---|---|
| 317-APR-DRG | High | TENDON, MUSCLE & OTHER SOFT TISSUE PROCEDURES |
| 317-MS-DRG | High | Concomitant Left Atrial Appendage Closure and Cardiac Ablation |
| 319-MS-DRG | High | Other Endovascular Cardiac Valve Procedures with MCC |
| 320-APR-DRG | High | OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE 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 319. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 319 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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