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See a sample rate comparisonMS-DRG 428 Fee Schedule
Last Verified: October 2026
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.
MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC
| Key Fact | Detail |
|---|---|
| Service Type | Diseases & Disorders of the Musculoskeletal System & Connective Tissue |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 428 by major payers:
$61,452.92
$77,523.15
$80,374.78
$89,404.20
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MS-DRG 428
5 of 25 sample ratesHigher to lower in this preview
Banner Boswell Medical Center
$145,957.71Published rateCatholic Health Iniatives Colorado, St Mary-Corwin Medical Center
Catholic Health Initiatives Colorado
$89,050.82Published rateDlp Conemaugh Memorial Medical Center LLC, Memorial Medical Center
$75,857.50Published rateEast Texas Medical Center Henderson
$58,805.80Published rateState Of Mississippi, Holmes County Hospital And Clinic
$1,500.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 428 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 428 code is part of the Diseases & Disorders of the Musculoskeletal System & Connective Tissue 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 428 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 |
|---|---|---|
| 427-APR-DRG | High | THYROID DISORDERS |
| 427-MS-DRG | High | MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC |
| 428-MS-DRG | High | MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC |
| 429-MS-DRG | High | COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 428. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 428 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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