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See a sample rate comparisonMS-DRG 451 Fee Schedule
Last Verified: September 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.
SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT 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 451 by major payers:
$29,562.83
$45,162.97
$48,755.08
$50,944.50
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MS-DRG 451
5 of 25 sample ratesHigher to lower in this preview
Doctors Medical Center, Doctors Behavioral Health
$104,504.29Published rateJohnson Memorial Hospital, Inc.
Johnson Memorial Hospital Inc
$61,281.00Published rateNassau Health Care Corporation, Nassau Universitty Medical Center -
$48,416.25Published rateAthens Hospital, LLC
$32,970.82Published rateMsh Partners, LLC, Baylor Scott & White Medical Center - Uptown
$5,185.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 451 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 451 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 451 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 |
|---|---|---|
| 450-MS-DRG | High | SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE |
| 451-MS-DRG | High | SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC |
| 456-MS-DRG | High | SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS 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 451. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 451 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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