MS-DRG 451 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 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
| 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 451 | ||||||
United | 451 | $5185.00 | 1386647717 - MSH PARTNERS, LLC, BAYLOR SCOTT & WHITE MEDICAL CENTER - UPTOWN | 752829613 | TX | General Acute Care Hospital (282N00000X) |
United | 451 | $104504.29 | 1407016793 - DOCTORS MEDICAL CENTER, DOCTORS BEHAVIORAL HEALTH | 752918774 | CA | Psychiatric Hospital (283Q00000X) |
United | 451 | $22628.00 | 1437308913 - CALIFORNIA HOSPITAL | 954310407 | CA | General Acute Care Hospital (282N00000X) |
United | 451 | $81213.00 | 1871547703 - GREENVIEW HOSPITAL, INC., TRISTAR GREENVIEW REGIONAL HOSPITAL | 610724492 - (KY) GREENVIEW HOSPITAL INC | KY | General Acute Care Hospital (282N00000X) |
United | 451 | $19562.15 | 1033635263 - MANGUM CITY HOSPITAL AUTHORITY, MANGUM REGIONAL MEDICAL CENTER | 822087512 | OK | Critical Access Hospital (282NC0060X) |
United | 451 | $22567.91 | 1265402838 - MADISON COMMUNITY HOSPITAL, MADISON REGIONAL HEALTH SYSTEM | 460228038 - (SD) MADISON COMMUNITY HOSPITAL | SD | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 451 | $44728.48 | 1295843753 - VALLEY BAPTIST MEDICAL CENTER | 452663071 | TX | General Acute Care Hospital (282N00000X) |
United | 451 | $21358.00 | 1003236878 - ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL INC, ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL SOMERSET | 221487243 - (NJ) ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL | NJ | General Acute Care Hospital (282N00000X) |
United | 451 | $32970.82 | 1417465824 - ATHENS HOSPITAL, LLC | 823934511 | TX | General Acute Care Hospital (282N00000X) |
United | 451 | $37723.26 | 1194757500 - COX-MONETT HOSPITAL, INC. | 431656689 - (MO) COX-MONETT HOSPITAL INC | MO | Critical Access Hospital (282NC0060X) |
United | 451 | $52100.94 | 1164400131 - LEHIGH VALLEY HOSPITAL, LEHIGH VALLEY HOSPITAL | 231689692 - LEHIGH VALLEY HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 451 | $54511.10 | 1801262423 - SMSJ TUCSON HOLDINGS LLC, ST. JOSEPHS HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 451 | $68098.00 | 1972857282 - STATE OF CONNECTICUT, JOHN DEMPSEY HOSPITAL-HEMOPHILIA CENTER | 66000798 | CT | General Acute Care Hospital (282N00000X) |
United | 451 | $66003.36 | 1003956913 - MISSION HOSPITAL REGIONAL MEDICAL CENTER, PROVIDENCE MISSION HOSPITAL | 951643360 - (CA) MISSION HOSPITAL REGIONAL MEDICAL CENTER | CA | Rehabilitation Hospital (283X00000X) |
United | 451 | $61281.00 | 1932123569 - JOHNSON MEMORIAL HOSPITAL, INC. | 475676956 - (CT) JOHNSON MEMORIAL HOSPITAL INC | CT | General Acute Care Hospital (282N00000X) |
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 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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