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See a sample rate comparisonMS-DRG 456 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.
SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH 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 456 by major payers:
$99,890.59
$100,897.45
$119,955.56
$135,114.89
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MS-DRG 456
5 of 25 sample ratesHigher to lower in this preview
Doctors Medical Center Of Modesto, Inc., Emanuel Medical Center
$284,912.37Published rateSwedish Health Services, Swedish Medical Center-Ballard Psych
Swedish Health Services
$170,188.56Published rateNew Medical Horizons II, Ltd., Cypress Fairbanks Medical Center Hospital
New Medical Horizons II Ltd
$131,092.81Published rateMetro Knoxville Hma LLC, Tennova Healthcare North Knoxville Medical Center
$66,957.50Published rateLancaster Regional Hospital, Lp, Crescent Medical Center Lancaster
Lancaster Regional Hospital, Lp
$3,000.00Published rate
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See a sample payer proposalMS-DRG 456 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 456 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 456 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 |
|---|---|---|
| 451-APR-DRG | Moderate | Cva And Precerebral Occlusion With Infarction |
| 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 |
| 457-APR-DRG | Moderate | Cva And Precerebral Occlusion With Infarction |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 456. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 456 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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