MS-DRG 458 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 458 by major payers:
$58,456.12
$54,348.81
$68,310.75
$71,561.44
| 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 458 | ||||||
United | 458 | $4120.00 | 1134448541 - SMYTH COUNTY COMMUNITY HOSPITAL, SOUTHWEST VIRGINIA INPATIENT REHABILITAION UNIT | 540794913 - (VA) SMYTH COUNTY COMMUNITY HOSPITAL | VA | Rehabilitation Hospital Unit (273Y00000X) |
United | 458 | $107215.93 | 1548291883 - TEXAS HEALTH PRESBYTERIAN HOSPITAL ALLEN | 752890358 - (TX) TEXAS HEALTH PRESBYTERIAN HOSPITAL ALLEN | TX | General Acute Care Hospital (282N00000X) |
United | 458 | $127225.54 | 1700998697 - HOLY FAMILY MEMORIAL INC, FROEDTERT HOLY FAMILY MEMORIAL HOSPITAL | 390806395 - HOLY FAMILY MEMORIAL INC | WI | General Acute Care Hospital (282N00000X) |
United | 458 | $124829.04 | 1639108434 - WILLAMETTE FALLS HOSPITAL, PROVIDENCE WILLAMETTE FALLS MEDICAL CENTER | 611659489 | OR | General Acute Care Hospital (282N00000X) |
United | 458 | $37176.44 | 1215359922 - DLP WILSON MEDICAL CENTER LLC, WILSON MEDICAL CENTER | 464317222 | NC | General Acute Care Hospital (282N00000X) |
United | 458 | $15594.05 | 1083790893 - ANTELOPE MEMORIAL HOSPITAL | 470393176 - (NE) ANTELOPE MEMORIAL HOSPITAL | NE | Critical Access Hospital (282NC0060X) |
United | 458 | $1921.00 | 1588868889 - THE BROOKDALE HOSPITAL MEDICAL CENTER | 111631746 - BROOKDALE HOSPITAL MEDICAL CENTER | NY | Psychiatric Hospital Unit (273R00000X) |
United | 458 | $90384.38 | 1689038408 - THEDACARE REGIONAL MEDICAL CENTER, APPLETON MEDICAL CENTER, INC. | 350983617 - COMMUNITY HEALTH NETWORK INC | WI | General Acute Care Hospital (282N00000X) |
United | 458 | $102673.04 | 1306992151 - SWEDISH HEALTH SERVICES, SWEDISH MEDICAL CENTER | 910433740 - (WA) SWEDISH HEALTH SERVICES | WA | General Acute Care Hospital (282N00000X) |
United | 458 | $76273.14 | 1578648614 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 458 | $25307.81 | 1871953802 - FREEDOM HOSPITAL OF MAGNOLIA, LLC, BEACHAM MEMORIAL HOSPITAL | 811097331 | MS | Rural Acute Care Hospital (282NR1301X) |
United | 458 | $78967.57 | 1497792568 - MERCY HEALTH-ST CHARLES HOSPITAL LLC, ST CHARLES HOSPITAL OF OREGON, OHIO | 344428250 - MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC | OH | General Acute Care Hospital (282N00000X) |
United | 458 | $99299.07 | 1639101199 - REGIONAL WEST MEDICAL CENTER | 470385129 - REGIONAL WEST MEDICAL CENTER | NE | General Acute Care Hospital (282N00000X) |
United | 458 | $68517.78 | 1497792527 - UNIVERSITY HEALTHCARE SYSTEM, L.C., TULANE LAKESIDE HOSPITAL | 621596506 | LA | General Acute Care Hospital (282N00000X) |
United | 458 | $124216.47 | 1861994808 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE NORTHEAST CAMPUS | 813935393 - (TX) HCN EP HORIZON CITY LLC | TX | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
MS-DRG 458 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 458 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 458 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 |
|---|---|---|
| 457-APR-DRG | Moderate | Cva And Precerebral Occlusion With Infarction |
| 457-MS-DRG | High | Spinal Fusion except Cervical with Spinal Curvature, Malignancy, Infection or Extensive Fusions with CC |
| 458-MS-DRG | High | Spinal Fusion except Cervical with Spinal Curvature, Malignancy, Infection or Extensive Fusions without CC/MCC |
| 461-APR-DRG | High | KIDNEY & URINARY TRACT MALIGNANCY |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 458. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 458 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like MS-DRG 458) and we'll show you how you compare in 15 minutes or less.