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See a sample rate comparisonMS-DRG 464 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.
WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC
| 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 464 by major payers:
$35,704.84
$39,055.98
$46,231.23
$47,664.34
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MS-DRG 464
5 of 25 sample ratesHigher to lower in this preview
University Hospital At Stony Brook
$89,091.95Published rateSwedish Health Services, Swedish Medical Center, Cherry Hill
Swedish Health Services
$59,252.12Published rateMercy Health-Lourdes Hospital LLC, Lourdes - Rehab
$43,340.21Published rateWilliam Beaumont Hospital, Beaumont Hospital, Troy
William Beaumont Hospital
$23,152.80Published rateUhs Corona Inc, Corona Regional Medical Center
$5,069.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 464 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 464 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 464 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 |
|---|---|---|
| 463-APR-DRG | High | KIDNEY & URINARY TRACT INFECTIONS |
| 463-MS-DRG | High | WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC |
| 464-MS-DRG | High | WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC |
| 465-APR-DRG | High | URINARY STONES & ACQUIRED UPPER URINARY TRACT OBSTRUCTION |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 464. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 464 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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