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See a sample rate comparisonMS-DRG 467 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.
REVISION OF HIP OR KNEE REPLACEMENT 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 467 by major payers:
$41,843.75
$42,641.70
$52,401.82
$54,821.74
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MS-DRG 467
5 of 25 sample ratesHigher to lower in this preview
Bon Secours-Richmond Community Hospital LLC, Bon Secours Richmond Community Hospital Pro Fee Service
$116,141.67Published rateChester County Hospital Spu
Chester County Hospital
$79,798.81Published rateFoundation Bariatric Hospital Of San Antonio, LLC, Foundation Surgical Hospital Of San Antonio
Foundation Bariatric Hospital Of San Antonio, LLC
$48,840.87Published rateDignity Health, Mercy General Hospital
$21,965.00Published rateClhg-Winn, LLC, Winn Parish Medical Center
$2,500.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 467 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 467 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 467 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 |
|---|---|---|
| 466-APR-DRG | High | MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC |
| 466-MS-DRG | High | REVISION OF HIP OR KNEE REPLACEMENT WITH MCC |
| 467-MS-DRG | High | REVISION OF HIP OR KNEE REPLACEMENT WITH CC |
| 468-APR-DRG | High | OTHER KIDNEY & URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 467. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 467 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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