MS-DRG 470 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 470 by major payers:
$24,609.52
$25,085.93
$31,664.86
$31,622.10
| 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 470 | ||||||
United | 470 | $50985.80 | 1356419147 - CHESTERFIELD GENERAL HOSPITAL | 473712858 - MCLEOD HEALTH CHERAW | SC | General Acute Care Hospital (282N00000X) |
United | 470 | $15706.54 | 1386793115 - GRAHAM REGIONAL MEDICAL CENTER | 463113489 | TX | General Acute Care Hospital (282N00000X) |
United | 470 | $25842.00 | 1497988596 - ST. JOHN BROKEN ARROW, INC, ST. JOHN BROKEN ARROW | 383833117 - ST JOHN BROKEN ARROW INC | OK | General Acute Care Hospital (282N00000X) |
United | 470 | $29805.98 | 1023472842 - THEDACARE REGIONAL MEDICAL CENTER, THEDA CLARK MEDICAL CENTER, INC. | 350983617 - COMMUNITY HEALTH NETWORK INC | WI | General Acute Care Hospital (282N00000X) |
United | 470 | $17543.08 | 1497839641 - CARITAS HOLY FAMILY HOSPITAL-OUTPATIENT | 272473701 | MA | General Acute Care Hospital (282N00000X) |
United | 470 | $3446.51 | 1265512917 - HARRISON COUNTY COMMUNITY HOSPITAL DISTRICT, HARRISON COUNTY COMMUNITY HOSPITAL | 431530883 | MO | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 470 | $35398.00 | 1659703254 - JERSEY CITY MEDICAL CENTER | 222783298 - (NJ) JERSEY CITY MEDICAL CENTER | NJ | General Acute Care Hospital (282N00000X) |
United | 470 | $32165.77 | 1497780084 - LOS ALAMITOS MEDICAL CENTER, INC., LOS ALAMITOS MEDICAL CENTER | 752919839 - (CA) LOS ALAMITOS MEDICAL CENTER INC | CA | Psychiatric Hospital Unit (273R00000X) |
United | 470 | $22079.21 | 1346380870 - THE BROOKDALE HOSPITAL MEDICAL CENTER | 111631746 - BROOKDALE HOSPITAL MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 470 | $3446.51 | 1265512917 - HARRISON COUNTY COMMUNITY HOSPITAL DISTRICT, HARRISON COUNTY COMMUNITY HOSPITAL | 431530883 | MO | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 470 | $28461.61 | 1497742365 - OUR LADY OF THE LAKE HOSPITAL, INC., OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER | 720423651 - (LA) OUR LADY OF THE LAKE HOSPITAL INC | LA | Rehabilitation Hospital Unit (273Y00000X) |
United | 470 | $7536.00 | 1225033020 - PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA, JACKSON HEALTH SYSTEMS JACKSON MEMORIAL HOSPITA | 591713947 - (FL) PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY FLORIDA | FL | General Acute Care Hospital (282N00000X) |
United | 470 | $20604.55 | 1750788667 - CARONDELET HEALTH NETWORK, BRIDGES GEROPSYCHIATRIC PROGRAM AT ST. MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 470 | $43372.16 | 1437582400 - HIGHLAND HOSPITAL | 943302014 | CA | General Acute Care Hospital (282N00000X) |
United | 470 | $19799.64 | 1396739165 - PARKWEST MEDICAL CENTER, PENINSULA DIV PARKWEST MC | 581897274 - (TN) PARKWEST MEDICAL CENTER | TN | 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 470 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 470 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 470 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 |
|---|---|---|
| 469-APR-DRG | High | ACUTE KIDNEY INJURY |
| 469-MS-DRG | High | Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity with MCC or Total Ankle Replacement |
| 470-MS-DRG | High | Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC |
| 471-APR-DRG | Moderate | Transient Ischemia |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 470. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 470 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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