MS-DRG 471 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 471 by major payers:
$55,422.69
$58,734.26
$68,182.14
$76,118.06
| 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 471 | ||||||
United | 471 | $80417.46 | 1649270257 - APPALACHIAN REGIONAL HEALTHCARE, INC., TUG VALLEY ARH REGIONAL MEDICAL CENTER | 520795508 - APPALACHIAN REGIONAL HEALTHCARE INC | KY | General Acute Care Hospital (282N00000X) |
United | 471 | $61965.17 | 1366521296 - PRESENCE CHICAGO HOSPITALS NETWORK, SAINT JOSEPH HOSPITAL - CHICAGO PSYCHIATRIC UNIT | 362235165 - (IL) PRESENCE CHICAGO HOSPITALS NETWORK | IL | Psychiatric Hospital Unit (273R00000X) |
United | 471 | $21089.00 | 1215534466 - COVENANT HOSPITAL HOBBS, COVENANT HEALTH HOBBS HOSPITAL | 844273963 - (NM) COVENANT HOSPITAL HOBBS | NM | General Acute Care Hospital (282N00000X) |
United | 471 | $35895.00 | 1073708392 - MONTEFIORE MEDICAL CENTER | 131740114 - MONTEFIORE MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 471 | $33284.26 | 1164476867 - SUN CITY HOSPITAL INC, HCA FLORIDA SOUTH SHORE HOSPITAL | 592822337 - (FL) SUN CITY HOSPITAL INC | FL | General Acute Care Hospital (282N00000X) |
United | 471 | $61965.17 | 1487715645 - PRESENCE CENTRAL AND SUBURBAN HOSPITALS NETWORK, PRESENCE ST. JOSEPH MEDICAL CENTER | 364195126 - (IL) PRESENCE CENTRAL AND SUBURBAN HOSPITALS NETWORK | IL | General Acute Care Hospital (282N00000X) |
United | 471 | $47941.55 | 1881977593 - DLP PERSON MEMORIAL HOSPITAL LLC, PERSON MEMORIAL HOSPITAL | 452909143 | NC | General Acute Care Hospital (282N00000X) |
United | 471 | $29053.41 | 1588631311 - SURGICAL SPECIALTY CENTER OF BATON ROUGE, LLC, SURGICAL SPECIALTY CENTER OF BATON ROUGE | 263120962 - (LA) SURGICAL SPECIALTY CENTER OF BATON ROUGE, LLC | LA | General Acute Care Hospital (282N00000X) |
United | 471 | $36130.39 | 1326041229 - ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDER, ST MARYS HOSPITAL | 370661244 - (IL) ST MARYS HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS | IL | General Acute Care Hospital (282N00000X) |
United | 471 | $61667.98 | 1639293483 - COOKEVILLE REGIONAL MEDICAL CENTER, COOKEVILLE REGIONAL MEDICAL CENTER INPATIENT REHABILITATION CENTER | 626002166 | TN | Rehabilitation Hospital Unit (273Y00000X) |
United | 471 | $4646.00 | 1255327920 - UHS CORONA INC, CORONA REGIONAL MEDICAL CENTER | 432035443 | CA | Rehabilitation Hospital Unit (273Y00000X) |
United | 471 | $61667.98 | 1639293483 - COOKEVILLE REGIONAL MEDICAL CENTER, COOKEVILLE REGIONAL MEDICAL CENTER INPATIENT REHABILITATION CENTER | 626002166 | TN | Rehabilitation Hospital Unit (273Y00000X) |
United | 471 | $3524.00 | 1962435792 - HOUSTON HOSPITALS INC, HOUSTON MEDICAL CENTER | 711045290 - (GA) HOUSTON HOSPITALS INC | GA | General Acute Care Hospital (282N00000X) |
United | 471 | $27787.00 | 1427091156 - SEQUOIA HEALTH SERVICES, SEQUOIA HOSPITAL | 943246947 | CA | Rehabilitation Hospital Unit (273Y00000X) |
United | 471 | $38921.53 | 1508859661 - MERCY HOSPITAL JEFFERSON, JEFFERSON MEMORIAL HOSPITAL ASSOCIATION | 430687077 - (MO) MERCY HOSPITAL JEFFERSON | MO | 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 471 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 471 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 471 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 |
|---|---|---|
| 470-APR-DRG | High | CHRONIC KIDNEY DISEASE |
| 470-MS-DRG | High | Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC |
| 471-MS-DRG | High | Cervical Spinal Fusion with MCC |
| 472-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 471. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 471 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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