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See a sample rate comparisonMS-DRG 475 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.
AMPUTATION FOR MUSCULOSKELETAL SYSTEM 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 475 by major payers:
$26,547.36
$29,358.65
$33,954.92
$34,961.39
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MS-DRG 475
5 of 25 sample ratesHigher to lower in this preview
Tenet Hospitals Limited, The Hospitals Of Providence Transmountain Campus
$72,949.10Published rateGreenville Health System, Ghs Cardiovascular Svcs Grnv
Prisma Health - Upstate
$54,924.85Published rateAgh Laveen LLC, Dignity Health Arizona General Hospital
Agh Laveen LLC
$35,932.30Published rateVhs Of Phoenix Inc, Abrazo Central Campus
$27,120.84Published rateTrophy Club Medical Center Lp, Baylor Scott & White Medical Center - Trophy Club
Trophy Club Medical Center Lp
$4,796.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 475 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 475 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 475 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 |
|---|---|---|
| 474-APR-DRG | Moderate | Transient Ischemia |
| 474-MS-DRG | High | AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC |
| 475-MS-DRG | High | AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC |
| 476-MS-DRG | High | AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 475. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 475 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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