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MS-DRG 476 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 WITHOUT CC/MCC
Key FactDetail
Service Type

Diseases & Disorders of the Musculoskeletal System & Connective Tissue

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Complexity LevelHigh

National average reimbursement for MS-DRG 476 by major payers:

bcbs

$15,722.01

uhc

$15,703.97

aetna

$18,384.60

cigna

$19,043.31

Compare published rates across providers.

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MS-DRG 476
5 of 25 sample ratesHigher to lower in this preview
  1. Froedtert Memorial Lutheran Hospital, Inc., Froedtert Bluemound Rehabilitation Hospital

    Froedtert Memorial Lutheran Hospital Inc

    WIRehabilitation Hospital UnitNPI 1003819475Tax ID 39-6105970

    $38,580.03Published rate
  2. Palm Beach Gardens Community Hospital, Inc., Palm Beach Gardens Medical Center

    FLGeneral Acute Care HospitalNPI 1144251216Tax ID 59-1223933

    $27,083.56Published rate
  3. Mercy Hospital

    Mercy Hospital Of Buffalo

    NYCritical Access HospitalNPI 1407184013Tax ID 16-0756336

    $21,509.21Published rate
  4. Franciscan Health Michigan City, Franciscan St. Anthony Health-Michigan City

    Franciscan Health Michigan City

    INRehabilitation Hospital UnitNPI 1124193750Tax ID 35-0876394

    $14,814.70Published rate
  5. Hampshire Memorial Hospital, Inc., Hampshire Memorial Hospital

    Valley Health System

    WVCritical Access HospitalNPI 1396897203Tax ID 20-8241398

    $4,742.56Published rate

National sample. Rates vary by location, specialty, and contract.

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MS-DRG 476 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes

The MS-DRG 476 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 476 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.

CodeComplexityDescription
475-APR-DRGModerateTransient Ischemia
475-MS-DRGHighAMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC
476-MS-DRGHighAMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
477-MS-DRGHighBIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH 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 476. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 476 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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