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MS-DRG 477 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.

BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH 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 477 by major payers:

bcbs

$39,167.89

uhc

$45,341.30

aetna

$53,857.94

cigna

$55,042.13

Compare published rates across providers.

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MS-DRG 477
5 of 25 sample ratesHigher to lower in this preview
  1. The New York And Presbyterian Hospital, Newyork-Presbyterian Hospital

    The New York And Presbyterian Hospital

    NYGeneral Acute Care HospitalNPI 1194832477Tax ID 13-3957095

    $116,575.21Published rate
  2. Tarzana Medical Center LLC, Providence Cedars-Sinai Tarzana Medical Center

    Tarzana Medical Center LLC

    CAGeneral Acute Care HospitalNPI 1821250762Tax ID 83-3972614

    $68,044.04Published rate
  3. St. Tammany Parish Hospital Service District No 1, St. Tammany Parish Hospital

    LAGeneral Acute Care HospitalNPI 1598798597Tax ID 72-0478620

    $57,864.60Published rate
  4. Chestnut Hill Hospital, LLC, Chestnut Hill Hospital

    PAPsychiatric Hospital UnitNPI 1295253920Tax ID 88-3577015

    $35,524.87Published rate
  5. Millcreek Community Hospital, Short Procedure Unit

    Millcreek Community Hospital

    PAGeneral Acute Care HospitalNPI 1720153968Tax ID 25-1002937

    $2,504.00Published rate

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

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MS-DRG 477 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes

The MS-DRG 477 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 477 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
476-MS-DRGHighAMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
477-MS-DRGHighBIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
478-MS-DRGHighBIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 477. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 477 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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