MS-DRG 487 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 487 by major payers:
$19,334.70
$21,377.88
$24,994.16
$25,710.69
| 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 487 | ||||||
United | 487 | $7221.50 | 1316537228 - DUBOIS REGIONAL MEDICAL CENTER, PENN HIGHLANDS CLEARFIELD-A CAMPUS OF PENN HIGHLANDS DUBOIS | 251490707 - DUBOIS REGIONAL MEDICAL CENTER | PA | General Acute Care Hospital (282N00000X) |
United | 487 | $18858.23 | 1396109500 - GOTTLIEB MEMORIAL HOSPITAL | 362379649 - (IL) GOTTLIEB MEMORIAL HOSPITAL | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 487 | $24552.42 | 1396160396 - PROSPECT CHARTERCARE SJHSRI, LLC, ST. JOSEPH HEALTH CENTER | 464661337 | RI | Psychiatric Hospital Unit (273R00000X) |
United | 487 | $40961.94 | 1790789212 - AHS HOSPITAL CORP, NEWTON MEDICAL CENTER | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | General Acute Care Hospital (282N00000X) |
United | 487 | $13552.91 | 1154355188 - BANNER THUNDERBIRD MEDICAL CENTER | 270036484 - (AZ) BANNER THUNDERBIRD MEDICAL CENTER | AZ | General Acute Care Hospital (282N00000X) |
United | 487 | $34320.78 | 1225113376 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 487 | $17029.82 | 1689838245 - ODESSA REGIONAL HOSPITAL LP | 621795574 | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 487 | $35529.21 | 1720454341 - SMSJ TUCSON HOLDINGS LLC, BRIDGES GEROPSYCHIATRIC PROGRAM AT ST. MARYS HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 487 | $27203.14 | 1396833844 - BAPTIST HEALTH SYSTEM INC, WALKER BAPTIST MEDICAL CENTER | 474790386 | AL | Psychiatric Hospital Unit (273R00000X) |
United | 487 | $14278.00 | 1922052992 - HCA-HEALTHONE LLC, ROSE MEDICAL CENTER | 841321373 | CO | General Acute Care Hospital (282N00000X) |
United | 487 | $15398.00 | 1821042979 - HCA HEALTHONE LLC, NORTH SUBURBAN MEDICAL CENTER | 841321373 | CO | General Acute Care Hospital (282N00000X) |
United | 487 | $12614.11 | 1700216850 - NASHOBA VALLEY MEDICAL CENTER, A STEWARD FAMILY HOSPITAL, INC. | 274157855 | MA | Psychiatric Hospital Unit (273R00000X) |
United | 487 | $19316.35 | 1760549562 - SKAGGS COMMUNITY HOSPITAL ASSOCIATION, COX MEDICAL CENTER BRANSON | 440577118 - LESTER E COX MEDICAL CENTER | MO | Rehabilitation Hospital Unit (273Y00000X) |
United | 487 | $27455.96 | 1295159028 - CATHOLIC HEALTH INITIATIVES COLORADO, ST. ANTHONY SUMMIT HOSPITAL SWING BED UNIT | 840405257 - CATHOLIC HEALTH INITIATIVES COLORADO | CO | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 487 | $17113.08 | 1659511988 - SSM SELECT REHAB ST LOUIS LLC | 263694972 | MO | Rehabilitation Hospital (283X00000X) |
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 487 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 487 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 487 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 |
|---|---|---|
| 486-MS-DRG | High | Knee Procedures with Principal Diagnosis of Infection with CC |
| 487-MS-DRG | High | Knee Procedures with Principal Diagnosis of Infection without CC/MCC |
| 488-APR-DRG | Moderate | Peripheral, Cranial And Autonomic Nerve Disorders |
| 488-MS-DRG | High | Knee Procedures without Principal Diagnosis of Infection with 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 487. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 487 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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