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See a sample rate comparisonMS-DRG 499 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.
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC
| 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 499 by major payers:
$15,346.44
$15,260.81
$18,898.26
$19,349.04
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MS-DRG 499
5 of 25 sample ratesHigher to lower in this preview
The Kingston Hospital
Healthalliance Hospital Marys Avenue Campus
$31,064.16Published rateUchealth Grandview Hospital, Uchealth Colorado Springs Hospital LLC
Uchealth Grandview Hospital
$20,466.06Published rateTyler Regional Hospital LLC
$14,533.21Published rateMidland County Hospital District, Midland Memorial Hospital
Midland County Hospital District
$10,429.41Published rateRock County Hospital
$3,446.51Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 499 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 499 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 499 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 |
|---|---|---|
| 498-MS-DRG | High | LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC |
| 499-MS-DRG | High | LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC |
| 500-APR-DRG | High | MALIGNANCY, MALE REPRODUCTIVE SYSTEM |
| 500-MS-DRG | High | SOFT TISSUE PROCEDURES 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 499. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 499 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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