MS-DRG 505 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 505 by major payers:
$18,117.40
$22,497.82
$27,606.60
$28,478.81
| 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 505 | ||||||
United | 505 | $26732.16 | 1881915585 - ADVOCATE ILLINOIS MASONIC MEDICAL CENTER | 363196629 - (IL) ADVOCATE NORTH SIDE HEALTH NETWORK | IL | General Acute Care Hospital (282N00000X) |
United | 505 | $21819.31 | 1134794506 - FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC, FROEDTERT COMMUNITY HOSPITAL | 843381796 | WI | General Acute Care Hospital (282N00000X) |
United | 505 | $18021.35 | 1740840909 - THIBODAUX REGIONAL HEALTH SYSTEM INC | 842046902 - (LA) THIBODAUX REGIONAL HEALTH SYSTEM INC | LA | Psychiatric Hospital (283Q00000X) |
United | 505 | $30240.41 | 1629053509 - PRESBYTERIAN HEALTHCARE SERVICES, PLAINS REGIONAL MEDICAL CENTER | 850105601 - PRESBYTERIAN HEALTHCARE SERVICES | NM | Rural Acute Care Hospital (282NR1301X) |
United | 505 | $2586.63 | 1972731800 - MERIWETHER HEALTHCARE, L.L.C., WARM SPRINGS MEDICAL CENTER | 870764535 - (GA) MERIWETHER HEALTHCARE, LLC D/B/A WARM SPRINGS MEDICAL CENTER | GA | Critical Access Hospital (282NC0060X) |
United | 505 | $3000.00 | 1851632616 - LANCASTER REGIONAL HOSPITAL, LP, CRESCENT MEDICAL CENTER LANCASTER | 273815440 - (TX) LANCASTER REGIONAL HOSPITAL, LP | TX | General Acute Care Hospital (282N00000X) |
United | 505 | $16610.10 | 1912473927 - RESILIENCE HEALTHCARE, LOUIS A. WEISS MEMORIAL HOSPITAL | 352637418 | IL | Psychiatric Hospital Unit (273R00000X) |
United | 505 | $6893.02 | 1376517508 - ENCOMPASS HEALTH VALLEYOFTHESUN REHABILITATION HOSPITAL, LLC, ENCOMPASS HEALTH VALLEY OF THE SUN REHABILITATION HOSPITAL | 631184848 - (AZ) ENCOMPASS HEALTH VALLEYOFTHESUN REHABILITATION HOSPITAL LLC | AZ | Rehabilitation Hospital (283X00000X) |
United | 505 | $42910.26 | 1508877689 - PROVIDENCE HEALTH & SERVICES WASHINGTON, PROVIDENCE ST. PETER HOSPITAL | 910567732 | WA | Psychiatric Hospital Unit (273R00000X) |
United | 505 | $26539.10 | 1851487086 - FAIRWAY MEDICAL CENTER, LLC, AVALA | 721426390 - (LA) FAIRWAY MEDICAL CENTER, LLC DBA AVALA | LA | General Acute Care Hospital (282N00000X) |
United | 505 | $25565.59 | 1497831655 - UPMC ALTOONA, ALTOONA EMERGENCY PHYSICIANS | 231352155 - UPMC | PA | General Acute Care Hospital (282N00000X) |
United | 505 | $26291.66 | 1538382239 - MEMORIAL HERMANN HEALTH SYSTEM, MEMORIAL HERMANN MEMORIAL CITY CICD | 741152597 - (TX) MEMORIAL HERMANN HEALTH SYSTEM | TX | General Acute Care Hospital (282N00000X) |
United | 505 | $22809.73 | 1881665164 - CLHG-LEESVILLE, BYRD REGIONAL HOSPITAL | 824337635 | LA | General Acute Care Hospital (282N00000X) |
United | 505 | $33883.78 | 1376521575 - LOYOLA UNIVERSITY MEDICAL CENTER, FOSTER G. MCGAW HOSPITAL | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | General Acute Care Hospital (282N00000X) |
United | 505 | $21819.31 | 1134794506 - FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC, FROEDTERT COMMUNITY HOSPITAL | 843381796 | WI | General Acute Care Hospital (282N00000X) |
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 505 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 505 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 505 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 |
|---|---|---|
| 504-APR-DRG | Moderate | Non-Bacterial Infections Of Nervous System Except Viral Meningitis |
| 504-MS-DRG | High | Foot Procedures with CC |
| 505-MS-DRG | High | Foot Procedures without CC/MCC |
| 506-MS-DRG | High | Major Thumb or Joint Procedures |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 505. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 505 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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