MS-DRG 507 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 507 by major payers:
$23,347.68
$25,849.34
$30,909.57
$31,873.14
| 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 507 | ||||||
United | 507 | $47482.00 | 1942446711 - UCSF MEDICAL CENTER | 943281657 | CA | General Acute Care Hospital (282N00000X) |
United | 507 | $7138.00 | 1336138403 - GLENDALE ADVENTIST MEDICAL CENTER, ADVENTIST HEALTH GLENDALE | 951816017 - (CA) GLENDALE ADVENTIST MEDICAL CENTER | CA | Psychiatric Hospital Unit (273R00000X) |
United | 507 | $30954.41 | 1184655581 - UNIVERSITY OF CALIFORNIA IRVINE, UCI HEALTH LAKEWOOD | 752919841 - (CA) LAKEWOOD REGIONAL MEDICAL CENTER INC | CA | General Acute Care Hospital (282N00000X) |
United | 507 | $38986.03 | 1073688354 - MIAMI VALLEY HOSPITAL | 310537504 - (OH) MIAMI VALLEY HOSPITAL | OH | General Acute Care Hospital (282N00000X) |
United | 507 | $20951.82 | 1689875320 - THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY | 356005697 | IN | General Acute Care Hospital (282N00000X) |
United | 507 | $40220.92 | 1427133917 - ALEGENT HEALTH IMMANUEL MEDICAL CENTER, CHI HEALTH IMMANUEL REHABILITATION INSTITUTE | 470376615 - ALEGENT HEALTH-IMMANUEL MEDICAL CENTER | NE | Rehabilitation Hospital Unit (273Y00000X) |
United | 507 | $56068.25 | 1912282369 - PROVIDENCE HEALTH & SERVICES, PROVIDENCE WILLAMETTE FALLS MEDICAL CENTER | 611659489 | OR | General Acute Care Hospital (282N00000X) |
United | 507 | $20362.73 | 1083274153 - THIBODAUX REGIONAL HEALTH SYSTEM INC | 842046902 - (LA) THIBODAUX REGIONAL HEALTH SYSTEM INC | LA | Rehabilitation Hospital (283X00000X) |
United | 507 | $3665.00 | 1528195724 - THE SHRINERS' HOSPITAL FOR CHILDREN | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | MA | Children's Hospital (282NC2000X) |
United | 507 | $14436.91 | 1568562551 - MERCY HEALTH, CLERMONT HOSPITAL | 310830955 | OH | General Acute Care Hospital (282N00000X) |
United | 507 | $15752.70 | 1417152745 - HONORHEALTH, SCOTTSDALE HEALTHCARE THOMPSON PEAK MEDICAL CENTER | 860181654 - HONORHEALTH | AZ | General Acute Care Hospital (282N00000X) |
United | 507 | $35512.00 | 1780927277 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS | 954537720 | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 507 | $33786.69 | 1003832098 - NASSAU HEALTH CARE CORPORATION, NUMC -DEPARTMENT OF PM&R, FPP | 113465690 | NY | General Acute Care Hospital (282N00000X) |
United | 507 | $16708.00 | 1619924719 - COLUMBIA RIO GRANDE HEALTHCARE, L.P., RIO GRANDE REGIONAL HOSPITAL | 621656022 - (TX) COLUMBIA RIO GRANDE HEALTHCARE LP | TX | General Acute Care Hospital (282N00000X) |
United | 507 | $11993.00 | 1962455816 - CHCA CONROE LP, CONROE REGIONAL MEDICAL CENTER | 621801361 - (TX) CHCA CONROE LP | TX | 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 507 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 507 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 507 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 |
|---|---|---|
| 506-MS-DRG | High | Major Thumb or Joint Procedures |
| 507-MS-DRG | High | Major Shoulder or Elbow Joint Procedures with CC/MCC |
| 508-MS-DRG | High | Major Shoulder or Elbow Joint Procedures without 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 507. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 507 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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