MS-DRG 514 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 514 by major payers:
$12,261.65
$13,941.20
$16,434.82
$16,968.58
| 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 514 | ||||||
United | 514 | $13149.78 | 1033100052 - HOLY REDEEMER HEALTH SYSTEM, SENIOR BEHAVORIAL HEALTH | 231534300 - HOLY REDEEMER HEALTH SYSTEM | PA | Psychiatric Hospital Unit (273R00000X) |
United | 514 | $9774.91 | 1497799597 - SIGNATURE PAMPA HOSPITAL LP, PAMPA REGIONAL MEDICAL CENTER | 455125687 - (TX) PRIME HEALTHCARE SERVICES PAMPA, LLC | TX | General Acute Care Hospital (282N00000X) |
United | 514 | $19316.32 | 1851344907 - NORTH MEMORIAL HEALTH CARE, NORTH MEMORIAL HEALTH HOSPITAL | 410729979 - NORTH MEMORIAL HEALTH CARE | MN | General Acute Care Hospital (282N00000X) |
United | 514 | $37725.19 | 1265466957 - THE GETTYSBURG HOSPITAL | 231352220 - GETTYSBURG HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 514 | $18521.02 | 1174571129 - SAINT JOSEPH REGIONAL MEDICAL CENTER- PLYMOUTH CAMPUS INC | 351142669 - SAINT JOSEPH REGIONAL MEDICAL CENTER-PLYMOUTH CAMPUS INC | IN | General Acute Care Hospital (282N00000X) |
United | 514 | $25434.36 | 1528013695 - NYU LUTHERAN MEDICAL CENTER | 133971298 - NYU LANGONE HOSPITALS | NY | Psychiatric Hospital Unit (273R00000X) |
United | 514 | $34393.14 | 1821026816 - EAST COOPER COMMUNITY HOSPITAL, INC., EAST COOPER MEDICAL CENTER | 934555562 | SC | General Acute Care Hospital (282N00000X) |
United | 514 | $13571.90 | 1588976260 - VHS SINAI-GRACE HOSPITAL INC, SINAI-GRACE HOSPITAL | 272844632 | MI | Psychiatric Hospital Unit (273R00000X) |
United | 514 | $18152.30 | 1851568687 - DIGNITY HEALTH, ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER | 463533638 - (AZ) DIGNITY HEALTH | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 514 | $13027.08 | 1831116441 - BRONSON METHODIST HOSPITAL | 381359087 - (MI) BRONSON METHODIST HOSPITAL | MI | General Acute Care Hospital (282N00000X) |
United | 514 | $4193.45 | 1427048453 - MEDINA COUNTY HOSPITAL DISTRICT, MEDINA REGIONAL HOSPITAL | 270492434 | TX | Critical Access Hospital (282NC0060X) |
United | 514 | $14978.28 | 1922018092 - MARYVIEW HOSPITAL LLC | 540506463 | VA | Rehabilitation Hospital Unit (273Y00000X) |
United | 514 | $11456.50 | 1770684441 - REEDSBURG AREA MEDICAL CENTER | 391091432 - (WI) REEDSBURG AREA MEDICAL CENTER INC | WI | Critical Access Hospital (282NC0060X) |
United | 514 | $2536.00 | 1730451899 - PRIME HEALTHCARE SERVICES ROXBOROUGH LLC, ROXBOROUGH MEMORIAL HOSPITAL | 454246163 - (PA) PRIME HEALTHCARE SERVICES ROXBOROUGH, LLC | PA | Rehabilitation Hospital Unit (273Y00000X) |
United | 514 | $29311.46 | 1902466840 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | 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 514 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 514 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 514 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 |
|---|---|---|
| 513-APR-DRG | High | UTERINE & ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA |
| 513-MS-DRG | High | Hand or Wrist Procedures, Except Major Thumb or Joint Procedures with CC/MCC |
| 514-MS-DRG | High | Hand or Wrist Procedures, Except Major Thumb or Joint Procedures without CC/MCC |
| 515-MS-DRG | High | Other Musculoskeletal System and Connective Tissue O.R. 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 514. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 514 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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