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See a sample rate comparisonMS-DRG 515 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.
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH 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 515 by major payers:
$37,348.55
$40,461.14
$47,274.35
$49,460.58
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MS-DRG 515
5 of 25 sample ratesHigher to lower in this preview
Emanuel Medical Center, Inc., Emanuel Family Practice - Colorado
$79,182.77Published rateMadison Parish Hospital Service District, Madison Parish Hospital
Madison Parish Hospital Service District
$51,268.80Published rateMemorial Health Care System Inc., Memorial Hospital
Memorial Health Care System Inc
$42,816.75Published rateSaline County Medical Center, Saline Memorial Hospital
$26,221.48Published rateGeisinger Bloomsburg Hospital, The Bloomsburg Hospital
Geisinger-Bloomsburg Hospital
$3,640.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 515 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 515 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 515 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 |
|---|---|---|
| 514-APR-DRG | High | FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES |
| 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 |
| 516-MS-DRG | High | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 515. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 515 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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