MS-DRG 517 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 517 by major payers:
$18,004.34
$20,510.14
$24,988.79
$24,301.73
| 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 517 | ||||||
United | 517 | $35990.00 | 1518911031 - GALEN OF FLORIDA, INC., HCA FLORIDA ST. PETERSBURG HOSPITAL | 591174716 - (FL) GALEN OF FLORIDA INC | FL | General Acute Care Hospital (282N00000X) |
United | 517 | $10531.00 | 1790956571 - UPPER SAN JUAN HEALTH SERVICE DISTRICT, PAGOSA SPRINGS MEDICAL CENTER | 840866061 - (CO) UPPER SAN JUAN HEALTH SERVICE DISTRICT | CO | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 517 | $23834.18 | 1568429454 - COMMUNITY MERCY HEALTH PARTNERS, MERCY HEALTH - URBANA HOSPITAL | 310785684 - COMMUNITY MERCY HEALTH PARTNERS | OH | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 517 | $17981.06 | 1720672934 - HAYWOOD COUNTY COMMUNITY HOSPITAL INC | 853679546 - (TN) HAYWOOD COUNTY COMMUNITY HOSPITAL INC | TN | General Acute Care Hospital (282N00000X) |
United | 517 | $28928.52 | 1760599344 - WEST PENN ALLEGHENY HEALTH SYSTEM INC., THE WESTERN PENNSYLVANIA HOSPITAL - REHAB | 250969492 - (PA) HIGHMARK HEALTH | PA | Rehabilitation Hospital Unit (273Y00000X) |
United | 517 | $49310.30 | 1912969064 - BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER LLC, MEMORIAL REGIONAL MEDICAL CENTER | 541744931 - BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER LLC | VA | General Acute Care Hospital (282N00000X) |
United | 517 | $35896.00 | 1518911833 - COLUMBIA NORTH HILLS HOSPITAL SUBSIDIARY LP, MEDICAL CITY NORTH HILLS | 621682205 - (TX) COLUMBIA NORTH HILLS HOSPITAL SUBSIDIARY LP | TX | General Acute Care Hospital (282N00000X) |
United | 517 | $30428.68 | 1902818883 - GRANT COUNTY PUBLIC HOSPITAL DISTRICT 1, SAMARITAN HEALTHCARE | 930386906 | WA | General Acute Care Hospital (282N00000X) |
United | 517 | $35981.53 | 1467506857 - BANNER -- UNIVERSITY MEDICAL CENTER PHOENIX | 270036499 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 517 | $26148.44 | 1548207608 - UNIVERSITY HEALTHCARE SYSTEM, L.C., EAST JEFFERSON GENERAL HOSPITAL | 621596506 | LA | Rehabilitation Hospital Unit (273Y00000X) |
United | 517 | $30309.73 | 1295848562 - THE MOSES H. CONE MEMORIAL HOSPITAL OPERATING CORPORATION | 581588823 - THE MOSES H CONE MEMORIAL HOSPITAL OPERATING CORPORATION | NC | Psychiatric Hospital Unit (273R00000X) |
United | 517 | $21407.00 | 1841624756 - PECONIC BAY MEDICAL CENTER | 111661359 - (NY) CENTRAL SUFFOLK HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 517 | $30428.68 | 1902818883 - GRANT COUNTY PUBLIC HOSPITAL DISTRICT 1, SAMARITAN HEALTHCARE | 930386906 | WA | General Acute Care Hospital (282N00000X) |
United | 517 | $2122.00 | 1801931944 - GENEVA COUNTY HEALTHCARE AUTHORITY, INC., LIFETIME HEALTH SERVICES | 636004474 - (AL) GENEVA COUNTY HEALTH CARE AUTHORITY INC DBA WIREGRASS MEDICAL CENTER | AL | Psychiatric Hospital Unit (273R00000X) |
United | 517 | $18542.32 | 1205882669 - BRANDON HMA LLC, MERIT HEALTH RANKIN | 640885458 | MS | 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 517 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 517 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 517 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 |
|---|---|---|
| 516-MS-DRG | High | Other Musculoskeletal System and Connective Tissue O.R. Procedures with CC |
| 517-MS-DRG | High | Other Musculoskeletal System and Connective Tissue O.R. Procedures without CC/MCC |
| 518-APR-DRG | High | OTHER FEMALE REPRODUCTIVE SYSTEM & RELATED PROCEDURES |
| 518-MS-DRG | High | Back and Neck Procedures except Spinal Fusion with MCC or Disc Device or Neurostimulator |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 517. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 517 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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