MS-DRG 519 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 519 by major payers:
$22,852.86
$25,441.54
$30,822.30
$32,090.89
| 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 519 | ||||||
United | 519 | $36977.05 | 1043293608 - BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION, THE MEDICAL CENTER | 610920842 - (KY) BOWLING GREEN-WARREN COUNTY COMMUNITY HOSPITAL CORPORATION | KY | General Acute Care Hospital (282N00000X) |
United | 519 | $22270.19 | 1578670543 - ADVOCATE HEALTH AND HOSPITALS CORPORATION, ADVOCATE GOOD SAMARITAN HOSPITAL | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | General Acute Care Hospital (282N00000X) |
United | 519 | $23609.41 | 1982719621 - WEBSTER HEALTH SERVICES, INC., WEBSTER GENERAL HOSPITAL | 640819193 - (MS) WEBSTER HEALTH SERVICES INC | MS | General Acute Care Hospital (282N00000X) |
United | 519 | $32522.55 | 1568825545 - PRIME HEALTHCARE SERVICES, SAINT MICHAEL'S MEDICAL CENTER | 463487442 | NJ | General Acute Care Hospital (282N00000X) |
United | 519 | $30280.00 | 1215945480 - MISSOURI BAPTIST HOSPITAL OF SULLIVAN, MISSOURI BAPTIST SULLIVAN HOSPITAL | 431459495 - MISSOURI BAPTIST HOSPITAL OF SULLIVAN | MO | Hospitalist Physician (208M00000X) |
United | 519 | $7275.00 | 1891809679 - FREEMAN-OAK HILL HEALTH SYSTEM, FREEMAN HEALTH SYSTEM | 431704371 - FREEMAN HEALTH SYSTEM | MO | General Acute Care Hospital (282N00000X) |
United | 519 | $17294.15 | 1508859661 - MERCY HOSPITAL JEFFERSON, JEFFERSON MEMORIAL HOSPITAL ASSOCIATION | 430687077 - (MO) MERCY HOSPITAL JEFFERSON | MO | General Acute Care Hospital (282N00000X) |
United | 519 | $21546.46 | 1417032145 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 519 | $4120.00 | 1861670903 - MOUNTAIN STATES HEALTH ALLIANCE, RUSSELL COUNTY SWING BED UNIT | 620476282 - MOUNTAIN STATES HEALTH ALLIANCE | VA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 519 | $18738.97 | 1508172339 - PEDIATRIC EXPRESS CARE LTD. | 362170840 - (IL) COPLEY MEMORIAL HOSPITAL INC | IL | Children's Hospital (282NC2000X) |
United | 519 | $10345.00 | 1447597240 - BAYLOR UNIVERSITY MEDICAL CENTER | 751837454 - (TX) BAYLOR UNIVERSITY MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 519 | $10339.53 | 1831975572 - DECATUR HEALTH SERVICES, LLC | 932081386 | TX | General Acute Care Hospital (282N00000X) |
United | 519 | $45085.00 | 1821041765 - SAN JOSE HEALTHCARE SYSTEM, L.P., REGIONAL MEDICAL CENTER OF SAN JOSE | 946000533 | CA | General Acute Care Hospital (282N00000X) |
United | 519 | $18088.91 | 1205859766 - WATAUGA MEDICAL CENTER INC, WATAUGA MEDICAL CENTER | 560510824 - (NC) WATAUGA MEDICAL CENTER INC | NC | General Acute Care Hospital (282N00000X) |
United | 519 | $50198.66 | 1194122390 - PROVIDENCE ST. VINCENT MEDICAL CENTER | 930386929 - (OR) PROVIDENCE HEALTH & SERVICES OREGON | OR | 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 519 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 519 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 519 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 |
|---|---|---|
| 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 |
| 519-MS-DRG | High | Back and Neck Procedures except Spinal Fusion with CC |
| 520-APR-DRG | Moderate | Alteration In Consciousness |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 519. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 519 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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