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See a sample rate comparisonMS-DRG 522 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.
HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT 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 522 by major payers:
$26,782.04
$28,638.15
$34,095.14
$34,711.08
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MS-DRG 522
5 of 25 sample ratesHigher to lower in this preview
Prisma Health-Midlands, Prisma Health Baptist Hospital
Prisma Health-Midlands
$62,821.37Published rateSmsj Tucson Holdings LLC, St. Marys Hospital
$46,098.76Published rateAurora Health Care Southern Lakes, Inc., Aurora Medical Center Summit
Aurora Health Care Inc
$31,811.23Published rateAdvocate Health And Hospitals Corporation, Advocate Christ Medical Center
Advocate Health And Hospitals Corporation
$24,430.76Published rateFreeman-Oak Hill Health System
Freeman Health System
$8,787.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 522 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 522 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 522 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 |
|---|---|---|
| 521-APR-DRG | Moderate | Alteration In Consciousness |
| 521-MS-DRG | High | HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC |
| 522-MS-DRG | High | HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC |
| 533-MS-DRG | High | FRACTURES OF FEMUR 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 522. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 522 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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