MS-DRG 522 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 522 by major payers:
$26,782.04
$28,638.15
$34,095.14
$34,711.08
| 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 522 | ||||||
United | 522 | $21387.84 | 1609860659 - FORT LOUDOUN MEDICAL CENTER | 621373691 - (TN) FORT LOUDOUN MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | 522 | $19500.00 | 1336559582 - FULTON MEDICAL CENTER LLC | 850857935 | MO | Psychiatric Hospital Unit (273R00000X) |
United | 522 | $41985.00 | 1649299827 - BARNES JEWISH HOSPITAL, BARNES-JEWISH HOSPITAL | 237309937 - BARNES JEWISH HOSPITAL | MO | General Acute Care Hospital (282N00000X) |
United | 522 | $43701.35 | 1639108434 - WILLAMETTE FALLS HOSPITAL, PROVIDENCE WILLAMETTE FALLS MEDICAL CENTER | 611659489 | OR | General Acute Care Hospital (282N00000X) |
United | 522 | $8787.00 | 1780747097 - FREEMAN-OAK HILL HEALTH SYSTEM | 431704371 - FREEMAN HEALTH SYSTEM | MO | General Acute Care Hospital (282N00000X) |
United | 522 | $39819.89 | 1528463080 - PRIME HEALTHCARE SERVICES KANSAS CITY, LLC, ST. JOSEPH MEDICAL CENTER | 471669781 - (MO) PRIME HEALTHCARE SERVICES - KANSAS CITY LLC | MO | General Acute Care Hospital (282N00000X) |
United | 522 | $27564.21 | 1679885347 - VHS SINAI-GRACE HOSPITAL INC, SINAI GRACE HOSPITAL | 272844632 | MI | Rehabilitation Hospital Unit (273Y00000X) |
United | 522 | $24430.76 | 1548375082 - ADVOCATE HEALTH AND HOSPITALS CORPORATION, ADVOCATE CHRIST MEDICAL CENTER | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | General Acute Care Hospital (282N00000X) |
United | 522 | $46098.76 | 1265818488 - SMSJ TUCSON HOLDINGS LLC, ST. MARYS HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 522 | $16191.99 | 1013937705 - MIZELL MEMORIAL HOSPITAL, INC. | 630307951 - (AL) MIZELL MEMORIAL HOSPITAL INC | AL | Rural Acute Care Hospital (282NR1301X) |
United | 522 | $60603.66 | 1902466840 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 522 | $37417.33 | 1851371959 - MOUNTAIN RIVER BIRTHING AND SURGERY CENTER LLC, IDAHO DOCTORS HOSPITAL | 470917144 - (ID) MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC | ID | General Acute Care Hospital (282N00000X) |
United | 522 | $29325.00 | 1699769901 - CURATORS OF THE UNIVERSITY OF MISSOURI, UNIVERSITY OF MISSOURI HEALTH CARE | 436003859 | MO | General Acute Care Hospital (282N00000X) |
United | 522 | $59442.10 | 1942772546 - SPARTANBURG MEDICAL CENTER | 576000934 | SC | Rehabilitation Hospital Unit (273Y00000X) |
United | 522 | $45490.69 | 1902824758 - PROVIDENCE HEALTH SYSTEM, PROVIDENCE HOLY CROSS MEDICAL CENTER | 954582647 - (CA) PROVIDENCE HEALTH SYSTEM | CA | Rehabilitation Hospital Unit (273Y00000X) |
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 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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