MS-DRG 533 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 533 by major payers:
$18,395.73
$23,548.29
$24,069.85
$24,425.40
| 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 533 | ||||||
United | 533 | $26948.02 | 1427806025 - LEE HEALTH SYSTEM INC, LEE PHARMACY #1 | 992646504 | FL | General Acute Care Hospital (282N00000X) |
United | 533 | $13605.48 | 1568406536 - WHITE COUNTY MEDICAL CENTER | 710772737 - WHITE COUNTY MEDICAL CENTER | AR | General Acute Care Hospital (282N00000X) |
United | 533 | $35296.96 | 1790722346 - CARLSBAD MEDICAL CENTER LLC, CARLSBAD MEDICAL CENTER | 621762526 - (NM) CARLSBAD MEDICAL CENTER LLC | NM | General Acute Care Hospital (282N00000X) |
United | 533 | $24595.10 | 1730710898 - FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC, FROEDTERT COMMUNITY HOSPITAL | 843381796 | WI | General Acute Care Hospital (282N00000X) |
United | 533 | $26948.02 | 1427806025 - LEE HEALTH SYSTEM INC, LEE PHARMACY #1 | 992646504 | FL | General Acute Care Hospital (282N00000X) |
United | 533 | $4708.00 | 1902280050 - JOHNSTON MEMORIAL HOSPITAL, INC, JOHNSTON MEMORIAL HOSPITAL REHABILITATION | 540544705 - JOHNSTON MEMORIAL HOSPITAL INC | VA | General Acute Care Hospital (282N00000X) |
United | 533 | $14817.45 | 1538207394 - UPMC HAMOT, SPU | 250965387 - (PA) UPMC | PA | General Acute Care Hospital (282N00000X) |
United | 533 | $64300.44 | 1831188705 - SAUNDERS MEDICAL CENTER | 476007158 - SAUNDERS MEDICAL CENTER | NE | Critical Access Hospital (282NC0060X) |
United | 533 | $18540.47 | 1336205798 - FRANCISCAN HEALTH CROWN POINT, FRANCISCAN ST. ANTHONY HEALTH - CROWN POINT | 352074283 - (IN) FRANCISCAN HEALTH CROWN POINT | IN | General Acute Care Hospital (282N00000X) |
United | 533 | $28203.02 | 1639108434 - WILLAMETTE FALLS HOSPITAL, PROVIDENCE WILLAMETTE FALLS MEDICAL CENTER | 611659489 | OR | General Acute Care Hospital (282N00000X) |
United | 533 | $52644.12 | 1144504044 - THE NEW YORK AND PRESBYTERIAN HOSPITAL, NEW YORK PRESBYTERIAN HOSPITAL | 133957095 - (NY) THE NEW YORK AND PRESBYTERIAN HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 533 | $14478.92 | 1568739423 - THREE RIVERS HEALTH SYSTEM, INC, THREE RIVERS HEALTH | 451257972 - THREE RIVERS HEALTH SYSTEM INC | MI | General Acute Care Hospital (282N00000X) |
United | 533 | $15677.88 | 1033163407 - ST JOSEPH HEALTH SYSTEM LLC, LUTHERAN DOWNTOWN HOSPITAL | 510382045 | IN | Rehabilitation Hospital Unit (273Y00000X) |
United | 533 | $20416.49 | 1265698948 - UNIVERSITY OF IOWA HOSPITAL AND CLINICS | 426004813 | IA | General Acute Care Hospital (282N00000X) |
United | 533 | $5264.00 | 1174521991 - PAWHUSKA HOSPITAL, INC. | 237169376 - (OK) PAWHUSKA HOSPITAL INC | OK | Critical Access Hospital (282NC0060X) |
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 533 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 533 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 533 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 |
|---|---|---|
| 522-APR-DRG | Moderate | Alteration In Consciousness |
| 522-MS-DRG | High | Hip Replacement with Principal Diagnosis of Hip Fracture without MCC |
| 533-MS-DRG | High | Fractures of Femur with MCC |
| 534-MS-DRG | High | Fractures of Femur without 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 533. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 533 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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