MS-DRG 534 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 534 by major payers:
$10,335.53
$11,111.43
$12,919.92
$13,283.08
| 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 534 | ||||||
United | 534 | $17258.42 | 1518988310 - SMDC MEDICAL CENTER, ESSENTIA HEALTH DULUTH (REHAB UNIT) | 411878730 - (MN) SMDC MEDICAL CENTER | MN | Rehabilitation Hospital Unit (273Y00000X) |
United | 534 | $9506.96 | 1972560654 - BAPTIST MEMORIAL HOSPITAL-DESOTO, INC. | 640682111 - (MS) BAPTIST MEMORIAL HOSPITAL-DESOTO INC | MS | Rehabilitation Hospital Unit (273Y00000X) |
United | 534 | $7756.60 | 1619676251 - TATE COUNTY HOSPITAL | 922135241 - (MS) TATE COUNTY HOSPITAL | MS | General Acute Care Hospital (282N00000X) |
United | 534 | $7452.52 | 1649278854 - ROOKS COUNTY HEALTH CENTER, PLAINVILLE RURAL HOSPITAL | 486084911 | KS | Critical Access Hospital (282NC0060X) |
United | 534 | $10925.50 | 1710051941 - FRANCISCAN HEALTH MICHIGAN CITY, FRANCISCAN ST. ANTHONY HEALTH - MICHIGAN CITY | 350876394 - (IN) FRANCISCAN HEALTH MICHIGAN CITY | IN | General Acute Care Hospital (282N00000X) |
United | 534 | $3665.00 | 1669513941 - SHRINERS HOSPITALS FOR CHILDREN | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | TX | Children's Hospital (282NC2000X) |
United | 534 | $13684.13 | 1932553385 - BBH WBMC, LLC, WALKER BAPTIST MEDICAL CENTER | 474790386 | AL | General Acute Care Hospital (282N00000X) |
United | 534 | $11964.16 | 1336378132 - ROTHMAN ORTHOPAEDIC SPECIALTY HOSPITAL, LLC, BUCKS COUNTY SPECIALTY HOSPITAL, LLC | 270260289 - (PA) ROTHMAN ORTHOPAEDIC SPECIALTY HOSPITAL LLC | PA | General Acute Care Hospital (282N00000X) |
United | 534 | $15269.00 | 1811739923 - INTERMOUNTAIN FRONT RANGE, INC, INTERMOUNTAIN HEALTH LUTHERAN HOSPITAL | 841103606 - (CO) SCL HEALTH - FRONT RANGE INC | CO | General Acute Care Hospital (282N00000X) |
United | 534 | $14165.42 | 1700978558 - SOUTHWEST VOLUSIA HEALTHCARE CORPORATION, ADVENTHEALTH FISH MEMORIAL | 593149293 - SOUTHWEST VOLUSIA HEALTHCARE CORPORATION | FL | General Acute Care Hospital (282N00000X) |
United | 534 | $17606.82 | 1316918287 - MEMORIAL MEDICAL CENTER | 370661220 - (IL) MEMORIAL HEALTH SYSTEM | IL | Psychiatric Hospital Unit (273R00000X) |
United | 534 | $6044.02 | 1023587045 - KETTERING MEDICAL CENTER, KETTERING HEALTH TROY | 310621866 - (OH) KETTERING COLLEGE | OH | General Acute Care Hospital (282N00000X) |
United | 534 | $8762.70 | 1316175417 - URGENT CARE CENTERS OF ST. ANTHONY'S MEDICAL CENTER, LC | 430980256 - (MO) MERCY HOSPITAL SOUTH | MO | General Acute Care Hospital (282N00000X) |
United | 534 | $22101.73 | 1023194271 - PROVIDENCE HEALTH & SERVICES OREGON, PROVIDENCE PORTLAND MEDICAL CENTER | 930386906 | OR | Psychiatric Hospital Unit (273R00000X) |
United | 534 | $15959.28 | 1780927277 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS | 954537720 | TX | 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 534 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 534 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 534 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 |
|---|---|---|
| 533-MS-DRG | High | Fractures of Femur with MCC |
| 534-MS-DRG | High | Fractures of Femur without MCC |
| 535-MS-DRG | High | Fractures of Hip and Pelvis 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 534. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 534 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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