Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonMS-DRG 543 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.
PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC
| 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 543 by major payers:
$13,450.94
$14,883.64
$16,971.57
$17,187.42
Compare published rates across providers.
Choose a payer to see a sample of rates for MS-DRG 543.
MS-DRG 543
5 of 25 sample ratesHigher to lower in this preview
Scripps Health, Scripps Memorial Hospital La Jolla
Scripps Health
$35,501.96Published rateSteward St. Elizabeth'S Medical Center Of Boston, Inc., St. Elizabeth'S Medical Center Psychiatric Unit
$16,433.58Published rateMercy Hospital Booneville
$13,225.91Published rateRoswell Hospital Corporation, Eastern New Mexico Medical Center
$8,143.18Published rateState Of Mississippi, Holmes County Hospital And Clinic
North Mississippi Medical Center Inc
$1,838.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalMS-DRG 543 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 543 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 543 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 |
|---|---|---|
| 542-APR-DRG | High | VAGINAL DELIVERY W O.R. PROCEDURE EXCEPT STERILIZATION &/OR D&C |
| 542-MS-DRG | High | PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC |
| 543-MS-DRG | High | PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC |
| 544-APR-DRG | High | D&C, Aspiration Curettage Or Hysterotomy For Obstetric Diagnoses |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 543. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 543 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like MS-DRG 543) and we'll show you how you compare in 15 minutes or less.