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See a sample rate comparisonMS-DRG 545 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.
CONNECTIVE TISSUE DISORDERS WITH 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 545 by major payers:
$28,016.26
$32,473.09
$39,568.52
$40,101.47
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MS-DRG 545
5 of 25 sample ratesHigher to lower in this preview
Texas Health Presbyterian Hospital Plano
$74,290.85Published rateMunster Medical Research Foundation Inc, Community Hospital
Munster Medical Research Foundation Inc
$44,718.55Published rateSt Elizabeths Hospital Of The Hospital Sisters Of The Third Order, Hshs St. Elizabeth'S Hospital
St Elizabeths Hospital Of The Hospital Sisters Of The Third Orde
$27,203.25Published rateGlen Cove Hospital, Glen Cove Rehab Exempt Unit
Glen Cove Hospital
$13,968.00Published rateProgressive Acute Care Dauterive, LLC, Dauterive Hospital
Progressive Acute Care Dauterive LLC
$2,500.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 545 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 545 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 545 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 |
|---|---|---|
| 544-APR-DRG | High | D&C, Aspiration Curettage Or Hysterotomy For Obstetric Diagnoses |
| 544-MS-DRG | High | PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC |
| 545-MS-DRG | High | CONNECTIVE TISSUE DISORDERS WITH MCC |
| 546-APR-DRG | High | Other O.R. Proc For Obstetric Diagnoses Except Delivery 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 545. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 545 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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