MS-DRG 545 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 545 by major payers:
$28,016.26
$32,473.09
$39,568.52
$40,101.47
| 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 545 | ||||||
United | 545 | $56516.64 | 1265605166 - AURORA SINAI MEDICAL CENTER, INC. | 390806181 - AURORA HEALTH CARE INC | WI | Rehabilitation Hospital Unit (273Y00000X) |
United | 545 | $40756.37 | 1902474430 - FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC, FROEDTERT COMMUNITY HOSPITAL | 843381796 | WI | General Acute Care Hospital (282N00000X) |
United | 545 | $27140.53 | 1598905762 - CENTRAL IOWA HOSPITAL CORPORATION, UNITYPOINT HEALTH - DES MOINES IOWA METHODIST MEDICAL CENTER | 420680452 - CENTRAL IOWA HOSPITAL CORPORATION | IA | General Acute Care Hospital (282N00000X) |
United | 545 | $30920.66 | 1881760759 - INTEGRIS BAPTIST MEDICAL CENTER INC, INTEGRIS MENTAL HEALTH CENTER ACUTE | 731034824 - (OK) INTEGRIS BAPTIST MEDICAL CENTER INC | OK | Psychiatric Hospital Unit (273R00000X) |
United | 545 | $18565.69 | 1982675955 - SAINT FRANCIS MEDICAL CENTER, CHI HEALTH ST. FRANCIS | 470376601 - (NE) SAINT FRANCIS MEDICAL CENTER | NE | General Acute Care Hospital (282N00000X) |
United | 545 | $22887.58 | 1467447508 - BROADLAWNS MEDICAL CENTER, BROADLAWNS MEDICAL CENTER | 426005830 - (IA) BROADLAWNS MEDICAL CENTER | IA | General Acute Care Hospital (282N00000X) |
United | 545 | $44718.55 | 1003918210 - MUNSTER MEDICAL RESEARCH FOUNDATION INC, COMMUNITY HOSPITAL | 351107009 - (IN) MUNSTER MEDICAL RESEARCH FOUNDATION INC | IN | General Acute Care Hospital (282N00000X) |
United | 545 | $13968.00 | 1336157791 - GLEN COVE HOSPITAL, GLEN COVE REHAB EXEMPT UNIT | 111633487 - (NY) GLEN COVE HOSPITAL | NY | Rehabilitation Hospital Unit (273Y00000X) |
United | 545 | $26431.36 | 1619915949 - CHI ST VINCENT HOSPITAL HOT SPRINGS | 710236913 - CHI ST VINCENT HOSPITAL HOT SPRINGS | AR | Psychiatric Hospital Unit (273R00000X) |
United | 545 | $21655.41 | 1073580726 - METHODIST HOSPITAL PLAINVIEW TEXAS, COVENANT HOSPITAL PLAINVIEW | 752426010 - (TX) METHODIST HOSPITAL PLAINVIEW TEXAS | TX | General Acute Care Hospital (282N00000X) |
United | 545 | $69896.57 | 1306817978 - SALEM HOSPITAL CORPORATION, MEMORIAL HOSPITAL OF SALEM COUNTY | 210634484 - (NJ) INSPIRA MEDICAL CENTERS INC | NJ | General Acute Care Hospital (282N00000X) |
United | 545 | $40021.03 | 1225289895 - PROVIDENCE HEALTH & SERVICES, PROVIDENCE HOLY FAMILY HOSPITAL | 352345508 | WA | General Acute Care Hospital (282N00000X) |
United | 545 | $64092.21 | 1548378235 - MEDSTAR WASHINGTON HOSPITAL CENTER | 521272129 - (DC) WASHINGTON HOSPITAL CENTER CORPORATION | DC | General Acute Care Hospital (282N00000X) |
United | 545 | $29202.60 | 1730166224 - INSIGHT CHICAGO, INC., INSIGHT HOSPITAL & MEDICAL CENTER CHICAGO | 862358048 - INSIGHT CHICAGO INC | IL | General Acute Care Hospital (282N00000X) |
United | 545 | $31518.19 | 1962721373 - AUBURN COMMUNITY HOSPITAL, AUBURN MEMORIAL HOSPITALISTS GROUP | 150532054 - AUBURN COMMUNITY HOSPITAL | NY | Hospitalist Physician (208M00000X) |
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 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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