MS-DRG 546 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 546 by major payers:
$14,323.34
$15,983.33
$18,367.22
$18,705.51
| 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 546 | ||||||
United | 546 | $22333.35 | 1700817756 - UNIVERSITY OF CALIFORNIA IRVINE, UCI HEALTH - PLACENTIA LINDA | 752918773 - (CA) UNIVERSITY OF CALIFORNIA IRVINE | CA | General Acute Care Hospital (282N00000X) |
United | 546 | $26586.58 | 1336172105 - TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH | 756001743 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH | TX | General Acute Care Hospital (282N00000X) |
United | 546 | $24772.19 | 1003845652 - COMANCHE COUNTY HOSPITAL | 486075762 - (KS) COMANCHE COUNTY HOSPITAL | KS | Critical Access Hospital (282NC0060X) |
United | 546 | $25796.22 | 1306212923 - SMSJ TUCSON HOLDINGS LLC, ST. JOSEPHS HOSPITAL | 474131755 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 546 | $13693.20 | 1255995361 - VHS OF PHOENIX INC, ABRAZO MESA HOSPITAL | 621809851 | AZ | General Acute Care Hospital (282N00000X) |
United | 546 | $23218.83 | 1407815830 - ST. CATHERINE OF SIENA MEDICAL CENTER | 61562701 - (NY) ST CATHERINE OF SIENA MEDICAL CENTER | NY | Psychiatric Hospital Unit (273R00000X) |
United | 546 | $25041.05 | 1144292020 - TAYLORVILLE MEMORIAL HOSPITAL | 370661250 - (IL) MEMORIAL HEALTH SYSTEM | IL | Critical Access Hospital (282NC0060X) |
United | 546 | $28163.36 | 1194926279 - ST JUDE HOSPITAL INC, PROVIDENCE ST. JUDE MEDICAL CENTER | 951643325 - (CA) ST JUDE HOSPITAL | CA | General Acute Care Hospital (282N00000X) |
United | 546 | $5392.00 | 1154364016 - MANCHESTER MEMORIAL HOSPITAL, MANCHESTER MEMORIL HOSPITAL PSYCHIATRIC | 812216981 | CT | Psychiatric Hospital Unit (273R00000X) |
United | 546 | $5713.00 | 1396792032 - RIVER OAKS HOSPITAL LLC, MERIT HEALTH RIVER OAKS | 640626874 - (MS) RIVER OAKS HOSPITAL LLC | MS | General Acute Care Hospital (282N00000X) |
United | 546 | $19521.14 | 1669466561 - STATE OF CONNECTICUT, JOHN DEMPSEY HOSPITAL | 66000798 | CT | General Acute Care Hospital (282N00000X) |
United | 546 | $11157.08 | 1730128836 - MIDWEST REGIONAL MEDICAL CENTER, LLC, ALLIANCEHEALTH MIDWEST | 730657693 - SSM HEALTH CARE OF OKLAHOMA INC | OK | General Acute Care Hospital (282N00000X) |
United | 546 | $16494.91 | 1659523132 - THE METHODIST HOSPITAL, THE METHODIST HOSPITAL | 350868133 - METHODIST HOSPITALS INC | IN | General Acute Care Hospital (282N00000X) |
United | 546 | $23154.00 | 1821091059 - WAYNESBORO HOSPITAL, WELLSPAN WAYNESBORO HOSPITAL | 231360854 - (PA) WAYNESBORO HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 546 | $7675.00 | 1497917918 - PHELPS MEMORIAL HOSPITAL ASSOCIATION, PHELPS HOSPITAL | 131725076 - (NY) PHELPS MEMORIAL HOSPITAL ASSOCIATION | NY | Psychiatric Hospital (283Q00000X) |
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 546 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 546 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 546 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 |
|---|---|---|
| 545-APR-DRG | High | Migraine And Other Headaches |
| 545-MS-DRG | High | Connective Tissue Disorders with MCC |
| 546-MS-DRG | High | Connective Tissue Disorders with CC |
| 547-APR-DRG | High | ANTEPARTUM W O.R. PROCEDURE |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 546. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 546 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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