MS-DRG 547 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 547 by major payers:
$10,138.88
$11,024.00
$11,994.84
$12,276.91
| 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 547 | ||||||
United | 547 | $14774.75 | 1992799050 - GRADY MEMORIAL HOSPITAL CORPORATION, GRADY HEALTH SYSTEMS | 262037695 - GRADY MEMORIAL HOSPITAL CORPORATION | GA | General Acute Care Hospital (282N00000X) |
United | 547 | $3564.00 | 1568649697 - MOUNTAIN STATES HEALTH ALLIANCE, RUSSELL COUNTY PSYCHIATRIC UNIT | 620476282 - MOUNTAIN STATES HEALTH ALLIANCE | VA | Psychiatric Hospital Unit (273R00000X) |
United | 547 | $11892.40 | 1376579532 - SOUTHWEST GENERAL HEALTH CENTER, OAKVIEW MENTAL HEALTH SERVICES | 340753531 - (OH) SOUTHWEST GENERAL HEALTH CENTER | OH | Psychiatric Hospital Unit (273R00000X) |
United | 547 | $8180.58 | 1851496152 - SSM HEALTH CARE ST. LOUIS, SSM HEALTH ST. CLARE HOSPITAL - FENTON | 431343281 - SSM HEALTH CARE ST LOUIS | MO | General Acute Care Hospital (282N00000X) |
United | 547 | $11697.42 | 1922239920 - WAYNE STATE UNIVERSITY/DETROIT MEDICAL CENTER | 272844942 | MI | General Acute Care Hospital (282N00000X) |
United | 547 | $9121.54 | 1275037921 - CBCH LLC | 823300758 - (MO) COX BARTON COUNTY HOSPITAL | MO | Critical Access Hospital (282NC0060X) |
United | 547 | $13354.74 | 1851370910 - TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA | 231352685 - TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA | PA | General Acute Care Hospital (282N00000X) |
United | 547 | $8926.79 | 1780648352 - BAPTIST MEMORIAL HOSPITAL UNION COUNTY, INC. | 630997281 - BAPTIST MEMORIAL HOSPITAL UNION COUNTY INC | MS | General Acute Care Hospital (282N00000X) |
United | 547 | $20723.88 | 1376564302 - INOVA HEALTH CARE SERVICES, INOVA LOUDOUN HOSPITAL | 540620889 - INOVA HEALTH CARE SERVICES | VA | General Acute Care Hospital (282N00000X) |
United | 547 | $5806.00 | 1891777983 - CENTRAL VALLEY GENERAL HOSPITAL | 770324630 - (CA) CENTRAL VALLEY GENERAL HOSPITAL | CA | General Acute Care Hospital (282N00000X) |
United | 547 | $14992.65 | 1912282369 - PROVIDENCE HEALTH & SERVICES, PROVIDENCE WILLAMETTE FALLS MEDICAL CENTER | 611659489 | OR | General Acute Care Hospital (282N00000X) |
United | 547 | $5847.39 | 1265437644 - WEST JEFFERSON HOLDINGS, LLC, WEST JEFFERSON MEDICAL CENTER | 472667968 - WEST JEFFERSON HOLDINGS, LLC | LA | General Acute Care Hospital (282N00000X) |
United | 547 | $10314.71 | 1114993086 - WAKEMED, WAKEMED CARY HOSPITAL | 566017737 - WAKEMED | NC | General Acute Care Hospital (282N00000X) |
United | 547 | $16522.81 | 1255540647 - , GEISINGER COMMUNITY MEDICAL CENTER | 240862246 - (PA) COMMUNITY MEDICAL CENTER | PA | General Acute Care Hospital (282N00000X) |
United | 547 | $11697.42 | 1922239920 - WAYNE STATE UNIVERSITY/DETROIT MEDICAL CENTER | 272844942 | MI | General Acute Care Hospital (282N00000X) |
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 547 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 547 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 547 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 |
|---|---|---|
| 546-APR-DRG | High | Other O.R. Proc For Obstetric Diagnoses Except Delivery Diagnoses |
| 546-MS-DRG | High | Connective Tissue Disorders with CC |
| 547-MS-DRG | High | Connective Tissue Disorders without CC/MCC |
| 548-APR-DRG | High | POSTPARTUM & POST ABORTION DIAGNOSIS 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 547. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 547 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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