MS-DRG 550 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 550 by major payers:
$11,336.09
$12,703.25
$13,747.80
$14,072.34
| 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 550 | ||||||
United | 550 | $11700.41 | 1831620632 - MACNEAL HOSPITAL | 363332852 - (IL) GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION | IL | General Acute Care Hospital (282N00000X) |
United | 550 | $9326.00 | 1689821944 - STATEN ISLAND UNIVERSITY HOSPITAL | 112868878 - (NY) STATEN ISLAND UNIVERSITY HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 550 | $8741.00 | 1366459570 - NORTH SHORE UNIVERSITY HOSPITAL | 111562701 - (NY) NORTH SHORE UNIVERSITY HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 550 | $37328.07 | 1740215219 - JOHN MUIR HEALTH, JOHN MUIR HEALTH, WALNUT CREEK MEDICAL CENTER | 941461843 - (CA) JOHN MUIR HEALTH | CA | General Acute Care Hospital (282N00000X) |
United | 550 | $22066.72 | 1639669617 - UCH-MHS, UCHEALTH EMERGENCY ROOM - MEADOWGRASS | 460796114 - (CO) UCH-MHS | CO | General Acute Care Hospital (282N00000X) |
United | 550 | $9651.70 | 1740876382 - DELTA HEALTH SYSTEM, DELTA HEALTH-NORTHWEST REGIONAL | 853959101 | MS | General Acute Care Hospital (282N00000X) |
United | 550 | $22347.35 | 1982636270 - CENTRASTATE MEDICAL CENTER INC. | 221750190 - (NJ) CENTRASTATE MEDICAL CENTER INC | NJ | Psychiatric Hospital Unit (273R00000X) |
United | 550 | $6733.50 | 1407191984 - BSA HOSPITAL LLC | 300754305 | TX | General Acute Care Hospital (282N00000X) |
United | 550 | $19375.69 | 1942267869 - MARIN GENERAL HOSPITAL | 942823538 - (CA) MARIN GENERAL HOSPITAL | CA | Psychiatric Hospital Unit (273R00000X) |
United | 550 | $12255.61 | 1225324833 - HARRIS REGIONAL HOSPITAL, INC., MEDWEST URGENT CARE SYLVA | 383932775 | NC | General Acute Care Hospital (282N00000X) |
United | 550 | $10173.75 | 1477537363 - VHS OF PHOENIX INC, ABRAZO CENTRAL CAMPUS | 621811285 | AZ | General Acute Care Hospital (282N00000X) |
United | 550 | $16767.88 | 1295159028 - CATHOLIC HEALTH INITIATIVES COLORADO, ST. ANTHONY SUMMIT HOSPITAL SWING BED UNIT | 840405257 - CATHOLIC HEALTH INITIATIVES COLORADO | CO | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 550 | $13832.32 | 1811341167 - BBH SBMC, LLC, SHELBY BAPTIST MEDICAL CENTER | 474780023 | AL | General Acute Care Hospital (282N00000X) |
United | 550 | $23815.50 | 1255401519 - THE MEDICAL CENTER INC, PIEDMONT COLUMBUS REGIONAL MIDTOWN | 581685139 - (GA) THE MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | 550 | $18194.28 | 1447368071 - ADVOCATE HEALTH AND HOSPITALS CORPORATION, ADVOCATE GOOD SHEPHERD HOSPITAL | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | 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 550 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 550 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 550 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 |
|---|---|---|
| 549-MS-DRG | High | Septice Arthritis with CC |
| 550-MS-DRG | High | Septice Arthritis without CC/MCC |
| 551-APR-DRG | Moderate | Head Trauma With Coma > 1 Hour Or Hemorrhage |
| 551-MS-DRG | High | Medical Back Problems with MCC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 550. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 550 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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