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See a sample rate comparisonMS-DRG 551 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.
MEDICAL BACK PROBLEMS 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 551 by major payers:
$18,786.55
$22,405.28
$25,700.12
$27,199.26
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MS-DRG 551
5 of 25 sample ratesHigher to lower in this preview
Sierra Vista Hospital, Inc., Sierra Vista Regional Medical Center
$96,961.06Published rateSt. Vincent Hospital & Health Care Center, Inc., St. Vincent Neighborhood Hospital
St Vincent Hospital & Health Care
$35,419.73Published rateMercy Hospital Waldron
$21,164.48Published rateValley Medical Facilities, Inc., Valley Medical Facilities D/B/A Sewickley Valley Hospital Inpt Rehab U
Heritage Valley Health System
$14,641.45Published rateClhg-Avoyelles LLC
$2,500.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 551 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 551 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 551 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 |
|---|---|---|
| 550-MS-DRG | High | SEPTIC ARTHRITIS WITHOUT CC/MCC |
| 551-MS-DRG | High | MEDICAL BACK PROBLEMS WITH MCC |
| 552-APR-DRG | Moderate | Head Trauma With Coma > 1 Hour Or Hemorrhage |
| 552-MS-DRG | High | MEDICAL BACK PROBLEMS WITHOUT 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 551. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 551 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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