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See a sample rate comparisonMS-DRG 552 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 WITHOUT 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 552 by major payers:
$10,790.40
$13,321.60
$15,348.69
$15,617.92
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MS-DRG 552
5 of 25 sample ratesHigher to lower in this preview
Westchester County Health Care Corporation, Westchester Medical Center
Peo Mid-Hudson Valley Staffco
$40,260.82Published rateUniversity Of Colorado Hospital Authority
$20,652.31Published rateMemorial Hermann Health System, Memorial Hermann Northeast
Memorial Hermann Health System
$13,432.58Published rateEast Texas Medical Center Athens
$10,297.24Published rateSt. Barnabas Hospital
St Barnabas Hospital
$2,531.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 552 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 552 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 552 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 |
|---|---|---|
| 551-APR-DRG | Moderate | Head Trauma With Coma > 1 Hour Or Hemorrhage |
| 551-MS-DRG | High | MEDICAL BACK PROBLEMS WITH MCC |
| 552-MS-DRG | High | MEDICAL BACK PROBLEMS WITHOUT MCC |
| 553-APR-DRG | Moderate | Head Trauma With Coma > 1 Hour Or Hemorrhage |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 552. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 552 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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