MS-DRG 553 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 553 by major payers:
$15,843.38
$18,012.57
$20,586.32
$20,984.87
| 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 553 | ||||||
United | 553 | $16616.68 | 1073751699 - MERCY TYLER HOSPITAL, TYLER MEMORIAL HOSPITAL | 274566015 | PA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 553 | $3744.00 | 1902972870 - HIGHLANDS HOSPITAL, PENN HIGHLANDS CONNELLSVILLE | 251494705 - HIGHLANDS HOSPITAL AND HEALTH CENTER | PA | General Acute Care Hospital (282N00000X) |
United | 553 | $14419.15 | 1598835308 - SSM HEALTH CARE ST. LOUIS, SSM HEALTH DEPAUL HOSPITAL - ST. LOUIS | 431343281 - SSM HEALTH CARE ST LOUIS | MO | General Acute Care Hospital (282N00000X) |
United | 553 | $22961.93 | 1548207608 - UNIVERSITY HEALTHCARE SYSTEM, L.C., EAST JEFFERSON GENERAL HOSPITAL | 621596506 | LA | Rehabilitation Hospital Unit (273Y00000X) |
United | 553 | $31071.05 | 1700978558 - SOUTHWEST VOLUSIA HEALTHCARE CORPORATION, ADVENTHEALTH FISH MEMORIAL | 591113901 - (FL) UNIVERSITY COMMUNITY HOSPITAL INC | FL | General Acute Care Hospital (282N00000X) |
United | 553 | $34884.57 | 1467420448 - COBB HOSPITAL, INC, WELLSTAR COBB HOSPITAL | 580968382 - COBB HOSPITAL | GA | General Acute Care Hospital (282N00000X) |
United | 553 | $3593.00 | 1881613909 - TAKOMA HOSPITAL & SANITARIUM TRAINING SCHOOL, INC., TAKOMA ADVENTIST HOSPITAL | 510603966 - TAKOMA REGIONAL HOSPITAL INC | TN | Rural Acute Care Hospital (282NR1301X) |
United | 553 | $23079.63 | 1982658407 - LEE MEMORIAL HEALTH SYSTEM, GULF COAST MEDICAL CENTER | 992646504 | FL | General Acute Care Hospital (282N00000X) |
United | 553 | $12662.34 | 1477941862 - SKAGGS COMMUNITY HOSPITAL ASSOCIATION, COXHEALTH BRANSON HOSPITALIST | 440577118 - LESTER E COX MEDICAL CENTER | MO | Hospitalist Physician (208M00000X) |
United | 553 | $23079.63 | 1982658407 - LEE MEMORIAL HEALTH SYSTEM, GULF COAST MEDICAL CENTER | 992646504 | FL | General Acute Care Hospital (282N00000X) |
United | 553 | $135891.90 | 1689608150 - UNIVERSITY OF CALIFORNIA IRVINE, UCI MEDICAL CENTER | 952226406 - REGENTS OF THE UNIVERSITY OF CALIFORNIA AT IRVINE | CA | General Acute Care Hospital (282N00000X) |
United | 553 | $32348.15 | 1902804552 - THE CHAMBERSBURG HOSPITAL, WELLSPAN CHAMBERSBURG HOSPITAL | 230465970 - CHAMBERSBURG HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 553 | $17172.58 | 1760482517 - ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC. | 481186704 - ASCENSION VIA CHRISTI HOSPITAL MANHATTAN INC | KS | General Acute Care Hospital (282N00000X) |
United | 553 | $23559.91 | 1942756051 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH INT MED/SUBSPEC CLINIC | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 553 | $24154.47 | 1841376092 - PROVIDENCE HEALTH & SERVICES OREGON, PROVIDENCE PORTLAND MEDICAL CENTER | 930386906 | OR | Rehabilitation Hospital Unit (273Y00000X) |
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 553 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 553 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 553 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 |
|---|---|---|
| 552-APR-DRG | Moderate | Head Trauma With Coma > 1 Hour Or Hemorrhage |
| 552-MS-DRG | High | Medical Back Problems without MCC |
| 553-MS-DRG | High | Bone Diseases and Arthropathies with MCC |
| 554-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 553. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 553 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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