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See a sample rate comparisonMS-DRG 554 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.
BONE DISEASES AND ARTHROPATHIES 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 554 by major payers:
$10,278.59
$11,812.33
$13,400.18
$13,651.89
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MS-DRG 554
5 of 25 sample ratesHigher to lower in this preview
Lawrence And Memorial Hospital, Inc., Lawrence And Memorial Hospital
Lawrence And Memorial Hospital Inc
$33,995.39Published rateBeth Israel Medical Center
$16,568.00Published rateValley Baptist Medical Center
$12,096.69Published rateGila River Health Care Corporation, Komatke Health Center
Gila River Health Care Corporation
$10,339.53Published rateCaldwell Memorial Hospital Inc, Caldwell Hospital Clinic
Caldwell Memorial Hospital, Inc.
$4,097.89Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 554 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 554 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 554 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 |
|---|---|---|
| 553-APR-DRG | Moderate | Head Trauma With Coma > 1 Hour Or Hemorrhage |
| 553-MS-DRG | High | BONE DISEASES AND ARTHROPATHIES WITH MCC |
| 554-MS-DRG | High | BONE DISEASES AND ARTHROPATHIES WITHOUT MCC |
| 555-MS-DRG | High | SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE 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 554. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 554 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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