MS-DRG 554 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 554 by major payers:
$10,278.59
$11,812.33
$13,400.18
$13,651.89
| 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 554 | ||||||
United | 554 | $4097.89 | 1588158497 - CALDWELL MEMORIAL HOSPITAL INC, CALDWELL HOSPITAL CLINIC | 720878037 - (LA) CALDWELL MEMORIAL HOSPITAL, INC. | LA | Rural Acute Care Hospital (282NR1301X) |
United | 554 | $12502.87 | 1114995677 - NORTH CAROLINA BAPTIST HOSPITAL | 560552787 - (NC) NORTH CAROLINA BAPTIST HOSPITAL | NC | Rehabilitation Hospital Unit (273Y00000X) |
United | 554 | $10339.53 | 1093780652 - KIMBALL COUNTY HOSPITAL, KIMBALL HEALTH SERVICES | 476007155 - KIMBALL COUNTY HOSPITAL | NE | Critical Access Hospital (282NC0060X) |
United | 554 | $33995.39 | 1073530879 - LAWRENCE AND MEMORIAL HOSPITAL, INC., LAWRENCE AND MEMORIAL HOSPITAL | 60646704 - (CT) LAWRENCE AND MEMORIAL HOSPITAL INC | CT | General Acute Care Hospital (282N00000X) |
United | 554 | $17814.53 | 1598337305 - STEWARD NSMC, INC. | 862695690 | FL | General Acute Care Hospital (282N00000X) |
United | 554 | $16424.08 | 1871594127 - UNIONTOWN HOSPITAL | 250965588 - (PA) UNIONTOWN HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 554 | $10432.50 | 1770671182 - NEWARK WAYNE COMMUNITY HOSPITAL | 150584188 - NEWARK WAYNE COMMUNITY HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 554 | $11293.80 | 1275531956 - COOKEVILLE REGIONAL MEDICAL CENTER | 626002166 | TN | General Acute Care Hospital (282N00000X) |
United | 554 | $12671.26 | 1932296696 - CROZER-CHESTER MEDICAL CENTER, CROZERTAYLORSPRINGFIELD | 811507712 | PA | Psychiatric Hospital Unit (273R00000X) |
United | 554 | $8088.10 | 1235357534 - WHITE RIVER HEALTH SYSTEM, INC., STONE COUNTY MEDICAL CENTER | 710411459 - WHITE RIVER HEALTH SYSTEM INC | AR | Critical Access Hospital (282NC0060X) |
United | 554 | $12329.25 | 1811973100 - OCHSNER CLINIC FOUNDATION, OCHSNER MEDICAL CENTER ACUTE | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | General Acute Care Hospital (282N00000X) |
United | 554 | $12096.69 | 1538260849 - VALLEY BAPTIST MEDICAL CENTER | 452663071 | TX | General Acute Care Hospital (282N00000X) |
United | 554 | $11330.53 | 1558607457 - THE METROHEALTH SYSTEM, METROHEALTH SYSTEM | 346004382 | OH | General Acute Care Hospital (282N00000X) |
United | 554 | $24537.24 | 1629138029 - ROCKWALL REGIONAL HOSPITAL, LLC, TEXAS HEALTH PRESBYTERIAN HOSPITAL ROCKWALL | 202848116 - (TX) ROCKWALL REGIONAL HOSPITAL, LLC | TX | General Acute Care Hospital (282N00000X) |
United | 554 | $10220.50 | 1033499017 - OLEAN GENERAL HOSPITAL, FOOTHILLS MEDICAL GROUP | 160743102 - OLEAN GENERAL HOSPITAL | NY | 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 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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