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See a sample rate comparisonMS-DRG 555 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.
SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE 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 555 by major payers:
$15,205.67
$19,791.64
$21,196.03
$21,594.45
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MS-DRG 555
5 of 25 sample ratesHigher to lower in this preview
Clarke County Public Hospital, Clarke County Hospital
$51,518.64Published rateLakewood Regional Medical Center, Inc., Lakewood Regional Medical Center
Lakewood Regional Medical Center Inc
$27,207.75Published rateUniversity Of Washington, University Of Washington Medical Center
$24,121.33Published rateSaint Thomas River Park Hospital, LLC, Ascension Saint Thomas River Park
$21,082.92Published rateScreven County Hospital, LLC, Optim Medical Center - Screven
$15,381.91Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 555 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 555 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 555 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 |
|---|---|---|
| 554-APR-DRG | Moderate | Head Trauma With Coma > 1 Hour Or Hemorrhage |
| 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 |
| 556-MS-DRG | High | SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE 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 555. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 555 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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