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See a sample rate comparisonMS-DRG 556 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 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 556 by major payers:
$9,312.19
$11,163.79
$12,997.45
$13,322.32
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MS-DRG 556
5 of 25 sample ratesHigher to lower in this preview
East Cooper Community Hospital, Inc., East Cooper Medical Center
$20,959.51Published rateSt Francis Hospital Inc, St. Francis Eastside
St Francis Hospital Inc
$17,489.42Published rateValley Baptist Medical Center
$11,456.62Published rateMcallen Hospitals L P, South Texas Health System
$9,113.21Published rateJohnston Memorial Hospital, Johnston Memorial Hospital Er Physicians
Johnston Memorial Hospital Inc
$4,158.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 556 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 556 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 556 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 |
|---|---|---|
| 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 |
| 557-APR-DRG | Moderate | Head Trauma With Coma > 1 Hour Or Hemorrhage |
| 557-MS-DRG | High | TENDONITIS, MYOSITIS AND BURSITIS 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 556. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 556 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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