MS-DRG 557 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 557 by major payers:
$16,755.43
$21,092.21
$24,347.09
$24,746.50
| 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 557 | ||||||
United | 557 | $40028.75 | 1487676789 - WILLAMETTE VALLEY MEDICAL CENTER LLC, WILLAMETTE VALLEY MEDICAL CENTER | 621762552 - (OR) WILLAMETTE VALLEY MEDICAL CENTER LLC | OR | Rehabilitation Hospital Unit (273Y00000X) |
United | 557 | $40281.35 | 1558394361 - USC UNIVERSITY HOSPITAL, INC., USC HOSPITAL | 851644866 - (CA) KECK MEDICAL CENTER OF USC | CA | General Acute Care Hospital (282N00000X) |
United | 557 | $500.00 | 1578799813 - PATIENTS CHOICE MEDICAL CENTER OF ERIN, TENNESSEE, LLC | 462490116 | TN | Psychiatric Hospital Unit (273R00000X) |
United | 557 | $28419.11 | 1033118716 - CASTRO COUNTY HOSPITAL DISTRICT, PLAINS MEMORIAL HOSPITAL | 756003939 | TX | Critical Access Hospital (282NC0060X) |
United | 557 | $48371.32 | 1306013388 - SAINT FRANCIS HOSPITAL, ST. FRANCIS HOSPITAL | 133964321 - (NY) PEO MID-HUDSON VALLEY STAFFCO | NY | General Acute Care Hospital (282N00000X) |
United | 557 | $19140.85 | 1386667533 - MERCY TYLER HOSPITAL, TYLER MEMORIAL HOSPITAL | 274566015 | PA | General Acute Care Hospital (282N00000X) |
United | 557 | $19952.39 | 1902989221 - NEWARK WAYNE COMMUNITY HOSPITAL, NEWARK WAYNE COMM HOSP - PSYCH | 150584188 - NEWARK WAYNE COMMUNITY HOSPITAL | NY | Psychiatric Hospital Unit (273R00000X) |
United | 557 | $30983.15 | 1447203989 - LAKEWOOD HOSPITAL ASSOCIATION, LAKEWOOD HOSPITAL | 340714585 - THE CLEVELAND CLINIC FOUNDATION | OH | General Acute Care Hospital (282N00000X) |
United | 557 | $14548.90 | 1871918870 - PROSPECT CHARTERCARE SJHSRI, LLC, OUR LADY OF FATIMA HOSPITAL | 464661337 | RI | General Acute Care Hospital (282N00000X) |
United | 557 | $28001.52 | 1083692941 - FAIRVIEW HEALTH SERVICES, FAIRVIEW LAKES REGIONAL MEDICAL CENTER | 410991680 - FAIRVIEW HEALTH SERVICES | MN | General Acute Care Hospital (282N00000X) |
United | 557 | $28209.22 | 1669639712 - UNIVERSITY OF WASHINGTON, UNIVERSITY OF WASHINGTON MEDICAL CENTER | 916001537 | WA | General Acute Care Hospital (282N00000X) |
United | 557 | $500.00 | 1578799813 - PATIENTS CHOICE MEDICAL CENTER OF ERIN, TENNESSEE, LLC | 462490116 | TN | Psychiatric Hospital Unit (273R00000X) |
United | 557 | $36548.12 | 1194926279 - ST JUDE HOSPITAL INC, PROVIDENCE ST. JUDE MEDICAL CENTER | 951643325 - (CA) ST JUDE HOSPITAL | CA | General Acute Care Hospital (282N00000X) |
United | 557 | $25125.55 | 1134118250 - ST MARY'S REGIONAL HEALTH CENTER, ESSENTIA HEALTH ST MARYS - DETROIT LAKES (SWINGBED) | 411620386 - ST MARYS REGIONAL HEALTH CENTER | MN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 557 | $46275.87 | 1003854688 - SCRIPPS HEALTH, SCRIPPS MEMORIAL HOSPITAL ENCINITAS REHAB UNIT | 951684089 - SCRIPPS HEALTH | CA | 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 557 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 557 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 557 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 |
|---|---|---|
| 556-MS-DRG | High | Signs and Symptoms of Musculoskeletal System and Connective Tissue without MCC |
| 557-MS-DRG | High | Tendinitis, Myositis and Bursitis with MCC |
| 558-APR-DRG | Moderate | Head Trauma With Coma > 1 Hour Or Hemorrhage |
| 558-MS-DRG | High | Tendinitis, Myositis and Bursitis 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 557. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 557 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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