MS-DRG 558 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 558 by major payers:
$10,043.62
$12,181.14
$13,899.30
$14,138.47
| 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 558 | ||||||
United | 558 | $6034.00 | 1487697215 - ST.FRANCIS MEDICAL CENTER | 850737566 | CA | General Acute Care Hospital (282N00000X) |
United | 558 | $20523.89 | 1467469023 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION, WOODHULL MEDICAL & MENTAL HEALTH CENTER | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | General Acute Care Hospital (282N00000X) |
United | 558 | $13261.20 | 1780375592 - SOUTH ARKANSAS REGIONAL HOSPITAL LLC | 923616260 | AR | General Acute Care Hospital (282N00000X) |
United | 558 | $19849.69 | 1588697296 - WEST BOCA MEDICAL CENTER, INC., WEST BOCA MEDICAL CENTER | 752922710 | FL | General Acute Care Hospital (282N00000X) |
United | 558 | $12914.00 | 1932296316 - JOHN T. MATHER MEMORIAL HOSPITAL | 111639818 - (NY) JOHN T MATHER MEMORIAL HOSPITAL | NY | Hospitalist Physician (208M00000X) |
United | 558 | $19421.67 | 1750788667 - CARONDELET HEALTH NETWORK, BRIDGES GEROPSYCHIATRIC PROGRAM AT ST. MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 558 | $12772.15 | 1225046709 - SUMMA HEALTH SYSTEM | 340714755 - SUMMA HEALTH SYSTEM | OH | Psychiatric Hospital Unit (273R00000X) |
United | 558 | $2954.00 | 1447285432 - WELLMONT HEALTH SYSTEM, LONESOME PINE SWING BED | 621636465 - WELLMONT HEALTH SYSTEM | VA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 558 | $10339.53 | 1184635229 - SHERIDAN COUNTY HOSPITAL | 480579744 - (KS) SHERIDAN COUNTY HOSPITAL | KS | Critical Access Hospital (282NC0060X) |
United | 558 | $18965.92 | 1417032145 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 558 | $9816.21 | 1477729952 - BLADEN HEALTHCARE, LLC, CAPE FEAR VALLEY BLADEN WOMEN'S HEALTH SPECIALISTS | 800164702 | NC | Critical Access Hospital Clinic/Center (261QC0050X) |
United | 558 | $8126.87 | 1891766051 - PHELPS COUNTY REGIONAL MEDICAL CENTER, PHELPS HEALTH | 436004435 - PHELPS COUNTY REGIONAL MEDICAL CENTER | MO | General Acute Care Hospital (282N00000X) |
United | 558 | $19464.00 | 1821216391 - DELRAY MEDICAL CENTER, INC., PINECREST REHABILITATION HOSPITAL | 752922687 | FL | Rehabilitation Hospital Unit (273Y00000X) |
United | 558 | $19837.16 | 1205960903 - HARRIS METHODIST FORT WORTH | 756001743 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 558 | $10554.00 | 1073518593 - BOONEVILLE COMMUNITY HOSPITAL, INC., BOONEVILLE COMMUNITY HOSPITAL | 463851119 - MERCY HOSPITAL BOONEVILLE | AR | Critical Access Hospital (282NC0060X) |
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 558 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 558 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 558 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 |
|---|---|---|
| 557-APR-DRG | Moderate | Head Trauma With Coma > 1 Hour Or Hemorrhage |
| 557-MS-DRG | High | Tendinitis, Myositis and Bursitis with MCC |
| 558-MS-DRG | High | Tendinitis, Myositis and Bursitis without MCC |
| 559-MS-DRG | High | Aftercare, 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 558. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 558 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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