MS-DRG 560 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 560 by major payers:
$13,866.22
$20,308.94
$17,970.08
$18,319.58
| 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 560 | ||||||
United | 560 | $17866.19 | 1265460232 - NORTH BROWARD HOSPITAL DISTRICT, BROWARD HEALTH IMPERIAL POINT | 596012065 - NORTH BROWARD HOSPITAL DISTRICT | FL | General Acute Care Hospital (282N00000X) |
United | 560 | $21623.91 | 1508920356 - SACRED HEART REHABILITATION INSTITUTE, INC., ASCENSION SACRED HEART REHABILITATION HOSPITAL | 390902199 - SACRED HEART REHABILITATION INSTITUTE INC | WI | Rehabilitation Hospital (283X00000X) |
United | 560 | $19889.85 | 1588697296 - WEST BOCA MEDICAL CENTER, INC., WEST BOCA MEDICAL CENTER | 752922710 | FL | General Acute Care Hospital (282N00000X) |
United | 560 | $23749.86 | 1164481529 - ST. CHARLES HOSPITAL | 111871039 - (NY) ST CHARLES HOSPITAL CORP | NY | General Acute Care Hospital (282N00000X) |
United | 560 | $11576.11 | 1417032673 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 560 | $24749.64 | 1073688354 - MIAMI VALLEY HOSPITAL | 310537504 - (OH) MIAMI VALLEY HOSPITAL | OH | General Acute Care Hospital (282N00000X) |
United | 560 | $11807.28 | 1801971965 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 560 | $11807.28 | 1801971965 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 560 | $74209.79 | 1760446009 - SIERRA VISTA HOSPITAL 69 | 850422820 | NM | Critical Access Hospital (282NC0060X) |
United | 560 | $12256.11 | 1902865355 - GOOD SAMARITAN HOSPITAL MEDICAL CENTER | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 560 | $29889.06 | 1104847888 - SOUND SHORE MEDICAL CENTER OF WESTCHESTER | 462931956 - (NY) MONTEFIORE NEW ROCHELLE HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 560 | $2786.00 | 1699444976 - HH HEALTH SYSTEM | 872027148 | AL | General Acute Care Hospital (282N00000X) |
United | 560 | $16481.38 | 1215043112 - INTEGRIS MIAMI HOSPITAL, INTEGRIS MIAMI HOSPITAL GENERATIONS PSYCH UNIT | 730584411 | OK | Psychiatric Hospital Unit (273R00000X) |
United | 560 | $11236.69 | 1407573132 - DEACONESS ILLINOIS RED BUD REGIONAL HOSPITAL INC, RED BUD REGIONAL HOSPITAL | 884142509 | IL | Critical Access Hospital (282NC0060X) |
United | 560 | $11095.49 | 1760243562 - HH HEALTH SYSTEM | 934333907 | AL | Psychiatric Hospital Unit (273R00000X) |
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 560 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 560 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 560 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 |
|---|---|---|
| 559-MS-DRG | High | Aftercare, Musculoskeletal System and Connective Tissue with MCC |
| 560-MS-DRG | High | Aftercare, Musculoskeletal System and Connective Tissue with CC |
| 561-APR-DRG | High | POSTPARTUM & POST ABORTION DIAGNOSES W/O PROCEDURE |
| 561-MS-DRG | High | Aftercare, Musculoskeletal System and Connective Tissue without CC/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 560. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 560 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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