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MS-DRG 561 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.

AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC
Key FactDetail
Service Type

Diseases & Disorders of the Musculoskeletal System & Connective Tissue

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Complexity LevelHigh

National average reimbursement for MS-DRG 561 by major payers:

bcbs

$10,206.30

uhc

$16,657.65

aetna

$12,896.71

cigna

$13,301.53

Compare published rates across providers.

Choose a payer to see a sample of rates for MS-DRG 561.

MS-DRG 561
5 of 25 sample ratesHigher to lower in this preview
  1. City Of Genoa, Genoa Community Hospital

    NECritical Access HospitalNPI 1649228511Tax ID 47-6006197

    $60,889.21Published rate
  2. Norcal Healthconnect LLC, Healdsburg Hospital

    CACritical Access HospitalNPI 1861009672Tax ID 85-2390012

    $17,245.64Published rate
  3. Ripon Medical Center

    Ripon Medical Center Inc

    WIGeneral Acute Care HospitalNPI 1477809978Tax ID 39-1101287

    $11,408.08Published rate
  4. Carondelet Health Network, St Mary'S Hospital

    AZPsychiatric Hospital UnitNPI 1801971916Tax ID 47-4131755

    $8,987.87Published rate
  5. Forrest County General Hospital

    MSRehabilitation Hospital UnitNPI 1104928548Tax ID 64-6001587

    $3,556.00Published rate

National sample. Rates vary by location, specialty, and contract.

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MS-DRG 561 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes

The MS-DRG 561 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 561 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.

CodeComplexityDescription
560-APR-DRGHighVAGINAL DELIVERY
560-MS-DRGHighAFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC
561-MS-DRGHighAFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC
562-APR-DRGModerateBrain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 561. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 561 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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