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See a sample rate comparisonMS-DRG 562 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.
FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH 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 562 by major payers:
$16,565.46
$19,274.81
$23,073.46
$23,429.94
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MS-DRG 562
5 of 25 sample ratesHigher to lower in this preview
Maimonides Medical Center
Maimonides Medical Center-
$46,745.64Published rateWest Penn Allegheny Health System Inc., The Western Pennsylvania Hospital - Rehab
Highmark Health
$27,038.40Published rateMarymount Hospital Inc, Marymount Hospital
Marymount Hospital Inc
$20,981.09Published rateCitizens Medical Center County Of Victoria, County Of Victoria Citizens Medical Center
$11,167.83Published rateTishomingo Health Services, Inc., Tishomingo Health Swing Bed
Tishomingo Health Services Inc
$1,688.00Published rate
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See a sample payer proposalMS-DRG 562 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 562 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 562 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 |
|---|---|---|
| 561-APR-DRG | High | POSTPARTUM & POST ABORTION DIAGNOSES W/O PROCEDURE |
| 561-MS-DRG | High | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC |
| 562-MS-DRG | High | FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC |
| 563-APR-DRG | High | Brain 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 562. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 562 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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