MS-DRG 562 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 562 by major payers:
$16,565.46
$19,274.81
$23,073.46
$23,429.94
| 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 562 | ||||||
United | 562 | $23265.18 | 1427360981 - STEWARD CARNEY HOSPITAL, INC. | 272473755 | MA | General Acute Care Hospital (282N00000X) |
United | 562 | $11592.37 | 1528079027 - SAINT ANTHONYS HEALTH CENTER | 370813229 - (IL) OSF HEALTHCARE SYSTEM | IL | General Acute Care Hospital (282N00000X) |
United | 562 | $5185.00 | 1689002651 - CR EMERGENCY ROOM, LLC, BAYLOR SCOTT & WHITE EMERGENCY HOSPITAL KELLER | 262978009 | TX | General Acute Care Hospital (282N00000X) |
United | 562 | $21580.25 | 1932642972 - ST LUKES HOSPITAL OF KANSAS CITY, SAINT LUKE'S HOSPITAL OF KANSAS CITY | 440545297 - ST LUKES HOSPITAL OF KANSAS CITY | MO | General Acute Care Hospital (282N00000X) |
United | 562 | $46745.64 | 1013389089 - MAIMONIDES MEDICAL CENTER | 111635081 - (NY) MAIMONIDES MEDICAL CENTER- | NY | General Acute Care Hospital (282N00000X) |
United | 562 | $4534.00 | 1922095116 - HUNTERDON MEDICAL CENTER | 221537688 - HUNTERDON MEDICAL CENTER | NJ | General Acute Care Hospital (282N00000X) |
United | 562 | $31276.13 | 1972139004 - BANNER HEALTH, BANNER OCOTILLO MEDICAL CENTER | 450233470 - BANNER HEALTH | AZ | General Acute Care Hospital (282N00000X) |
United | 562 | $19253.36 | 1841453644 - CITIZENS BAPTIST MEDICAL CENTER | 474802869 | AL | Rural Acute Care Hospital (282NR1301X) |
United | 562 | $23474.53 | 1255367611 - KENNEWICK PUBLIC HOSPITAL DISTRICT, KENNEWICK GENERAL HOSPITAL | 823962056 | WA | General Acute Care Hospital (282N00000X) |
United | 562 | $29155.84 | 1316137201 - MEDSTAR GEORGETOWN MEDICAL CENTER, INC, GEORGETOWN UNIVERSITY HOSPITAL PHYSICIANS | 522218584 - (DC) MEDSTAR-GEORGETOWN MEDICAL CENTER INC | DC | General Acute Care Hospital (282N00000X) |
United | 562 | $32986.14 | 1396882205 - VANDERBILT UNIVERSITY MEDICAL CENTER | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | 562 | $4120.00 | 1891973939 - MOUNTAIN STATES HEALTH ALLIANCE, RUSSELL COUNTY HOSPITAL | 620476282 - MOUNTAIN STATES HEALTH ALLIANCE | VA | General Acute Care Hospital (282N00000X) |
United | 562 | $20981.09 | 1942248737 - MARYMOUNT HOSPITAL INC, MARYMOUNT HOSPITAL | 340714458 - (OH) MARYMOUNT HOSPITAL INC | OH | General Acute Care Hospital (282N00000X) |
United | 562 | $11167.83 | 1124052162 - CITIZENS MEDICAL CENTER COUNTY OF VICTORIA, COUNTY OF VICTORIA CITIZENS MEDICAL CENTER | 741698143 | TX | General Acute Care Hospital (282N00000X) |
United | 562 | $12052.15 | 1275600967 - LAKELAND COMMUNITY HOSPITAL, INC., LAKELAND COMMUNITY HOSPITAL | 472367677 - (AL) LAKELAND COMMUNITY HOSPITAL INC | AL | Rural Acute Care Hospital (282NR1301X) |
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 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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