MS-DRG 566 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 566 by major payers:
$9,164.58
$10,893.99
$11,888.32
$12,225.48
| 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 566 | ||||||
United | 566 | $14607.40 | 1538111653 - NYU LUTHERAN MEDICAL CENTER | 133971298 - NYU LANGONE HOSPITALS | NY | General Acute Care Hospital (282N00000X) |
United | 566 | $10599.07 | 1558365890 - METHODIST HEALTHCARE | 620479367 - METHODIST HEALTHCARE-MEMPHIS | TN | General Acute Care Hospital (282N00000X) |
United | 566 | $16654.19 | 1225113376 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 566 | $16652.71 | 1548216880 - NEW HANOVER REGIONAL MEDICAL CENTER | 853777599 | NC | General Acute Care Hospital (282N00000X) |
United | 566 | $8791.66 | 1528181393 - MURRAY-CALLOWAY COUNTY PUBLIC HOSPITAL CORPORATION | 610620567 | KY | General Acute Care Hospital (282N00000X) |
United | 566 | $6452.79 | 1033165501 - METHODIST HOSPITALS OF DALLAS, METHODIST RICHARDSON MEDICAL CENTER | 750800661 - METHODIST HOSPITALS OF DALLAS | TX | General Acute Care Hospital (282N00000X) |
United | 566 | $6555.50 | 1215359922 - DLP WILSON MEDICAL CENTER LLC, WILSON MEDICAL CENTER | 464317222 | NC | General Acute Care Hospital (282N00000X) |
United | 566 | $24151.11 | 1184654923 - DOCTORS MEDICAL CENTER OF MODESTO, INC., DOCTORS MEDICAL CENTER OF MODESTO | 752918774 | CA | General Acute Care Hospital (282N00000X) |
United | 566 | $8942.84 | 1629085659 - ST JAMES HOSPITAL AND HEALTH CENTER | 362167869 - FRANCISCAN HEALTH OLYMPIA FIELDS | IL | Psychiatric Hospital (283Q00000X) |
United | 566 | $10339.53 | 1093341810 - CLEARSKY REHABILITATION HOSPITAL OF RIO RANCHO LLC | 845065073 - (NM) CLEARSKY REHABILITATION HOSPITAL OF RIO RANCHO LLC | NM | Rehabilitation Hospital (283X00000X) |
United | 566 | $10845.00 | 1326283854 - STAMFORD HOSPITAL | 60646917 - (CT) STAMFORD HOSPITAL | CT | General Acute Care Hospital (282N00000X) |
United | 566 | $10969.00 | 1215027966 - NEWARK BETH ISRAEL MEDICAL CENTER INC, NEWARK BETH ISRAEL MEDICAL CENTER | 223452311 | NJ | General Acute Care Hospital (282N00000X) |
United | 566 | $2665.00 | 1790756203 - CLEVELAND TENNESSEE HOSPITAL COMPANY LLC, TENNOVA HEALTHCARE-CLEVELAND | 621281627 | TN | General Acute Care Hospital (282N00000X) |
United | 566 | $21642.16 | 1629152939 - TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | 751438726 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 566 | $9144.00 | 1477616571 - LENOX HILL HOSPITAL | 131624070 - (NY) LENOX HILL HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
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 566 vs. Other Diseases & Disorders of the Musculoskeletal System & Connective Tissue Codes
The MS-DRG 566 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 566 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 |
|---|---|---|
| 565-APR-DRG | High | Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma |
| 565-MS-DRG | High | Other Musculoskeletal System and Connective Tissue Diagnoses with CC |
| 566-MS-DRG | High | Other Musculoskeletal System and Connective Tissue Diagnoses 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 566. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 566 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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