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    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Musculoskeletal System and Connective TissueDRG 558-tendonitis-myositis-and-bursitis-without-mcc
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    Tendonitis, Myositis and Bursitis without MCC: Inpatient Reimbursement Overview

    DRG 558 encompasses inpatient stays for tendonitis, myositis and bursitis without Major Complication or Comorbidity, focusing on inflammatory soft-tissue conditions that do not carry high-severity comorbidities. It matters for inpatient reimbursement because it defines the bundled payment level Medicare provides for these lower-severity musculoskeletal admissions.

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    DRG 558 Overview

    DRG 558 covers inpatient admissions for tendonitis, myositis and bursitis without Major Complication or Comorbidity. These are soft-tissue inflammatory conditions affecting tendons, muscles and bursae that may require hospital-level pain control, immobilization or procedure-based interventions. This Diagnosis-Related Group matters for Medicare payment because it groups cases by expected resource use and sets the base inpatient reimbursement for hospitals when no higher-severity comorbidities are present. Understanding the clinical scope helps clarify payment relative to more complex musculoskeletal admissions.

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    Clinical Trials

    • Acute procedural intervention trials investigating effectiveness and safety of minimally invasive tendon or bursa interventions (such as ultrasound-guided corticosteroid injections versus image-guided needle tenotomy) in hospitalized patients with severe tendonitis, myositis, or bursitis who have failed outpatient care; these studies enroll patients early in their inpatient course to measure short-term pain reduction, functional improvement, and avoidance of surgical escalation, and are relevant to providers and payers because demonstrated inpatient procedures that reduce length of stay or prevent higher-cost interventions can inform care pathways and resource allocation.
    • Comparative effectiveness trials of multimodal nonoperative management strategies for moderate-to-severe inflammatory soft-tissue disorders in medically complex inpatients, comparing combinations such as optimized physical therapy regimens, systemic anti-inflammatory strategies, and localized therapies; these studies focus on patients with comorbidities (eg, diabetes, obesity, anticoagulation) who may respond differently to conservative care and address which bundles of therapies improve function and reduce readmissions, providing evidence to guide inpatient protocols and reimbursement decisions.
    • Post-discharge outcomes and utilization studies examining long-term functional recovery, recurrence rates, outpatient rehabilitation needs, and healthcare utilization among patients discharged after inpatient treatment for tendonitis, myositis, or bursitis; these observational studies follow diverse populations (including older adults and those with work-related musculoskeletal issues) to identify predictors of readmission, durable functional outcomes, and cost drivers, which helps payers evaluate post-acute care benefits and providers design transitions of care that reduce downstream costs.

    Related Codes

    402-SINGLE-LEVEL-COMBINED-ANTERIOR-AND-POSTERIOR-SPINAL-FUSION-EXCEPT-CERVICAL

    Single Level Combined Anterior and Posterior Spinal Fusion Except Cervical: Inpatient Reimbursement Overview

    426-MULTIPLE-LEVEL-COMBINED-ANTERIOR-AND-POSTERIOR-SPINAL-FUSION-EXCEPT-CERVICAL-WITH-MCC-OR-CUSTOM-MADE-ANATOMICALLY-DESIGNED-INTERBODY-FUSION-DEVICE

    Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with MCC or Custom-Made Anatomically Designed Interbody Fusion Device: Inpatient Reimbursement Overview

    427-MULTIPLE-LEVEL-COMBINED-ANTERIOR-AND-POSTERIOR-SPINAL-FUSION-EXCEPT-CERVICAL-WITH-CC

    Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with CC: Inpatient Reimbursement Overview

    428-MULTIPLE-LEVEL-COMBINED-ANTERIOR-AND-POSTERIOR-SPINAL-FUSION-EXCEPT-CERVICAL-WITHOUT-CC-MCC

    Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical without CC/MCC: Inpatient Reimbursement Overview

    429-COMBINED-ANTERIOR-AND-POSTERIOR-CERVICAL-SPINAL-FUSION-WITH-MCC

    Combined Anterior and Posterior Cervical Spinal Fusion with MCC: Inpatient Reimbursement Overview

    430-COMBINED-ANTERIOR-AND-POSTERIOR-CERVICAL-SPINAL-FUSION-WITHOUT-MCC

    Combined Anterior and Posterior Cervical Spinal Fusion without MCC: Inpatient Reimbursement Overview

    447-MULTIPLE-LEVEL-SPINAL-FUSION-EXCEPT-CERVICAL-WITH-MCC-OR-CUSTOM-MADE-ANATOMICALLY-DESIGNED-INTERBODY-FUSION-DEVICE

    Multiple Level Spinal Fusion Except Cervical with MCC: Inpatient Reimbursement Overview

    448-MULTIPLE-LEVEL-SPINAL-FUSION-EXCEPT-CERVICAL-WITHOUT-MCC

    Multiple Level Spinal Fusion Except Cervical without MCC: Inpatient Reimbursement Overview

    450-SINGLE-LEVEL-SPINAL-FUSION-EXCEPT-CERVICAL-WITH-MCC-OR-CUSTOM-MADE-ANATOMICALLY-DESIGNED-INTERBODY-FUSION-DEVICE

    Single Level Spinal Fusion Except Cervical with MCC or Custom-Made Device: Inpatient Reimbursement Overview

    451-SINGLE-LEVEL-SPINAL-FUSION-EXCEPT-CERVICAL-WITHOUT-MCC

    Single Level Spinal Fusion Except Cervical without MCC: Inpatient Reimbursement Overview

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    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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