MS-DRG 572 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 Skin, Subcutaneous Tissue & Breast |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 572 by major payers:
$14,642.84
$15,881.82
$18,073.19
$18,730.02
| 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 572 | ||||||
United | 572 | $14992.86 | 1396927117 - SSM HEALTH CARE ST. LOUIS, SSM HEALTH ST. JOSEPH HOSPITAL - ST, CHARLES | 431343281 - SSM HEALTH CARE ST LOUIS | MO | Rehabilitation Hospital Unit (273Y00000X) |
United | 572 | $11070.70 | 1205923414 - MEMORIAL HOSPITAL, MEMORIAL HEALTHCARE | 381358208 - MEMORIAL HOSPITAL | MI | Rehabilitation Hospital Unit (273Y00000X) |
United | 572 | $24871.76 | 1396835138 - CARONDELET HEALTH NETWORK, ST. MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 572 | $17693.49 | 1083696710 - MEDINA HOSPITAL | 340733166 - (OH) MEDINA HOSPITAL | OH | General Acute Care Hospital (282N00000X) |
United | 572 | $13197.00 | 1841257631 - TERREBONNE PARISH HOSPITAL SERVICE DISTRICT #1, TERREBONE GENERAL REHABILITATION UNIT | 720880258 - (LA) TERREBONNE HOSPITAL SERVICE DISTRICT NO 1 | LA | Rehabilitation Hospital Unit (273Y00000X) |
United | 572 | $17620.69 | 1073781225 - ADVOCATE HOPE CHILDREN'S HOSPITAL | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Children's Hospital (282NC2000X) |
United | 572 | $20800.82 | 1891354726 - UCH-MHS, MEMORIAL HEALTH SYSTEM | 460796114 - (CO) UCH-MHS | CO | General Acute Care Hospital (282N00000X) |
United | 572 | $5761.00 | 1669569984 - IRVING-COPPELL SURGICAL HOSPITAL LLP, BAYLOR SCOTT & WHITE SURGICAL HOSPITAL - LAS COLINAS | 542086863 | TX | General Acute Care Hospital (282N00000X) |
United | 572 | $29240.86 | 1508687021 - NYU LANGONE HOSPITALS | 133971298 - NYU LANGONE HOSPITALS | NY | Psychiatric Hospital Unit (273R00000X) |
United | 572 | $34708.21 | 1518355759 - TEXAS HEALTH HUGULEY, INC, TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH | 452694620 - (TX) TEXAS HEALTH HUGULEY INC | TX | Psychiatric Hospital Unit (273R00000X) |
United | 572 | $9171.86 | 1396790325 - THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY, CAROLINAS HEALTHCARE SYSTEM UNION | 560529945 | NC | General Acute Care Hospital (282N00000X) |
United | 572 | $23382.31 | 1760427157 - VENICE HMA LLC, SHOREPOINT HEALTH VENICE | 201852812 - (FL) VENICE HMA LLC | FL | General Acute Care Hospital (282N00000X) |
United | 572 | $20819.34 | 1568427383 - ALLINA HEALTH SYSTEM, CAMBRIDGE MEDICAL CENTER | 363261413 - ALLINA HEALTH SYSTEM | MN | General Acute Care Hospital (282N00000X) |
United | 572 | $24458.77 | 1750940987 - UCH-MHS, MEMORIAL HEALTH SYSTEM | 460796114 - (CO) UCH-MHS | CO | General Acute Care Hospital (282N00000X) |
United | 572 | $23840.75 | 1316137201 - MEDSTAR GEORGETOWN MEDICAL CENTER, INC, GEORGETOWN UNIVERSITY HOSPITAL PHYSICIANS | 522218584 - (DC) MEDSTAR-GEORGETOWN MEDICAL CENTER INC | DC | 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 572 vs. Other Diseases & Disorders of the Skin, Subcutaneous Tissue & Breast Codes
The MS-DRG 572 code is part of the Diseases & Disorders of the Skin, Subcutaneous Tissue & Breast 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 572 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 |
|---|---|---|
| 571-APR-DRG | Moderate | Concussion, Closed Skull Fracture Nos, And Uncomplicated Intracranial Injury, Coma < 1 Hour Or No Coma |
| 571-MS-DRG | High | Skin Debridement with CC |
| 572-MS-DRG | High | Skin Debridement without CC/MCC |
| 573-APR-DRG | Moderate | Concussion, Closed Skull Fracture Nos, And Uncomplicated Intracranial Injury, 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 572. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 572 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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