MS-DRG 578 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 578 by major payers:
$18,286.45
$21,808.58
$26,722.91
$27,545.23
| 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 578 | ||||||
United | 578 | $41067.75 | 1508800186 - GAFFNEY HMA LLC, MARY BLACK HEALTH SYSTEM GAFFNEY | 832531807 | SC | General Acute Care Hospital (282N00000X) |
United | 578 | $27002.44 | 1740661305 - SAINT THOMAS DEKALB HOSPITAL, LLC, ASCENSION SAINT THOMAS DEKALB | 474063289 - (TN) SAINT THOMAS DEKALB HOSPITAL LLC | TN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 578 | $24466.60 | 1467473579 - INTEGRIS GROVE HOSPITAL | 730731338 | OK | General Acute Care Hospital (282N00000X) |
United | 578 | $22967.47 | 1780375592 - SOUTH ARKANSAS REGIONAL HOSPITAL LLC | 923616260 | AR | General Acute Care Hospital (282N00000X) |
United | 578 | $18266.46 | 1124099858 - ASCENSION MACOMB OAKLAND HOSPITAL, ST. JOHN MACOMB OAKLAND HOSPITAL-WARREN CAMPUS | 383322109 - ASCENSION MACOMB OAKLAND HOSPITAL | MI | General Acute Care Hospital (282N00000X) |
United | 578 | $9357.79 | 1770155525 - SELECT SPECIALTY HOSPITAL TUCSON, LLC, CURAHEALTH TUCSON | 812297468 | AZ | Long Term Care Hospital (282E00000X) |
United | 578 | $18520.75 | 1073765475 - HENRY COUNTY MEDICAL CENTER | 626007078 | TN | Hospitalist Physician (208M00000X) |
United | 578 | $22967.47 | 1780375592 - SOUTH ARKANSAS REGIONAL HOSPITAL LLC | 923616260 | AR | General Acute Care Hospital (282N00000X) |
United | 578 | $40260.89 | 1467690891 - SENTARA HOSPITALS, SENTARA WILLIAMSBURG REGIONAL MEDICAL CENTER | 541547408 - SENTARA HOSPITALS | VA | Rehabilitation Hospital Unit (273Y00000X) |
United | 578 | $15092.66 | 1295789907 - CAROLINAS MEDICAL CENTER | 561398929 | NC | General Acute Care Hospital (282N00000X) |
United | 578 | $36642.35 | 1285719385 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 578 | $17554.44 | 1598756686 - INGALLS MEMORIAL HOSPITAL, THE INGALLS MEMORIAL HOSPITAL | 362170866 - (IL) INGALLS MEMORIAL HOSPITAL | IL | General Acute Care Hospital (282N00000X) |
United | 578 | $15128.66 | 1770662348 - CHEROKEE INDIAN HOSPITAL AUTHORITY | 50524222 | NC | General Acute Care Hospital (282N00000X) |
United | 578 | $41029.39 | 1912108002 - MISSION HOSPITAL REGIONAL MEDICAL CENTER, PROVIDENCE MISSION HOSPITAL | 951643360 - (CA) MISSION HOSPITAL REGIONAL MEDICAL CENTER | CA | General Acute Care Hospital (282N00000X) |
United | 578 | $28821.38 | 1336475789 - LEE MEMORIAL HEALTH SYSTEM, LEE MEMORIAL SENIOR BEHAVIOR UNIT | 590714812 - LEE MEMORIAL HEALTH SYSTEM | FL | Psychiatric Hospital Unit (273R00000X) |
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 578 vs. Other Diseases & Disorders of the Skin, Subcutaneous Tissue & Breast Codes
The MS-DRG 578 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 578 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 |
|---|---|---|
| 577-MS-DRG | High | Skin Graft except for Skin Ulcer or Cellulitis with CC |
| 578-MS-DRG | High | Skin Graft except for Skin Ulcer or Cellulitis without CC/MCC |
| 579-APR-DRG | Moderate | Concussion, Closed Skull Fracture Nos, And Uncomplicated Intracranial Injury, Coma < 1 Hour Or No Coma |
| 579-MS-DRG | High | Other Skin, Subcutaneous Tissue and Breast Procedures with 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 578. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 578 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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