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See a sample rate comparisonMS-DRG 580 Fee Schedule
Last Verified: October 2026
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.
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC
| 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 580 by major payers:
$19,754.74
$23,244.64
$28,325.91
$28,892.76
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MS-DRG 580
5 of 25 sample ratesHigher to lower in this preview
Emanuel Medical Center, Inc., Emanuel Family Practice - Monte Vista
$59,645.48Published rateNorth Brevard County Hospital District, Parrish Medical Center
North Brevard County Hospital Dist Parrish Medical Center
$33,586.78Published rateOro Valley Hospital
$22,985.16Published rateBowling Green Warren County Community Hospital Corporation, The Medical Center At Albany
Bowling Green-Warren County Community Hospital Corporation
$17,730.00Published rateCumberland County Hospital System Inc, Highsmith-Rainey Speciality Hospital
Cumberland County Hospital System Inc
$7,948.25Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 580 vs. Other Diseases & Disorders of the Skin, Subcutaneous Tissue & Breast Codes
The MS-DRG 580 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 580 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 |
|---|---|---|
| 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 |
| 580-MS-DRG | High | OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC |
| 581-APR-DRG | High | NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 580. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 580 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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