MS-DRG 580 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 580 by major payers:
$19,754.74
$23,244.64
$28,325.91
$28,892.76
| 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 580 | ||||||
United | 580 | $59645.48 | 1386871788 - EMANUEL MEDICAL CENTER, INC., EMANUEL FAMILY PRACTICE - MONTE VISTA | 752918774 | CA | General Acute Care Hospital (282N00000X) |
United | 580 | $45544.00 | 1568759991 - VHS HARLINGEN HOSPITAL COMPANY LLC, VALLEY BAPTIST MEDICAL CENTER - REHAB UNIT | 452662980 | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 580 | $10867.00 | 1386897148 - JERSEY CITY MEDICAL CENTER, LIBERTY HOSPITALIST SERVICES | 222783298 - (NJ) JERSEY CITY MEDICAL CENTER | NJ | Hospitalist Physician (208M00000X) |
United | 580 | $20361.13 | 1043348808 - NORTON HOSPITALS INC | 610703799 - (KY) NORTON HOSPITALS INC | KY | General Acute Care Hospital (282N00000X) |
United | 580 | $22086.25 | 1477537363 - VHS OF PHOENIX INC, ABRAZO CENTRAL CAMPUS | 621809851 | AZ | General Acute Care Hospital (282N00000X) |
United | 580 | $22678.24 | 1427230234 - J C BLAIR MEMORIAL HOSPITAL, PENN HIGHLANDS HUNTINGDON | 231352159 - (PA) J C BLAIR MEMORIAL HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 580 | $33586.78 | 1053424648 - NORTH BREVARD COUNTY HOSPITAL DISTRICT, PARRISH MEDICAL CENTER | 596020427 - (FL) NORTH BREVARD COUNTY HOSPITAL DIST PARRISH MEDICAL CENTER | FL | General Acute Care Hospital (282N00000X) |
United | 580 | $35263.19 | 1306938071 - ADVENTIST HEALTH SYSTEM-SUNBELT, INC, ADVENTHEALTH ORLANDO | 590724459 - (FL) ADVENTIST HEALTH SYSTEM-SUNBELT INC | FL | General Acute Care Hospital (282N00000X) |
United | 580 | $7948.25 | 1982607115 - CUMBERLAND COUNTY HOSPITAL SYSTEM INC, HIGHSMITH-RAINEY SPECIALITY HOSPITAL | 560845796 - CUMBERLAND COUNTY HOSPITAL SYSTEM INC | NC | Special Hospital (284300000X) |
United | 580 | $23178.89 | 1477805406 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL WESTOVER HILLS | 452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 580 | $16334.65 | 1952390643 - PROVIDENCE HOSPITAL | 931394239 - (AL) USA HEALTH HCA PROVIDENCE HOSPITAL LLC | AL | General Acute Care Hospital (282N00000X) |
United | 580 | $59147.28 | 1952347205 - NEWYORK-PRESBYTERIAN-QUEENS | 111839362 - NEWYORK-PRESBYTERIAN-QUEENS | NY | General Acute Care Hospital (282N00000X) |
United | 580 | $19997.66 | 1487607784 - NORTHWEST HOSPITAL LLC, NORTHWEST MEDICAL CENTER | 522379881 | AZ | General Acute Care Hospital (282N00000X) |
United | 580 | $33107.42 | 1629055694 - INSPIRA MEDICAL CENTER WOODBURY, INC., INSPIRA INPATIENT ADULT BEHAVIORAL HEALTH WOODBURY | 221820210 - (NJ) INSPIRA MEDICAL CENTER WOODBURY | NJ | Psychiatric Hospital (283Q00000X) |
United | 580 | $44167.19 | 1033135959 - WELLSTAR NORTH FULTON HOSPITAL, INC, NORTH FULTON HOSPITAL | 810851756 - (GA) WELLSTAR NORTH FULTON HOSPITAL INC | GA | Rehabilitation Hospital Unit (273Y00000X) |
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 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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