MS-DRG 581 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 581 by major payers:
$15,795.28
$18,870.20
$23,049.36
$23,578.65
| 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 581 | ||||||
United | 581 | $4796.00 | 1235510090 - HERITAGE PARK SURGICAL HOSPITAL LLC, BAYLOR SCOTT & WHITE SURGICAL HOSPITAL AT SHERMAN | 611762781 | TX | General Acute Care Hospital (282N00000X) |
United | 581 | $29724.77 | 1053371138 - PIEDMONT MOUNTAINSIDE HOSPITAL, INC, PIEDMONT MOUNTAINSIDE HOSPTIAL SWING BED UNIT | 352228583 - (GA) PIEDMONT MOUNTAINSIDE HOSPITAL INC | GA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 581 | $13050.73 | 1295253920 - CHESTNUT HILL HOSPITAL, LLC, CHESTNUT HILL HOSPITAL | 883577015 | PA | Psychiatric Hospital Unit (273R00000X) |
United | 581 | $52791.00 | 1639523004 - SUTTER BAY HOSPITALS, ALTA BATES SUMMIT MEDICAL CENTER - ALTA BATES CAMPUS | 940562680 - (CA) SUTTER BAY HOSPITALS | CA | General Acute Care Hospital (282N00000X) |
United | 581 | $26299.93 | 1073608139 - VANDERBILT UNIV. MEDICAL CENTER, TVHS | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | 581 | $13532.04 | 1700509577 - PRIME HEALTHCARE SERVICES PAMPA LLC | 455125687 - (TX) PRIME HEALTHCARE SERVICES PAMPA, LLC | TX | Critical Access Hospital (282NC0060X) |
United | 581 | $11084.71 | 1730128836 - MIDWEST REGIONAL MEDICAL CENTER, LLC, ALLIANCEHEALTH MIDWEST | 730657693 - SSM HEALTH CARE OF OKLAHOMA INC | OK | General Acute Care Hospital (282N00000X) |
United | 581 | $22658.75 | 1699773465 - UPMC ALTOONA | 231352155 - UPMC | PA | Psychiatric Hospital Unit (273R00000X) |
United | 581 | $12995.67 | 1740876382 - DELTA HEALTH SYSTEM, DELTA HEALTH-NORTHWEST REGIONAL | 853959101 | MS | General Acute Care Hospital (282N00000X) |
United | 581 | $11221.42 | 1992103857 - PRIME HEALTHCARE SERVICES, RIVERVIEW REGIONAL MEDICAL CENTER | 472228529 | AL | General Acute Care Hospital (282N00000X) |
United | 581 | $19111.71 | 1821035940 - AKRON GENERAL MEDICAL CENTER | 340714478 - (OH) AKRON GENERAL MEDICAL CENTER | OH | General Acute Care Hospital (282N00000X) |
United | 581 | $21271.31 | 1225195464 - CANNON COUNTY HOSPITAL LLC, STONES RIVER HOSPITAL | 474063232 | TN | Rehabilitation Hospital Unit (273Y00000X) |
United | 581 | $15487.04 | 1578078036 - WINONA HEALTH SERVICES, WINONA HEALTH SERVICES- SWING BED | 410713914 - (MN) WINONA HEALTH SERVICES | MN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 581 | $31647.44 | 1023194271 - PROVIDENCE HEALTH & SERVICES OREGON, PROVIDENCE PORTLAND MEDICAL CENTER | 930386906 | OR | Psychiatric Hospital Unit (273R00000X) |
United | 581 | $16672.64 | 1407364847 - TYLER REGIONAL HOSPITAL LLC | 823878395 | TX | 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 581 vs. Other Diseases & Disorders of the Skin, Subcutaneous Tissue & Breast Codes
The MS-DRG 581 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 581 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 |
|---|---|---|
| 580-APR-DRG | High | NEONATE, TRANSFERRED <5 DAYS OLD, NOT BORN HERE |
| 580-MS-DRG | High | Other Skin, Subcutaneous Tissue and Breast Procedures with CC |
| 581-MS-DRG | High | Other Skin, Subcutaneous Tissue and Breast Procedures without CC/MCC |
| 582-APR-DRG | Moderate | Other Disorders Of Nervous System |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 581. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 581 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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