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See a sample rate comparisonMS-DRG 581 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 WITHOUT CC/MCC
| 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
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MS-DRG 581
5 of 25 sample ratesHigher to lower in this preview
Sutter Bay Hospitals, Alta Bates Summit Medical Center - Alta Bates Campus
Sutter Bay Hospitals
$52,791.00Published rateNovant Health Mint Hill Medical Center, LLC
Novant Health Mint Hill Medical Center LLC
$29,568.35Published rateAkron General Medical Center
$19,111.71Published rateClaiborne County Hospital Claiborne County Ambulance, Claiborne County Hospital
Claiborne Medical Center
$13,756.54Published rateHeritage Park Surgical Hospital LLC, Baylor Scott & White Surgical Hospital At Sherman
$4,796.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-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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