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See a sample rate comparisonMS-DRG 584 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.
BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH 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 584 by major payers:
$22,228.34
$26,594.74
$32,539.72
$33,334.57
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MS-DRG 584
5 of 25 sample ratesHigher to lower in this preview
Froedtert Memorial Lutheran Hospital, Inc., Froedtert Hospital
Community Memorial Hospital Of Menomonee Falls Inc
$60,324.58Published rateCatholic Health Initiatives Colorado, St. Thomas More Hospital
Catholic Health Initiatives Colorado
$43,723.78Published rateSwedishamerican Hospital
$31,808.41Published rateAdvocate Health And Hospitals Corporation, Advocate Christ Medical Center
Advocate Health And Hospitals Corporation
$22,545.50Published rateJohnston Memorial Hospital
Johnston Memorial Hospital Inc
$4,958.00Published rate
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See a sample payer proposalMS-DRG 584 vs. Other Diseases & Disorders of the Skin, Subcutaneous Tissue & Breast Codes
The MS-DRG 584 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 584 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 |
|---|---|---|
| 583-APR-DRG | High | NEONATE W ECMO |
| 583-MS-DRG | High | MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC |
| 584-MS-DRG | High | BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC |
| 585-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 584. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 584 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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