MS-DRG 585 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 585 by major payers:
$19,991.10
$25,671.26
$31,160.41
$32,155.58
| 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 585 | ||||||
United | 585 | $39184.03 | 1538131214 - VHS ACQUISITION SUBSIDIARY NUMBER 7 INC, SAINT VINCENT HOSPITAL | 621861198 - (MA) VHS ACQUISITION SUBSIDIARY NUMBER 7 INC | MA | General Acute Care Hospital (282N00000X) |
United | 585 | $32972.71 | 1871660522 - HIGHLINE MEDICAL CENTER | 910712166 - (WA) HIGHLINE MEDICAL CENTER | WA | Long Term Care Hospital (282E00000X) |
United | 585 | $43189.82 | 1053354100 - LONG ISLAND COMMUNITY HOSPITAL AT NYU LANGONE HEALTH, LONG ISLAND COMMUNITY HOSPITAL | 133971298 - NYU LANGONE HOSPITALS | NY | General Acute Care Hospital (282N00000X) |
United | 585 | $29661.35 | 1538186143 - NASSAU HEALTH CARE CORPORATION, NASSAU UNIV MED CENTER-PSYCH | 113465690 | NY | Psychiatric Hospital Unit (273R00000X) |
United | 585 | $9845.13 | 1013941780 - COVENANT LONG-TERM CARE LLC, COVENANT SPECIALTY HOSPITAL | 205033419 - (TX) COVENANT LONGTERM CARE LLC | TX | Long Term Care Hospital (282E00000X) |
United | 585 | $18732.82 | 1831255397 - ST BERNARDS HOSPITAL INC, ST BERNARDS DAYPLACE | 710290019 - (AR) ST BERNARDS HOSPITAL INC | AR | General Acute Care Hospital (282N00000X) |
United | 585 | $9516.57 | 1447465075 - WARDS 3 4 & 10 HOSPITAL SERVICE DISTRICT PARISH OF UNION, REEVES MEMORIAL MEDICAL CENTER | 720685207 | LA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 585 | $49043.87 | 1306406285 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 585 | $59187.67 | 1780927277 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS | 954537720 | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 585 | $37762.01 | 1942267869 - MARIN GENERAL HOSPITAL | 942823538 - (CA) MARIN GENERAL HOSPITAL | CA | Psychiatric Hospital Unit (273R00000X) |
United | 585 | $51433.94 | 1245220300 - KERSHAW HOSPITAL LLC | 571098556 - (SC) MEDICAL UNIVERSITY HOSPITAL AUTHORITY | SC | General Acute Care Hospital (282N00000X) |
United | 585 | $21734.85 | 1174706576 - LUTHERAN MUSCULOSKELETAL CENTER LLC, THE ORTHOPAEDIC HOSPITAL OF LUTHERAN HEALTH NETWORK | 261483076 - (IN) LUTHERAN MUSCULOSKELETAL CENTER LLC | IN | General Acute Care Hospital (282N00000X) |
United | 585 | $59187.67 | 1780927277 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS | 954537720 | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 585 | $10339.53 | 1821087230 - COUNTY OF LOGAN, LOGAN COUNTY HOSPITAL | 486092185 - (KS) DARCY HOWARD, ADMINISTRATOR | KS | Critical Access Hospital (282NC0060X) |
United | 585 | $40370.98 | 1902844988 - PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA, PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER TORRANCE | 421672810 - (CA) UNITED STATES CATHLOC CONFERENCE | CA | 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 585 vs. Other Diseases & Disorders of the Skin, Subcutaneous Tissue & Breast Codes
The MS-DRG 585 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 585 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 |
|---|---|---|
| 584-APR-DRG | Moderate | Other Disorders Of Nervous System |
| 584-MS-DRG | High | Breast Biopsy, Local Excision and Other Breast Procedures with CC/MCC |
| 585-MS-DRG | High | Breast Biopsy, Local Excision and Other Breast Procedures without CC/MCC |
| 592-APR-DRG | Moderate | Anoxic And Other Severe Brain Damage |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 585. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 585 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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