MS-DRG 595 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 595 by major payers:
$23,336.61
$26,966.06
$33,185.44
$33,641.85
| 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 595 | ||||||
United | 595 | $68434.06 | 1750466363 - VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY, MEDICAL COLLEGE OF VIRGINIA HOSPITALS | 541848065 | VA | General Acute Care Hospital (282N00000X) |
United | 595 | $26995.01 | 1750190542 - SAINT MARY OF NAZARETH HOSPITAL | 992171028 | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 595 | $2060.00 | 1033159173 - GREENWOOD LEFLORE HOSPITAL, REHAB UNIT | 646000400 - (MS) GREENWOOD LEFLORE HOSPITAL | MS | Rehabilitation Hospital Unit (273Y00000X) |
United | 595 | $26658.72 | 1730425190 - BSA HOSPITAL LLC | 300754305 | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 595 | $38119.05 | 1073893020 - PASCO-PINELLAS HILLSBOROUGH COMMUNITY HEALTH SYSTEM INC, ADVENTHEALTH WESLEY CHAPEL | 208488713 - (FL) PASCO-PINELLAS HILLSBOROUGH COMMUNITY HEALTH SYSTEM INC | FL | General Acute Care Hospital (282N00000X) |
United | 595 | $7619.00 | 1043402050 - CENTRAL SUFFOLK HOSPITAL, PECONIC BAY MEDICAL CENTER PROFESSIONAL GROUP PRACTICE | 111661359 - (NY) CENTRAL SUFFOLK HOSPITAL | NY | Hospitalist Physician (208M00000X) |
United | 595 | $29139.73 | 1720028772 - BROOKDALE HOSPITAL MEDICAL CENTER | 111631746 - BROOKDALE HOSPITAL MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 595 | $48573.26 | 1003883158 - TEXAS HEALTH PRESBYTERIAN HOSPITAL DENTON, TEXAS HEALTH PRESBYTERIAN HOSPITAL DENTON | 432008974 - (TX) TEXAS HEALTH PRESBYTERIAN HOSPITAL DENTON | TX | General Acute Care Hospital (282N00000X) |
United | 595 | $17000.08 | 1386779031 - ADVOCATE LUTHERAN GENERAL | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | General Acute Care Hospital (282N00000X) |
United | 595 | $52085.26 | 1215969787 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 595 | $9401.00 | 1083709109 - RHODE ISLAND HOSPITAL, RHODE ISLAND HOSPITAL PSYCHIATRIC UNIT | 50258954 - RHODE ISLAND HOSPITAL | RI | Psychiatric Hospital Unit (273R00000X) |
United | 595 | $68976.50 | 1932131489 - SAN RAMON REGIONAL MEDICAL CENTER, LLC | 752918809 | CA | General Acute Care Hospital (282N00000X) |
United | 595 | $23073.15 | 1831140979 - SUTTON COUNTY HOSPITAL DISTRICT, LILLIAN M HUDSPETH MEMORIAL HOSPITAL | 752152933 | TX | Critical Access Hospital (282NC0060X) |
United | 595 | $35565.41 | 1962401497 - CANONSBURG GENERAL HOSPITAL | 251737079 - (PA) HIGHMARK HEALTH | PA | General Acute Care Hospital (282N00000X) |
United | 595 | $18265.50 | 1841224870 - BANNER | 270036499 | AZ | 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 595 vs. Other Diseases & Disorders of the Skin, Subcutaneous Tissue & Breast Codes
The MS-DRG 595 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 595 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 |
|---|---|---|
| 594-APR-DRG | Moderate | Anoxic And Other Severe Brain Damage |
| 594-MS-DRG | High | Skin Ulcers without CC/MCC |
| 595-MS-DRG | High | Major Skin Disorders with MCC |
| 596-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 595. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 595 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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