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MS-DRG 585

BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC

Reported by 402 hospitals in the network under the case rate methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.

National pricing summary

Low

$5.4k

Average

$22.6k

Median

$21.1k

High

$72.4k

Hospitals reporting this code

#HospitalLocation
1The Finley HospitalDubuque, IA$11.0k$15.5k$17.2k$27.6k$4.0k
2Northwest Iowa Hospital CorporationSioux City, IA$14.1k$16.6k$18.3k$27.6k$3.8k
3St Luke'sJones Regional Medical CenterAnamosa, IA$24.8k$26.2k$26.2k$27.6k$1.4k
4Medical Ctiy ArgyleArgyle, TX$927$13.8k$14.8k$56.9k$4.4k
5Medical City AllianceSAGINAW, TX$2.4k$13.4k$14.8k$56.9k$4.4k
6St Luke's Methodist HospitalCedar Rapids, IA$14.3k$14.8k$18.5k$27.6k$4.7k
7Trinity Medical CenterRock Island, IL$11.0k$16.3k$17.5k$27.6k$4.0k
8Trinity Medical CenterBettendorf, IA$13.8k$16.3k$18.6k$27.6k$4.9k
9University of Iowa Health Care Medical Center DowntownIowa City, IA$13.5k$26.5k$25.4k$45.5k$9.3k
10Unity HealthcareMuscatine, IA$11.0k$22.0k$21.0k$27.6k$5.0k
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