Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.30
    OpenPayerBilling CodesDiseases and Disorders of the Skin, Subcutaneous Tissue and BreastDRG 580-other-skin-subcutaneous-tissue-and-breast-procedures-with-cc
    Ask Trek AI about this page

    Other Skin, Subcutaneous Tissue and Breast Procedures with CC: Inpatient Reimbursement Overview

    DRG 580 encompasses inpatient admissions for other skin, subcutaneous tissue, and breast procedures accompanied by a Complication or Comorbidity, reflecting increased clinical complexity. This grouping matters for inpatient reimbursement because the presence of a Complication or Comorbidity typically raises the payment relative to similar procedures without such comorbid conditions.

    Customize your policy alerts

    Sign up for drg 580 policy alerts

    Get alerted when payer policies referencing 580 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    DRG 580 Overview

    DRG 580 covers inpatient stays for other skin, subcutaneous tissue, and breast procedures when a Complication or Comorbidity is present. Typical cases include complex excisions, debridements, reconstructive or secondary procedures on skin and breast tissue complicated by infection, wound issues, or other comorbid conditions. This Diagnosis-Related Group groups patients by resource use influenced by the presence of a Complication or Comorbidity, affecting Medicare payment levels for the episode of care. Accurate documentation of the procedures and secondary diagnoses is important for proper classification and reimbursement.

    Table of contents

    Progress1 / 3

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical Trials

    • Acute perioperative infection management trials: randomized or pragmatic studies evaluating different intraoperative and immediate postoperative strategies for treating infected or contaminated skin, subcutaneous tissue, and breast wounds (for example comparing antibiotic regimens, wound debridement timing, or use of topical antiseptics versus standard care). These studies enroll inpatients who present with cellulitis, abscesses, necrotizing soft tissue infections, or infected surgical sites and require urgent procedural intervention; endpoints include resolution of infection, need for reoperation, length of stay, and in-hospital complications. This research is relevant to hospital providers and payers because effective acute management can reduce ICU transfers, procedure rates, antimicrobial use, and overall inpatient costs associated with complications and prolonged admissions.
    • Comparative effectiveness studies of reconstructive and wound-closure techniques: prospective cohort or randomized trials comparing different surgical approaches (for example various flap techniques, graft types, or staged closure versus primary closure after extensive debridement) in patients receiving procedures on skin, subcutaneous tissue, or breast for oncologic resection, trauma, or complex wounds. These trials focus on functional and cosmetic outcomes, postoperative complication rates (including seroma, infection, or wound breakdown), readmission and reoperation rates, and patient-reported outcomes over the inpatient stay and early post-discharge period. Findings inform surgeons and payers about which techniques optimize short-term clinical outcomes and resource utilization, helping guide procedure selection, anticipated length of stay, and bundled payment considerations.
    • Post-discharge outcomes and care-transition studies: observational studies or randomized trials testing different discharge planning, home health, and outpatient follow-up models for patients hospitalized under this DRG who have complex wounds, drains, or need ongoing wound care (including studies of telemedicine wound monitoring, standardized dressing protocols, or nurse-led home visits). These studies enroll patients at discharge to evaluate rates of wound complications, emergency department returns, 30-day readmissions, and costs of post-acute care services. This area is important to providers and payers because reducing readmissions and unplanned utilization directly affects quality metrics and reimbursement under value-based payment programs and can identify efficient models to support recovery after inpatient skin, subcutaneous tissue, and breast procedures.

    Related Codes

    570-SKIN-DEBRIDEMENT-WITH-MCC

    Skin Debridement with Major Complication or Comorbidity: Inpatient Reimbursement Overview

    571-SKIN-DEBRIDEMENT-WITH-CC

    Skin Debridement with CC: Inpatient Reimbursement Overview

    572-SKIN-DEBRIDEMENT-WITHOUT-CC-MCC

    Skin Debridement without CC/MCC: Inpatient Reimbursement Overview

    573-SKIN-GRAFT-FOR-SKIN-ULCER-OR-CELLULITIS-WITH-MCC

    Skin Graft for Skin Ulcer or Cellulitis with MCC: Inpatient Reimbursement Overview

    574-SKIN-GRAFT-FOR-SKIN-ULCER-OR-CELLULITIS-WITH-CC

    Skin Graft for Skin Ulcer or Cellulitis with CC: Inpatient Reimbursement Overview

    575-SKIN-GRAFT-FOR-SKIN-ULCER-OR-CELLULITIS-WITHOUT-CC-MCC

    Skin Graft for Skin Ulcer or Cellulitis without CC/MCC: Inpatient Reimbursement Overview

    576-SKIN-GRAFT-EXCEPT-FOR-SKIN-ULCER-OR-CELLULITIS-WITH-MCC

    Skin Graft Except for Skin Ulcer or Cellulitis with MCC: Inpatient Reimbursement Overview

    577-SKIN-GRAFT-EXCEPT-FOR-SKIN-ULCER-OR-CELLULITIS-WITH-CC

    Skin Graft Except for Skin Ulcer or Cellulitis with CC: Inpatient Reimbursement Overview

    578-SKIN-GRAFT-EXCEPT-FOR-SKIN-ULCER-OR-CELLULITIS-WITHOUT-CC-MCC

    Skin Graft Except for Skin Ulcer or Cellulitis without CC/MCC: Inpatient Reimbursement Overview

    579-OTHER-SKIN-SUBCUTANEOUS-TISSUE-AND-BREAST-PROCEDURES-WITH-MCC

    Other Skin, Subcutaneous Tissue and Breast Procedures with MCC: Inpatient Reimbursement Overview

    Showing 1–10 of 31

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.