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    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Skin, Subcutaneous Tissue and BreastDRG 592-skin-ulcers-with-mcc
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    Skin Ulcers with MCC: Inpatient Reimbursement Overview

    DRG 592 addresses inpatient stays for skin ulcers with a Major Complication or Comorbidity, encompassing advanced or complicated ulcer disease requiring higher-intensity care. It matters for inpatient reimbursement because Diagnosis-Related Group assignment with a Major Complication or Comorbidity increases payment relative to less severe ulcer categories, reflecting greater expected resource use.

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    DRG 592 Overview

    DRG 592 covers hospital admissions for patients with skin ulcers accompanied by a Major Complication or Comorbidity, reflecting cases with significant clinical complexity such as severe infection, extensive tissue loss, or systemic instability. This Diagnosis-Related Group groups resource use and clinical severity to determine Medicare inpatient payment adjustments for higher-intensity care. Accurate capture of principal diagnosis and Major Complication or Comorbidity is essential for appropriate Medicare Severity Diagnosis-Related Group assignment and reimbursement. The classification affects hospital payment by aligning expected resource consumption with the severity of the ulcer-related admission.

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    Clinical Trials

    • Acute wound management randomized studies: Trials testing acute inpatient interventions (for example advanced topical biologics, negative pressure wound therapy protocols, or optimized debridement strategies) in patients admitted with severe skin ulcers complicated by major comorbidities (such as uncontrolled diabetes, peripheral vascular disease, or significant infection). These studies enroll patients during the index hospitalization to evaluate time-to-granulation, infection resolution, and need for surgical procedures, providing evidence on therapies that may shorten length of stay or reduce complications — outcomes directly relevant to hospital resource use and DRG-based reimbursement.
    • Comparative effectiveness and care-pathway studies in medically complex cohorts: Prospective cohort or pragmatic trials comparing multidisciplinary inpatient care pathways (standard wound care versus integrated teams including vascular surgery, infectious disease, endocrinology, and nutrition) for patients with skin ulcers and major comorbid conditions leading to MCC classification. These studies focus on readmission rates, wound healing trajectories, amputation avoidance, and total cost of care over 30–180 days, informing clinicians and payers about which care models yield better clinical outcomes and lower post-discharge utilization.
    • Post-discharge outcomes and transitional care trials: Studies evaluating post-discharge interventions such as structured home health programs, telemedicine wound monitoring, or nurse-led follow-up for patients with severe skin ulcers and substantial comorbid illness discharged from inpatient care. These trials target reductions in early readmission, delayed healing complications, and cumulative downstream costs, generating data on which follow-up strategies improve long-term outcomes and are cost-effective for payers responsible for episodes of care that begin under DRG 592.

    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

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    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.
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