MS-DRG 407 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 Hepatobiliary System & Pancreas |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 407 by major payers:
$26,430.49
$28,104.55
$33,903.45
$34,666.39
| 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 407 | ||||||
United | 407 | $31396.25 | 1134172000 - CONWAY HOSPITAL, INC., CONWAY MEDICAL CENTER | 570314381 - (SC) CONWAY HOSPITAL INC | SC | General Acute Care Hospital (282N00000X) |
United | 407 | $45278.55 | 1578053567 - UCH-MHS, UCHEALTH EMERGENCY ROOM - WOODMEN | 460796114 - (CO) UCH-MHS | CO | General Acute Care Hospital (282N00000X) |
United | 407 | $48450.62 | 1962579029 - TEMPLE UNIVERSITY HOSPITAL, INC | 232825878 - (PA) TEMPLE UNIVERSITY HOSPITAL INC | PA | General Acute Care Hospital (282N00000X) |
United | 407 | $31665.02 | 1609189604 - UNIVERSITY HOSPITALS AHUJA MEDICAL CENTER, INC, UH AHUJA MEDICAL CENTER | 264827222 - (OH) UNIVERSITY HOSPITALS HEALTH SYSTEM INC | OH | General Acute Care Hospital (282N00000X) |
United | 407 | $45362.44 | 1528028396 - SENTARA PRINCESS ANNE HOSPITAL, SENTARA HOSPITALS | 273208969 - (VA) SENTARA PRINCESS ANNE HOSPITAL | VA | General Acute Care Hospital (282N00000X) |
United | 407 | $34760.14 | 1700281763 - MERCY HEALTH-REGIONAL MEDICAL CENTER LLC, MERCY REGIONAL MEDICAL CENTER | 340714704 | OH | Psychiatric Hospital Unit (273R00000X) |
United | 407 | $30956.28 | 1619270188 - VALLEY BAPTIST MEDICAL CENTER | 452663071 | TX | General Acute Care Hospital (282N00000X) |
United | 407 | $18878.33 | 1326288770 - DECATUR GENERAL HOSPITAL, THE HEALTHCARE AUTHORITY OF MORGAN COUNTY | 460928982 | AL | Psychiatric Hospital Unit (273R00000X) |
United | 407 | $53843.51 | 1710140322 - MCKEE MEDICAL CENTER | 840826332 - (CO) MCKEE MEDICAL CENTER | CO | General Acute Care Hospital (282N00000X) |
United | 407 | $4193.00 | 1851639280 - PALISADES MEDICAL CENTER | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | General Acute Care Hospital (282N00000X) |
United | 407 | $32763.16 | 1811904063 - OVERLAKE HOSPITAL MEDICAL CENTER | 910652651 - (WA) OVERLAKE HOSPITAL MEDICAL CENTER | WA | Psychiatric Hospital Unit (273R00000X) |
United | 407 | $34306.30 | 1831157205 - COMMUNITY MERCY HEALTH PARTNERS, MERCY HEALTH - SPRINGFIELD REGIONAL MEDICAL CENTER | 310785684 - COMMUNITY MERCY HEALTH PARTNERS | OH | Rehabilitation Hospital Unit (273Y00000X) |
United | 407 | $16266.08 | 1376537555 - COLUMBUS REGIONAL HEALTHCARE SYSTEM, SOUTH COLUMBUS MEDICAL CLINIC | 560538020 - (NC) COLUMBUS REGIONAL HEALTHCARE SYSTEM | NC | General Acute Care Hospital (282N00000X) |
United | 407 | $26519.22 | 1669414884 - MEMORIAL HERMANN HEALTH SYSTEM, MEMORIAL HERMANN HOSPITAL SYSTEM REHABILITATION UNIT | 741152597 - (TX) MEMORIAL HERMANN HEALTH SYSTEM | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 407 | $29888.92 | 1629166194 - CITIZENS BAPTIST MEDICAL CENTER, CITIZENS BAPTIST MEDICAL CENTER | 474802869 | AL | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
MS-DRG 407 vs. Other Diseases & Disorders of the Hepatobiliary System & Pancreas Codes
The MS-DRG 407 code is part of the Diseases & Disorders of the Hepatobiliary System & Pancreas 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 407 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 |
|---|---|---|
| 406-APR-DRG | Moderate | Spinal Disorders And Injuries |
| 406-MS-DRG | High | Pancreas, Liver and Shunt Procedures with CC |
| 407-MS-DRG | High | Pancreas, Liver and Shunt Procedures without CC/MCC |
| 408-MS-DRG | High | Biliary Tract Procedures except Only Cholecystectomy with OR Without C.D.E. with MCC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 407. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 407 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like MS-DRG 407) and we'll show you how you compare in 15 minutes or less.