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See a sample rate comparisonMS-DRG 411 Fee Schedule
Last Verified: October 2026
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.
CHOLECYSTECTOMY WITH C.D.E. WITH MCC
| 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 411 by major payers:
$38,081.27
$36,784.45
$43,623.52
$44,459.26
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MS-DRG 411
5 of 25 sample ratesHigher to lower in this preview
Beaufort County Memorial Hospital
$101,028.45Published rateCarondelet Health Network, St. Mary'S Hospital
$52,653.64Published rateFranciscan Health Crown Point, Franciscan St. Anthony Health - Crown Point
Franciscan Health Crown Point
$43,913.21Published rateNashoba Valley Medical Center, A Steward Family Hospital, Inc, Nashoba Valley Medical Center
$23,388.09Published rateSmyth County Community Hospital, Smyth County Community Hospital Rehabilitation
Smyth County Community Hospital
$3,949.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 411 vs. Other Diseases & Disorders of the Hepatobiliary System & Pancreas Codes
The MS-DRG 411 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 411 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 |
|---|---|---|
| 410-APR-DRG | Moderate | Nervous System Malignancy |
| 410-MS-DRG | High | BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC |
| 411-MS-DRG | High | CHOLECYSTECTOMY WITH C.D.E. WITH MCC |
| 412-APR-DRG | Moderate | Nervous System Malignancy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 411. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 411 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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