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See a sample rate comparisonMS-DRG 412 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 CC
| 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 412 by major payers:
$26,784.55
$27,707.47
$33,582.20
$34,513.96
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MS-DRG 412
5 of 25 sample ratesHigher to lower in this preview
Inspira Medical Centers, Inc., Inspira Inpatient Adult Behavioral Health Bridgeton
Inspira Medical Centers Inc
$63,501.35Published rateSouthview Hospital Pharmacy
Dayton Osteopathic Hospital
$44,233.55Published rateFarmers Union Hospital Association, Great Plains Regional Medical Center - Psychiatric Unit
Farmers Union Hospital Association
$25,252.69Published rateUchealth Pikes Peak Regional Hospital
$22,138.80Published rateDmc-Memphis, LLC, Delta Specialty Hospital
Dmc - Memphis, Inc.
$1,236.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 412 vs. Other Diseases & Disorders of the Hepatobiliary System & Pancreas Codes
The MS-DRG 412 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 412 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 |
|---|---|---|
| 411-APR-DRG | Moderate | Nervous System Malignancy |
| 411-MS-DRG | High | CHOLECYSTECTOMY WITH C.D.E. WITH MCC |
| 412-MS-DRG | High | CHOLECYSTECTOMY WITH C.D.E. WITH CC |
| 413-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 412. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 412 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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