MS-DRG 414 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 414 by major payers:
$41,225.22
$45,297.38
$55,000.39
$56,380.12
| 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 414 | ||||||
United | 414 | $54130.21 | 1548624851 - PROSPECT DCMH, LLC, ACUTE | 811520273 | PA | General Acute Care Hospital (282N00000X) |
United | 414 | $10345.00 | 1609855139 - TEXAS HEART HOSPITAL OF THE SOUTHWEST, LLC, BAYLOR SCOTT & WHITE HEART AND VASCULAR HOSPITAL - DALLAS | 412101361 - (TX) TEXAS HEART HOSPITAL OF THE SOUTHWEST, L.L.P | TX | General Acute Care Hospital (282N00000X) |
United | 414 | $89196.24 | 1114015971 - PROVIDENCE HEALTH & SERVICES OREGON, PROVIDENCE ST VINCENT MEDICAL CENTER | 930386929 - (OR) PROVIDENCE HEALTH & SERVICES OREGON | OR | General Acute Care Hospital (282N00000X) |
United | 414 | $34420.91 | 1316413313 - RESILIENCE HEALTHCARE, LOUIS A. WEISS MEMORIAL HOSPITAL | 352637418 | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 414 | $34420.91 | 1316413313 - RESILIENCE HEALTHCARE, LOUIS A. WEISS MEMORIAL HOSPITAL | 352637418 | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 414 | $41140.37 | 1043659816 - ORO VALLEY HOSPITAL LLC, ORO VALLEY HOSPITAL | 621762430 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 414 | $41140.37 | 1043659816 - ORO VALLEY HOSPITAL LLC, ORO VALLEY HOSPITAL | 621762430 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 414 | $28303.31 | 1386746592 - KENNEDY UNIVERSITY HOSPITAL INC. | 221773439 - (NJ) KENNEDY UNIVERSITY HOSPITAL INC | NJ | General Acute Care Hospital (282N00000X) |
United | 414 | $31377.52 | 1952493512 - THE FINLEY HOSPITAL, UNITYPOINT HEALTH - FINLEY HOSPITAL | 420680354 - THE FINLEY HOSPITAL | IA | Rehabilitation Hospital Unit (273Y00000X) |
United | 414 | $42602.69 | 1386802023 - SOUTHEAST HEALTH CENTER OF STODDARD COUNTY, LLC, MERCY HOSPITAL STODDARD | 461481133 - (MO) SOUTHEAST HEALTH CENTER OF STODDARD COUNTY LLC | MO | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 414 | $64211.51 | 1427085232 - WARREN MEMORIAL HOSPITAL, INC. | 540488103 - VALLEY HEALTH SYSTEM | VA | General Acute Care Hospital (282N00000X) |
United | 414 | $14682.71 | 1477759462 - HOSPITAL AUTHORITY OF WILKES COUNTY, WILLS MEMORIAL HOSPITAL | 586001920 - (GA) HOSPITAL AUTHORITY OF WILKES COUNTY D/B/A WILLS MEMORIAL & NURSING HOM | GA | Critical Access Hospital (282NC0060X) |
United | 414 | $87943.34 | 1144683723 - CHILDREN'S HOSPITAL COLORADO, CHILDREN'S HOSPITAL COLORADO PARKER ADVENTIST HOSPITAL | 840166760 - CHILDRENS HOSPITAL COLORADO | CO | Children's Hospital (282NC2000X) |
United | 414 | $41985.17 | 1356891600 - SSM SELECT REHAB ST. LOUIS, LLC | 263694972 | MO | Rehabilitation Hospital (283X00000X) |
United | 414 | $163949.81 | 1073510277 - PEACEHEALTH, ST. JOHN MEDICAL CENTER | 910564987 | WA | 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 |
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MS-DRG 414 vs. Other Diseases & Disorders of the Hepatobiliary System & Pancreas Codes
The MS-DRG 414 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 414 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 |
|---|---|---|
| 413-APR-DRG | Moderate | Nervous System Malignancy |
| 413-MS-DRG | High | Cholecystectomy with C.D.E. without CC/MCC |
| 414-MS-DRG | High | Cholecystectomy except by Laparoscope without C.D.E. with MCC |
| 415-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 414. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 414 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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