MS-DRG 417 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 417 by major payers:
$27,199.35
$30,934.48
$36,341.03
$37,610.78
| 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 417 | ||||||
United | 417 | $29642.08 | 1205801362 - AUBURN COMMUNITY HOSPITAL | 150532054 - AUBURN COMMUNITY HOSPITAL | NY | Psychiatric Hospital Unit (273R00000X) |
United | 417 | $33050.03 | 1487251401 - USC VERDUGO HILLS HOSPITAL | 851634852 - (CA) USC VERDUGO HILLS HOSPITAL | CA | Psychiatric Hospital Unit (273R00000X) |
United | 417 | $43948.62 | 1164464921 - MERCY HOSPITAL OF BUFFALO | 160756336 - (NY) MERCY HOSPITAL OF BUFFALO | NY | General Acute Care Hospital (282N00000X) |
United | 417 | $32025.71 | 1841290467 - MELROSEWAKEFIELD HEALTHCARE, INC. | 42767880 - MELROSEWAKEFIELD HEALTHCARE INC | MA | General Acute Care Hospital (282N00000X) |
United | 417 | $44015.98 | 1902818883 - GRANT COUNTY PUBLIC HOSPITAL DISTRICT 1, SAMARITAN HEALTHCARE | 930386906 | WA | General Acute Care Hospital (282N00000X) |
United | 417 | $38811.55 | 1023305034 - LEGACY MERIDIAN PARK HOSPITAL | 930618975 - LEGACY MERIDIAN PARK HOSPITAL | OR | Hospitalist Physician (208M00000X) |
United | 417 | $27329.75 | 1902800352 - UNITED MEMORIAL MEDICAL CENTER | 160743029 - (NY) UNITED MEMORIAL MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 417 | $52209.32 | 1467546580 - ASPIRUS WAUSAU HOSPITAL, INC, ASPIRUS WAUSAU HOSPITAL REHABILITATION | 391138241 - ASPIRUS WAUSAU HOSPITAL INC | WI | Rehabilitation Hospital Unit (273Y00000X) |
United | 417 | $37536.82 | 1144384876 - UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS, UT SOUTHWESTERN UNIVERSITY HOSPITAL - ZALE LIPSHY | 753175630 | TX | Psychiatric Hospital Unit (273R00000X) |
United | 417 | $28403.92 | 1508901448 - ST. JOSEPH HEALTH SERVICES OF RI, PULMONARY GROUP | 464661337 | RI | General Acute Care Hospital (282N00000X) |
United | 417 | $9847.20 | 1407121189 - PREFERRED HOSPITAL LEASING COLEMAN, INC., COLEMAN COUNTY MEDICAL CENTER | 453780407 | TX | Critical Access Hospital (282NC0060X) |
United | 417 | $16770.27 | 1407887193 - MEDICINE LODGE MEMORIAL HOSPITAL | 480579742 | KS | Critical Access Hospital (282NC0060X) |
United | 417 | $27907.24 | 1164821559 - NATCHEZ HOSPITAL COMPANY LLC, MERIT HEALTH NATCHEZ | 371756496 | MS | General Acute Care Hospital (282N00000X) |
United | 417 | $59643.01 | 1427114099 - JOHNS HOPKINS ALL CHILDREN'S HOSPITAL, INC, ALL CHILDREN'S HOSPITAL | 590683252 - (FL) JOHNS HOPKINS ALL CHILDRENS HOSPITAL INC | FL | Children's Hospital (282NC2000X) |
United | 417 | $54505.92 | 1548248321 - STATE UNIVERSITY OF IOWA, UNIVERSITY OF IOWA HOSPITALS & CLINICS-PSYCHIATRIC MENTAL HEALTH UNIT | 426004813 | IA | Psychiatric Hospital Unit (273R00000X) |
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 417 vs. Other Diseases & Disorders of the Hepatobiliary System & Pancreas Codes
The MS-DRG 417 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 417 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 |
|---|---|---|
| 416-APR-DRG | Moderate | Nervous System Malignancy |
| 416-MS-DRG | High | Cholecystectomy except by Laparoscope without C.D.E. without CC/MCC |
| 417-MS-DRG | High | Laparoscopic Cholecystectomy without C.D.E. with MCC |
| 418-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 417. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 417 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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