MS-DRG 418 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 418 by major payers:
$19,892.40
$21,973.25
$25,880.73
$26,893.83
| 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 418 | ||||||
United | 418 | $16937.22 | 1134123193 - ST. ANTHONY SHAWNEE HOSPITAL, INC., SSM HEALTH ST. ANTHONY HOSPITAL - SHAWNEE | 455055149 - (OK) ST ANTHONY SHAWNEE HOSPITAL INC | OK | General Acute Care Hospital (282N00000X) |
United | 418 | $54244.94 | 1962464016 - BON SECOURS ST. MARY'S HOSPITAL OF RICHMOND LLC, BON SECOURS ST MARY'S HOSPITAL | 540793767 - BON SECOURS ST MARYS HOSPITAL OF RICHMOND LLC | VA | General Acute Care Hospital (282N00000X) |
United | 418 | $28060.92 | 1194179440 - BBH WBMC, LLC, WALKER BAPTIST MEDICAL CENTER | 474790386 | AL | Psychiatric Hospital Unit (273R00000X) |
United | 418 | $16552.00 | 1124023015 - NAZARETH HOSPITAL | 232794121 - NAZARETH HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 418 | $30378.02 | 1780971127 - VHS BROWNSVILLE HOSPITAL COMPANY LLC, VALLEY BAPTIST MEDICAL CENTER PSYCH | 452663071 | TX | Psychiatric Hospital Unit (273R00000X) |
United | 418 | $26491.27 | 1447639398 - SAINT THOMAS STONES RIVER HOSPITAL, LLC, ASCENSION SAINT THOMAS STONES RIVER | 474063232 | TN | General Acute Care Hospital (282N00000X) |
United | 418 | $21591.33 | 1336205798 - FRANCISCAN HEALTH CROWN POINT, FRANCISCAN ST. ANTHONY HEALTH - CROWN POINT | 352074283 - (IN) FRANCISCAN HEALTH CROWN POINT | IN | General Acute Care Hospital (282N00000X) |
United | 418 | $22380.67 | 1992159370 - BBH BMC, LLC, BROOKWOOD MEDICAL CENTER | 474757851 | AL | Rehabilitation Hospital Unit (273Y00000X) |
United | 418 | $23351.68 | 1619911104 - JOHNSTON HEALTH SERVICES CORPORATION, JOHNSTON HEALTH | 463176429 - (NC) JOHNSTON HEALTH SERVICES CORPORATION | NC | General Acute Care Hospital (282N00000X) |
United | 418 | $25368.44 | 1932190626 - PROVIDENCE HOSPITAL, PROVIDENCE HOSPITAL URGENT CARE CENTER | 530196636 - PROVIDENCE HOSPITAL | DC | General Acute Care Hospital (282N00000X) |
United | 418 | $16552.00 | 1124023015 - NAZARETH HOSPITAL | 232794121 - NAZARETH HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 418 | $23612.77 | 1518983634 - NORTH MEMORIAL HEALTH CARE, NORTH MEMORIAL HEALTH HOSPITALIST SERVICES | 410729979 - NORTH MEMORIAL HEALTH CARE | MN | Hospitalist Physician (208M00000X) |
United | 418 | $63551.51 | 1548301112 - DESERT REGIONAL MEDICAL CENTER, INC., DESERT REGIONAL MEDICAL CENTER | 752694137 | CA | Psychiatric Hospital Unit (273R00000X) |
United | 418 | $22380.67 | 1992159370 - BBH BMC, LLC, BROOKWOOD MEDICAL CENTER | 474757851 | AL | Rehabilitation Hospital Unit (273Y00000X) |
United | 418 | $29778.23 | 1629369681 - UNIVERSITY OF KANSAS HOSPITAL AUTHORITY, UNIVERSITY OF KANSAS HOSPITAL / UNIVERSITY OF KANSAS CANCER CENTER | 481202402 - UNIVERSITY OF KANSAS HOSPITAL AUTHORITY | KS | 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 418 vs. Other Diseases & Disorders of the Hepatobiliary System & Pancreas Codes
The MS-DRG 418 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 418 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 |
|---|---|---|
| 417-MS-DRG | High | Laparoscopic Cholecystectomy without C.D.E. with MCC |
| 418-MS-DRG | High | Laparoscopic Cholecystectomy without C.D.E. with CC |
| 419-APR-DRG | Moderate | Nervous System Malignancy |
| 419-MS-DRG | High | Laparoscopic Cholecystectomy without C.D.E. without CC/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 418. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 418 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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