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 | $11901.70 | 1508842964 - ANIMAS SURGICAL HOSPITAL, LLC, ANIMAS SURGICAL HOSPITAL | 161632441 - (CO) ANIMAS SURGICAL HOSPITAL, LLC | CO | General Acute Care Hospital (282N00000X) |
United | 418 | $28932.44 | 1487633509 - VHS SAN ANTONIO PARTNERS LLC, BAPTIST HEALTH SYSTEM | 760714523 | TX | Psychiatric Hospital Unit (273R00000X) |
United | 418 | $24024.02 | 1477879195 - RCHP OTTUMWA LLC, OTTUMWA REGIONAL HEALTH CENTER | 272200283 | IA | Rehabilitation Hospital Unit (273Y00000X) |
United | 418 | $11767.05 | 1811036726 - NEW LIBERTY HOSPITAL DISTRICT, LIBERTY HOSPITAL | 431684627 - (MO) NEW LIBERTY HOSPITAL CORPORATION | MO | General Acute Care Hospital (282N00000X) |
United | 418 | $32303.13 | 1427083153 - LAKEWOOD REGIONAL MEDICAL CENTER, INC., LAKEWOOD REGIONAL MEDICAL CENTER | 752919841 - (CA) LAKEWOOD REGIONAL MEDICAL CENTER INC | CA | Rehabilitation Hospital Unit (273Y00000X) |
United | 418 | $25368.44 | 1932190626 - PROVIDENCE HOSPITAL, PROVIDENCE HOSPITAL URGENT CARE CENTER | 530196636 - PROVIDENCE HOSPITAL | DC | General Acute Care Hospital (282N00000X) |
United | 418 | $38653.12 | 1740772268 - FLORIDA HOSPITAL OCALA INC, ADVENT HEALTH OCALA | 824372339 - (FL) FLORIDA HOSPITAL OCALA INC | FL | General Acute Care Hospital (282N00000X) |
United | 418 | $45383.50 | 1326095324 - PRISMA HEALTH-MIDLANDS, PRISMA HEALTH RICHLAND SPRINGS HOSPITAL | 582296052 - (SC) PRISMA HEALTH-MIDLANDS | SC | Psychiatric Hospital Unit (273R00000X) |
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 | $2412.00 | 1881899284 - CITY OF PHILA TRUSTEE ACTING BY THE BRD OF DIR OF CITY TRUSTS | 236000204 - (PA) CITY OF PHILADELPHIA TTEE ADMINISTERING WILLS EYE INSTITUTE | PA | Special Hospital (284300000X) |
United | 418 | $35871.19 | 1427181882 - MEMORIAL MEDICAL CENTER | 370661220 - (IL) MEMORIAL HEALTH SYSTEM | IL | General Acute Care Hospital (282N00000X) |
United | 418 | $32076.76 | 1265787923 - OSF SAINT FRANCIS | 370662569 - (IL) SAINT FRANCIS MEDICAL CENTER | IL | General Acute Care Hospital (282N00000X) |
United | 418 | $42175.26 | 1356496582 - SWEDISH HEALTH SERVICES, SWEDISH MEDICAL CENTER, CHERRY HILL | 910373400 - (WA) SWEDISH HEALTH SERVICES | WA | General Acute Care Hospital (282N00000X) |
United | 418 | $24024.02 | 1477879195 - RCHP OTTUMWA LLC, OTTUMWA REGIONAL HEALTH CENTER | 272200283 | IA | Rehabilitation Hospital Unit (273Y00000X) |
United | 418 | $63551.51 | 1548301112 - DESERT REGIONAL MEDICAL CENTER, INC., DESERT REGIONAL MEDICAL CENTER | 752694137 | CA | 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 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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