MS-DRG 419 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 419 by major payers:
$15,187.06
$17,406.50
$20,623.94
$21,522.41
| 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 419 | ||||||
United | 419 | $15083.87 | 1982662557 - HEALTH CARE AUTHORITY OF ATHENS AND LIMESTONE COUNTY, ATHENS LIMESTONE HOPSITAL | 475531420 | AL | General Acute Care Hospital (282N00000X) |
United | 419 | $15481.21 | 1124495239 - PRIME HEALTHCARE SERVICES-SUBURBAN HOSPITAL LLC, SUBURBAN COMMUNITY HOSPITAL | 472819044 | PA | General Acute Care Hospital (282N00000X) |
United | 419 | $17902.11 | 1497194690 - MORRISTOWN MEDICAL CENTER | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | General Acute Care Hospital (282N00000X) |
United | 419 | $18829.82 | 1215979190 - VANDERBILT UNIVERSITY MEDICAL CENTER, VANDERBILT WILSON COUNTY HOSPITAL | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Rehabilitation Hospital Unit (273Y00000X) |
United | 419 | $13132.00 | 1851705370 - MCDONOUGH COUNTY HOSPITAL DISTRICT, MCDONOUGH DISTRICT HOSPITAL | 376016777 | IL | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 419 | $12548.82 | 1477874337 - RCHP, NORTH ALABAMA MEDICAL CENTER | 272451336 | AL | General Acute Care Hospital (282N00000X) |
United | 419 | $23654.42 | 1306938071 - ADVENTIST HEALTH SYSTEM-SUNBELT, INC, ADVENTHEALTH ORLANDO | 590724459 - (FL) ADVENTIST HEALTH SYSTEM-SUNBELT INC | FL | General Acute Care Hospital (282N00000X) |
United | 419 | $27789.98 | 1144236571 - INTEGRIS BASS BAPTIST HEALTH CENTER, INTEGRIS BASS BAPTIST HEALTH CENTER | 730612674 | OK | General Acute Care Hospital (282N00000X) |
United | 419 | $9744.09 | 1366436123 - OUR LADY OF THE LAKE HOSPITAL INC., OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER | 720423651 - (LA) OUR LADY OF THE LAKE HOSPITAL INC | LA | General Acute Care Hospital (282N00000X) |
United | 419 | $22968.40 | 1720003312 - NASSAU HEALTHCARE CORPORATION, NUMC DEPARTMENT OF PATHOLOGY, FPP | 113465690 | NY | General Acute Care Hospital (282N00000X) |
United | 419 | $15397.70 | 1356307656 - THE BROOKDALE HOSPITAL MEDICAL CENTER | 111631746 - BROOKDALE HOSPITAL MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 419 | $21405.16 | 1841277704 - SCRIPPS HEALTH, SCRIPPS MEMORIAL HOSPITAL LA JOLLA | 951684089 - SCRIPPS HEALTH | CA | General Acute Care Hospital (282N00000X) |
United | 419 | $22893.33 | 1770924219 - UNIVERSITY OF IOWA HOSPITALS AND CLINICS | 426004813 | IA | Chronic Disease Hospital (281P00000X) |
United | 419 | $22081.91 | 1114079019 - CITIZENS BAPTIST MEDICAL CENTER, CITIZENS BAPTIST MEDICAL CENTER | 474802869 | AL | Psychiatric Hospital Unit (273R00000X) |
United | 419 | $30018.91 | 1154453579 - ALAMEDA HEALTH SYSTEM, FAIRMONT HOSPITAL | 943302014 | CA | Rehabilitation Hospital (283X00000X) |
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 419 vs. Other Diseases & Disorders of the Hepatobiliary System & Pancreas Codes
The MS-DRG 419 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 419 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 |
|---|---|---|
| 418-APR-DRG | Moderate | Nervous System Malignancy |
| 418-MS-DRG | High | Laparoscopic Cholecystectomy without C.D.E. with CC |
| 419-MS-DRG | High | Laparoscopic Cholecystectomy without C.D.E. without CC/MCC |
| 420-APR-DRG | High | DIABETES |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 419. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 419 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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